The Pharmaceutical Journal
Vol 270 No 7239 p325
8 March 2003

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DoH: Local Pharmaceutical Services (more)

Health Department to revise LPS application papers

The Department of Health is revising its local pharmaceutical services (LPS) guidance notes and proposal forms for the next wave of pilots, which have to be submitted by 1 September. The revised documents, expected in mid-March, take into account deficiencies that became apparent in the first and second wave of bids.

The consultation process for bids will be extended to give 30 days for people to respond. The Department found it unsatisfactory that some bids had allowed only five days for consultation. Impact assessments will also be more clearly defined under new headings. Primary care trusts will have to produce a draft assessment stating their views on each application and any negative impact of an LPS bid on existing primary care services will need to be justified.

Speaking at a conference about LPS this week, Department of Health LPS implementation manager Theresa Prendergast said that the introduction of the LPS scheme has been "a learning curve for all parties".

Many problems have become apparent to the Department. One of the main issues to emerge is that an understanding of what LPS is for is crucial. PCTs that grasped it early on got further with their bids. The Department also found that processes within the PCTs have been variable and not robust enough and this could lead to problems later.

''We want PCTs to have processes that are transparent and command the confidence of the people working with them. There needs to be clinical governance,'' Ms Prendergast said.

The dispensing element of LPS needs consideration, because the Department does not want to put any more pressure on the global sum. If PCTs find that the levels of LPS dispensing are far higher than predicted, exceeding the national average volume increase, the Department would "need to rethink the relationship with the global sum".

Another issue is the timetable for implementation. PCTs need to act quickly and have pilots in place within three months of approval to avoid them becoming outdated, since any changes to the original proposal would need to be resubmitted.

Ms Prendergast said the Department was sympathetic to the pressures and difficulties that PCTs were under. ''We found PCT responsiveness to LPS was influenced by where they were in their organisational agenda. Some are now established, some are still evolving,'' explained Ms Prendergast. Once more PCTs mature, the number of LPS bids may go up. However, she stressed that there is no quota for LPS bids. ''PCTs are the driver for LPS. There is no element of force.''

Overall, LPS has got off to a very slow start. Only one proposal of the four approved in the first wave was a full proposal and only seven of the 14 second wave approvals were for full schemes. When personal medical services were introduced by for general practitioners there were 82 schemes in the first wave and 106 in the second wave.