More enhanced service specifications planned as data reveal slow uptake by primary care bodies
One year after the first
template specifications for enhanced services in England and Wales were announced (PJ, 10 September 2005, p299), three more are on the horizon.
The Pharmaceutical Services Negotiating Committee plans to publish specifications
for emergency hormonal contraception, anticoagulant monitoring and patient
group direction services shortly.
Recent
evidence shows that over 80 per cent of enhanced services in England
were already being commissioned before the new contract was introduced
(PJ, 19 August, p224). Although uptake of supervised administration,
needle and syringe exchange and stop smoking services are relatively
widespread, other services are not and few primary care trusts plan to
increase their commissioning of pharmacy services over the next 12 months.
In addition, use of national templates has so far been limited.
Data from the Government Statistical Service show that currently only
1 per cent of community pharmacies in England are commissioned to provide
disease specific medicines management services and only 7 per cent for
clinical medication review.
Alison Blenkinsopp, professor of the practice of pharmacy at the department
of medicines management, Keele University, commented: “In the first
year of the new contract, many pharmacists were trying to get to grips
with essential services, medicines use reviews and contract monitoring.
And so were PCTs. This begs the question: what level of commissioning
of enhanced services was expected and feasible?”
Professor Blenkinsopp believes, however, that the issue for year 2 of
the new contract is that PCTs are not planning to increase their commissioning
of enhanced services to any great extent. She would like to see service
specifications being developed and promoted for specific disease areas,
such as asthma and diabetes, as well as active involvement of community
pharmacy in discussions on practice-based commissioning.
Alastair Buxton, head of NHS services at the PSNC, commented that, with
PCT reorganisation still under way, it is too early to assess whether
the service specifications published so far are being actively used to
standardise previously commissioned services. The PSNC will keep the
situation under review over the next 12 months, he added.
Professor Blenkinsopp is currently undertaking a review of the community
pharmacy contract for the Pharmacy Practice Research Trust. The review
will look at how the contract has been implemented at a strategic health
authority, primary care organisation and individual community pharmacy
level.
News feature p272 |
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