Further DoH guidance provides clarification on PBC
Cecilia Lim/Dreamstime.com
Call for pharmacists to be guaranteed a seat at the commissioning
table |
Further guidance on the implementation
of practice-based commissioning (PBC) is published by the Department
of Health this week. The guidance supersedes “Practice-based commissioning: achieving universal coverage”,
published in January.
The new guidance provides clarification and strengthening of governance
and accountability arrangements to avoid potential conflicts of interest
between the commissioner and provider roles in PBC. It also clarifies
the procurement rules for services commissioned through PBC and sets
out an alternative to the tendering process.
The guidance says that tendering is not required for providers looking
to provide a routine elective service. The opportunity for any provider
who can demonstrate that they meet national minimum quality criteria
to supply services should not be constrained by commissioners, however,
there are no guarantees of volume or payment in any given contract.
Commenting on the guidance, Graham Phillips, a community pharmacist and
member of the Royal Pharmaceutical Society’s Council, said: “In
other words, the primary care trust will give you the contract but cannot
guarantee you the business. This is good for pharmacy — it is what
pharmacists spend their lives doing.”
The guidance says that the same approach of fostering, not limiting,
choice should be extended to the development of enhanced primary care
services through PBC. “PCTs should seek to establish a range of
providers (such as GP limited companies, third sector organisations that
are values-driven, community pharmacies and private companies) from which
patients can choose, driving up quality through contestability,” it
says. The tendering process should only be necessary when the intention
is to create a monopoly by awarding a contract to a single provider,
it adds.
Mr Phillips believes that the guidance does not go far enough. “If
pharmacy does not get a guaranteed seat at the commissioning table, how
can it ever progress to provide enhanced services and make use of independent
prescribers and pharmacists with special interests,” he said.
At the NHS Alliance annual conference held in Bournemouth last week,
Mr Phillips asked Duncan Selbie, commissioning director at the Department
of Health, whether he would make some commitment to guarantee that pharmacists
have at least a reasonable seat at the commissioning table which, he
said, they currently lack. Mr Selbie replied that he had met the representative
bodies of community pharmacy that week and that they contributed to the
DoH’s new guidance on PBC. “Community pharmacists are a big
part of the solution. Some pharmacy providers are as trusted as the NHS
in the public’s mind to give advice and to assist, so it is all
to play for,” Mr Selbie said.
Mr Phillips later said that he had further discussed this with Mr Selbie.
He pointed out that there is already guidance
for PCTs on engaging pharmacists in PBC produced by Primary Care Contracting (PJ,
8 July, p37). All that is necessary is to turn the advisory guidance
into obligatory guidelines,
which strategic health authorities should monitor. “Until this
is done, GPs will continue to hijack PBC with impunity while community
pharmacists are sidelined along with other potential providers,” he
told The Journal. |
The
Pharmaceutical Journal
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