The Pharmaceutical Journal
Vol 269 No 7215 p358-361
14 September 2002

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Letters to the Editor

LPS

Deterioration in quality of services

From Mr D. M. Billington, MRPharmS

I have attended several meetings regarding local pharmaceutical services over past months but have never been able to establish precisely what are the objectives of the Department of Health, in terms of patient benefit. Now though, with some published details of first wave bids, a worrying picture may be emerging and, if followed through, could strike at the whole infrastructure of community pharmacy.

Take the following scenario: a medical practitioner, who is a primary care trust board member, in a large group practice and the practice manager, who is a pharmacist, set up a company which bids for an LPS contract. The thrust of the bid is to set up a medicines management and an anticoagulant monitoring unit within the group practice. It is estimated that some 70 per cent of prescriptions and associated pharmaceutical services generated by the practice will be handled by the new LPS unit. A fanciful notion? Not at all. Such a bid was approved by the Local Pharmaceutical Services Evaluation Panel on 13 August.

The panel approved the bid by seven votes to one. The local pharmaceutical committee voted against, with the comment: "not even a covert attempt to gain a pharmaceutical services contract by the back door. Medicines management is already being introduced locally and anticoagulant clinics are already run by pharmacists in the area. [This] would have a disastrous effect on local contractors and is not in the public interest".

At an earlier stage, one general practitioner member of the evaluation panel had questioned the justification for the proposal on the grounds that the group practice may already be contracted through its personal medical services contract to deliver the same objectives. It was pointed out that "as the proposal had been submitted by an independent company, and not the GP practice, it should be considered in its own right. The issue of payment for the same outcomes would need to be addressed by the PCT".

Of course, the PCT must now evaluate the likely effect of the bid on existing pharmaceutical services before submission to the Department of Health. Let us hope that wisdom will prevail and that the tried, tested and trusted network of pharmaceutical services will not be replaced by a concentration of LPSs within group practices. The latter course would lead to a serious deterioration of the quality and availability of pharmaceutical services to the public.

 David Billington
Formby, Liverpool

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