The Pharmaceutical Journal
Vol 268 No 7203 p861-867
22 June 2002

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Nottingham PCTs plan primary care centres without considering the need for pharmacy services

Four primary care trusts in Nottingham have developed proposals for modernising GP premises without realising that they could have significant consequences for pharmacy services in the area.

The situation has its roots in erroneous local advice four years ago that community pharmacists were not entitled to be involved in PCT and primary care group boards or professional executive committees because they were not National Health Service employees. This means that they have not a natural involvement in local planning.

The four trusts have drawn up a £111m plan to redevelop GP services on a "hub and spoke" model involving new primary care centres (hubs) providing a number of services linked to a network of local GP surgeries (spokes). A bid is to be made for NHS LIFT funding to pay for the development. NHS LIFT (Local Improvement Finance Trust) is a public-private partnership scheme to build or refurbish primary care premises and lease them to pharmacists, GPs or dentists.

The trusts (Broxtowe and Hucknall, Gedling, Nottingham City and Rushcliffe) have not taken into account the effect that moving GP premises can have on the financial viability of community pharmacies and the provision of pharmacy services where patients need them.

Barry Besbrode, secretary of Nottingham Local Pharmaceutical Committee, said: "I don't think that, in itself, [the scheme] is a good idea. It depends on how robust the spokes are. ... The important thing is to promote easy access to primary care for people who don't know how the system works. I see pharmacists as one of the gatekeepers to the NHS, which means that we should be involved in planning decisions."

He believes that the failure to include pharmacy in the plans is based on oversight and a misunderstanding of how community pharmacy relates to other NHS services.

"They are so focused on GP provision that they have assumed that community pharmacists will regroup and follow on," Mr Besbrode said. " I don't think it has occurred to them that they need to involve pharmacists in the planning cycle. It's not that they have wilfully ignored us, it just didn't occur to them to involve us. They see the large corporate pharmacy operators and assume that there is money available to invest in new premises and that it will happen. They know that someone will step in, so why should they worry. Pharmacists should be sitting round the table with them to help them when the plans are decided, rather than be consulted afterwards on their implementation."