Welcome to the LPC Conference 2010

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Video intro here

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Welcome to the LPC Conference 2010

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LPC Conference 2010 Dr. Christopher Hodges Chairman PSNC

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LPC Conference 2010 Dr. Christopher Hodges Chairman PSNC

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LPC Conference 2010

Chief Executive’s Report Sue Sharpe

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Progress under the Labour Government

• Progress beyond dispensing • Using the skills of the pharmacist • Implementing MURs – 85% of pharmacies • Patient approval • Public health 12

A period of uncertainty and transition

• Service decommissioning • Opportunity in chaos • NHS to change fundamentally • Set the foundations for the new commissioning regime • Public health • Any Willing Provider – real competition?

• Getting the evidence together 13

New Government Pharmacy policy

• White Paper – expansion of pharmacy services • Medicines optimisation • Funding to reward quality and outcomes • Timelines for a new pharmacy contract • Financial Constraints • Cost of Service Inquiry 14

Pressures affecting Pharmacy Contractors

• Supply chain • Pricing accuracy – PRISM • EPS • PNAs • Specials • Responsible Pharmacist & Supervision • Confidentiality of data 15

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PSNC

• Budget 2010-11 • Major Expenditure: – PRISM – PharmaBase £3,200,000 • New Committee Composition • Work programme for 2011 17

Overview

• Why PharmaBase is needed • The vision for PharmaBase • PharmaBase functionality at launch • Future developments • The role of LPCs

Why is PharmaBase needed?

1. Problems with Enhanced services 2. Existing software does not cater for pharmacy’s needs 3. Potential for an increasing number of commissioners to add complexity to Enhanced service delivery 4. New NHS mantra: Prove it or lose it!

Why is PharmaBase needed?

5. New national services require support from the start of provision • Don’t want to use paper or wait for modules in PMR systems to be developed • Slow implementation by contractors risks a loss of funding • Need to collate evidence base to support case for ongoing commissioning

Why is PharmaBase needed?

Problems with Enhanced services: – Variable commissioner paperwork – Variable approaches to invoicing – Slow processing of payment claims by commissioners

Why is PharmaBase needed?

Problems with Enhanced services (cont.): – Difficulties reconciling payments from PCTs (including accurate assessment of VAT liability) – Difficult to collate management data across a number of pharmacies – Poor data capture by commissioners can lead to a lack of evidence for the value of the service

Why is PharmaBase needed?

Existing software does not cater for pharmacy’s needs – Focussed on commissioners’ needs – Lack of service and clinical support for pharmacies – Potential for compatibility issues with PMR systems – Some information governance concerns have been raised by contractors – Access to management data for pharmacy use is not always part of the software vendor’s focus or service

The PharmaBase Vision To provide a national web based platform to support the efficient commissioning, delivery and invoicing of pharmacy services and to capture the evidence base

Our aims

• Make service delivery more effective and efficient – Clinical support – Consistent approach across all pharmacies • Drive increased uniformity in commissioning • Increase the efficiency of local payment systems

Our aims

• Build the national and local evidence base for services • To make it easy to commission and administer pharmacy services!

• Allow pharmacy to control its own IT support

PharmaBase functionality at launch

• EHC service – Pharmacy clinical records – PCT commissioning dataset – Invoicing (including consolidated data across an area) • Supervised Consumption service – Records for PCT claim – Invoicing (including consolidated data across an area) • PSNC Contract Workbook – Linked to CPAF

EHC

EHC

Supervised consumption

Contract Workbook

Future development of PharmaBase

Many possibilities...

• Support for new national services • Support for more Enhanced services • Interface with PMRs and other software • Electronic data transfer and sharing with other health professionals

The role of LPCs in promoting PharmaBase

• Raise contractor awareness • Raise commissioner awareness – Sell the use of the initial three modules – Promote consolidated data approach • Suggest enhancements and new modules to develop

Our shared aims

• Build the national and local evidence base for services • To make it easy to commission and administer pharmacy services!

• Allow pharmacy to control its own IT support

www.psnc.org.uk/pharmabase Visit the stand for a demonstration

LPC Conference 2010

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LPC Conference 2010

Your Questions…

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LPC Conference 2010 Appendix 1

Report on Last Year’s Resolutions

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LPC Conference 2010 Appendix 2

Adoption of Standing Orders

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LPC Conference 2010 Appendix 3

Resolutions for 2010

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LPC Conference 2010 R1 Swindon & Wiltshire LPC

This conference calls for a review of the reimbursement of dispensed medicines to ensure that access to retained margin is fair across all contractors. While the overall retained margin is protected, the access to this funding depends not only on the contractor’s purchasing decisions, but on local prescribing policies on branded generics and prescriber use of branded products. This is unfair and must be addressed as a matter of urgency. 43

LPC Conference 2010 R3 Bedfordshire LPC

While recognising that the Global Sum for purchase profits may be monitored and maintained, a system which entails the dispensing of branded medicines at a loss and the manipulation of purchase profits at a local level via the prescribing of branded generics is manifestly unfair to individual contractors.

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LPC Conference 2010 R4 Cambridgeshire and Peterborough LPC

Cambridgeshire and Peterborough LPC calls upon PSNC to insist the DH ensures that the PCTs local prescribing policies do not affect the nationally agreed funding for pharmacy contractors, for example the prescribing of branded generics, thus allowing all contractors to receive fair share remuneration. 45

LPC Conference 2010 R6 Lambeth, Southwark and Lewisham LPC

Dispensing at a loss is morally indefensible. This Conference requests PSNC to examine the inconsistencies in prescribing, such as brand switching and prescribing non-discounted items which often results in dispensing at a loss and introduces instability in stock procurement, planning and stockholding and could ultimately be detrimental to patient care.

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Discussion and Vote

Collectively on resolutions R1, R3, R4, and R6 47

LPC Conference 2010 R2 Dorset LPC

Dorset LPC believes Community Pharmacy Contractors should share the benefits of their efficient purchasing of medicines. Savings beyond the £500m cap should be re-invested in Community Pharmacy through an Enhanced Services Innovation Fund. This could be used to encourage the transition from a supply, to a service driven remuneration structure, as recommended by the recent Bow Group policy paper.

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LPC Conference 2010 R5 Wirral LPC

This conference calls on PSNC to assure all contractors that current levels of remuneration and fees for Pharmacy Services will continue to be protected at the current levels following devolvement of the global sum and the abolition of PCT’s.

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LPC Conference 2010 R7 North East London LPC

This conference calls on PSNC, Department of Local Government, and the DoH to take immediate steps to formulate plans to develop pharmacy as a centre for local community engagement and health services and put a new ‘contract’ in place as soon as is practicable (but not later than April 2012) that rewards pharmacy contractors for the investment of risk capital and quality of outcomes of pharmacy based services. 50

LPC Conference 2010 R8 Joint resolution from North East London LPC and Kingston, Richmond and Twickenham LPC

This conference calls on PSNC and the DoH to take immediate steps to ensure that all members of the public eligible to receive free treatment on the NHS for minor ailments are able to receive the treatments from all of the nation’s community pharmacies now and in the future. 51

LPC Conference 2010 R9 Wirral LPC

In the light of the proposed GP consortia, Wirral LPC call upon the PSNC to negotiate with the Department of Health for standard national templates for each enhanced service ensuring standards across the country are uniform for all commissioned services.

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LPC Conference 2010 R10 Lambeth, Southwark and Lewisham LPC

This Conference urges PSNC to ensure that the new service commissioning arrangements proposed in the White Paper are adequately separated from provision and safeguards are built in to ensure fairness, transparency and accountability in both the commissioning and provision of such services.

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LPC Conference 2010 R11 Joint resolution from Northamptonshire and South Staffordshire LPCs

This Conference believes that there should be a national agreed service, with separate and new money, negotiated by PSNC, for pharmacists to dispense weekly medication into a Monitored Dosage System (MDS) container for any patient who would not qualify for MDS under the Disability Discrimination Act but who has fulfilled all of the inclusion criteria for the service. The inclusion criteria are: • The patient must have an MUR initially to ensure all current medication is required and/or to rationalise the timing of their doses • The patient must be able to self-administer their medication • Without the aid of MDS the patient would require support from a carer of some sort to comply with their medication regimen.

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LPC Conference 2010 R12 Hertfordshire LPC

The MUR service should be further developed to include safety specific MURs, disease specific MURs, public health MURs and social MURs (social MURs are to support vulnerable people). Outcome data should be collated on a national scale and resource implications addressed. 55

LPC Conference 2010 R13 Kingston, Richmond and Twickenham LPC

The KR&T LPC is concerned that if service gaps are identified in the PNA and the gap has occurred because the PCT is not willing to pay fair fees for the service, then the PCTs could use the threat of allowing a new pharmacy to open who will agree to offer the service at their required fee. This Conference asks that PSNC brings this to the attention of the DoH and a safeguard procedure is agreed. 56

LPC Conference 2010 R14 Ealing, Hammersmith &Hounslow LPC

This Conference believes that the Information Governance Requirements scheme is far too extensive and places a huge burden on community pharmacy practice. Beyond a minimum level of good and robust confidentiality, it adds nothing to existing patient safety and this Conference urges PSNC to reach agreement with DH on the depth and breadth of information required from individual pharmacy contractors.

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LPC Conference 2010 R15 Hertfordshire LPC

This conference believes that the level of bureaucracy now facing community pharmacists is unsustainable, and is causing additional and unnecessary pressure on an already-overstretched workforce. The concerns around pharmacy and “workplace pressure” are well-documented and are affecting patient care. 58

LPC Conference 2010 R16 Surrey LPC

We call upon the conference to request that the PSNC will improve the level of communication on current and on-going matters, which should contain a more detailed analysis of the negotiations performed on behalf of the members, so that the results and the process by which the results are achieved are more transparent. With present market forces and the current economic climate, community pharmacists need to maximise all opportunities and it would benefit the members to see that the PSNC are also performing to maximise contract negotiation opportunities presented to them. 59

LPC Conference 2010 R17 Hampshire and Isle of Wight LPC

This conference has no confidence in the ability of the Prescription Services to deliver their core function.

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LPC Conference 2010 R18 Cambridgeshire and Peterborough LPC

Cambridgeshire and Peterborough LPC calls upon the PSNC and DH to set clear standards of governance and scrutinises direction of prescriptions when the prescriber has a financial interest in where the prescription is dispensed, such as GP owned pharmacies. 61

LPC Conference 2010 R19 Essex LPC

PSNC have developed an excellent framework to support the management of LPCs. We ask the PSNC to be more proactive in the implementation of this framework to better support LPCs. We feel this would raise the standards of all LPCs so that we are better able to meet the needs of our contractors. 62

LPC Conference 2010 R20 Essex LPC

We ask the conference to recommend that PSNC use contractor funds to commission an independent extensive research programme to conduct an impact assessment of the savings that could be offered to the NHS through pharmacy taking on extended roles. 63

LPC Conference 2010

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LPC Conference 2010 Public Health and Local Authorities

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LPC Conference 2010 Public Health and Local Authorities

Your Questions

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LPC Conference 2010

Final Q&A session

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LPC Conference 2010 Dr. Christopher Hodges Chairman PSNC

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LPC Conference 2010

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