| How will the new pharmacy contract affect local pharmaceutical
services? This seemed to be an important question for participants attending
a session at the British Pharmaceutical Conference entitled “LPS
in action”.
Participants first heard about the experiences of two pharmacists involved
in LPS — Riaz
Esmail, a community pharmacist from Harrow, Middlesex
(see PJ, 3/10 January, p19) and Nicola
Roe, pharmacy service development
manager for Rowlands (see PJ, 17 April, p473) — and then Juliette
Kendall, project manager of the team evaluating LPS in England and research
fellow at the University of Manchester, gave her views on the opportunities
and obstacles that it poses.
One of the key benefits is the opportunity for pharmacists to extend
their roles. “The pilots have enabled pharmacists to become better
integrated within primary care teams and to work alongside social care
and secondary care providers,” said Ms Kendall. She added that
the way that many of the LPS pilots have developed reflects the development
of the new national contract and primary care trusts have been able to
learn from the LPS experience, which will enable them to inform the development
of the national contract locally.
“LPS is a good example of how community pharmacy can contribute
towards local projects and initiatives,” said Ms Kendall. For example,
the LPS contract is being used to set up new premises in Local Improvement
Finance Trust developments and funding for LPS has been obtained from
social care budgets in order to provide services to certain at risk populations,
including older people and substance misusers.
“Development of the new national contract has slowed development
of LPS, and the role of the LPS contract until the new national contract
is developed
is rather unclear,” she said. “However, to date, LPS has
allowed a number of innovative services to be developed and many providers
are keen to continue their LPS contracts into the medium term.”
A question and answer session following the presentations centred around
the role of LPS following implementation of the new contract. “Given
the small numbers of people that are currently on LPS (around or less
than 1 per cent of pharmacists), and the longer services look like they
can be delivered under the new contract, is LPS a solution looking for
a problem,” asked Jonathan Buisson, NHS strategy manager, Moss
Pharmacy.
Ms Kendall said that in the same way that GPs can now choose between
PMS and GMS, pharmacists may have the choice between the new national
contract and something more innovative.
With regard to funding for LPS, Ms Roe explained: “You have to
say up front the number of dispensed items you think you are going to
do in a year and if you overestimate then fees are clawed back.”
Colette McCreedy, National Pharmaceutical Association director of pharmacy
practice, suggested that something needs to be built into the LPS formula
which allows for adjustment in dispensing volumes. Ms Kendall replied
that she had seen a number of LPS contracts that allowed for an adjustment
in dispensing volume, which was negotiated between the provider and the
PCT.
Andrew Gray, an LPS provider from Berwick-upon-Tweed, told participants
that he may have to withdraw from LPS. “Although [LPS] was not
supposed to be dependent on prescription numbers, that is all the Department
[of Health] seems to be interested in. Also, when the new contract comes
in, the Drug Tariff will be reduced and, again, although LPS was supposed
to take us away from retaining profits from dispensing ... unless there
is a corresponding increase in LPS funding, there will be a large gap
in our income.”
Jeannette Howe, deputy chief pharmacist, Department of Health, said that
the department is aware of the potential implications in terms of the
changes to reimbursement of generic medicines and, once it has settled
negotiations on the new contract, it is also aware that it needs to look
at the implications of that for LPS providers. “We cannot give
you any answers at the moment because we are not at that point, but we
completely recognise that we need to take those changes into account,” she
commented.
Linda Dodds, pharmaceutical adviser, Ashford PCT, asked whether prices
negotiated for LPS were going to be shared with PCTs and used as a basis
for pricing enhanced services. Ms Howe replied: “In developing
the service specifications for enhanced services we have been looking
to existing experience in the NHS, including LPS. ... We have been
doing some work to bring together the different pricing mechanisms and
we will need to provide some indications in terms of benchmarks.” |
The
Pharmaceutical Journal