Pharmaceutical needs assessments (PNAs) are a key tool in the process of achieving high quality, accessible services, responsive to local needs. NHS Employers has developed new guidance for PCTs on how to produce PNAs in the broader context of world class commissioning. This is in response to the Pharmacy White Paper in England: building on strengths – delivering the future action plan, requiring a review and strengthening of current arrangements to ensure that PNAs are an effective and robust commissioning tool.1
In this guidance, ‘Pharmaceutical services’ refers to the provision of pharmaceutical services such as the supply of medicines and advice, support for health and well-being and better medicines taking. This could include services provided by community pharmacies, dispensing doctors, appliance contractors and others including the acute sector. PCTs must recognise the range of providers of pharmaceutical services and the PNA should take account of the resource this represents.
What is the background to this?
The PNA is not new. In 2004/05 all PCTs in England were advised to develop a PNA in preparation for the community pharmacy contractual framework and the reform of control of entry regulations. However, the white paper identified considerable variation in the scope and quality of PNAs. In addition, some have not been updated or renewed to take account of changing circumstances.
Whilst acknowledging good overall provision and much good practice amongst providers, the white paper suggests that more must be done by PCTs as they aspire to world class standards of commissioning for their local populations. The production of the PNA should be an integral part of a PCTs approach to producing the commissioning strategic plan.
Pharmaceutical Needs Assessment (PNAs) as part of world class commissioning is the first in a series of documents that are planned for 2009 to support PCTs in commissioning primary care, including a toolkit which will provide PCTs with more detailed recommendations for the content of PNAs. This guidance is not intended as advice on how to commission pharmaceutical services. Further publications in 2009 will describe the commissioning process in more detail.
What does this mean to medicines management?
The white paper raised concerns about medicines usage and access to medicines, highlighting the need for more commissioned medicines management services attributed to the need of local populations. PNAs can be used to inform decisions on applications to provide services based on the current needs of the local population. PCTs could also soon be using PNAs to help identify services commissioned under a proposed new category of service under the community pharmacy contractual framework (directed enhanced services) based on local need.
To make optimal use of these medicines management services more has to be done to make effective use of the skills and abilities of NHS professionals who lead on and provide pharmaceutical services to patients. To achieve the desirable outcomes pharmaceutical service providers will need to work in partnership with other service providers. Providers of pharmaceutical services could play an important role in achieving the strategic goals of the NHS.
How does this relate to other publications or evidence?
The white paper, Pharmacy in England: building on strengths – delivering the future, recommends that more should be done by PCTs to achieve world class standards of commissioning for the populations they serve. The Operating Framework for the NHS in England 2009/10 reinforces the importance of this by stating that PCTs should pay due regard to the white paper when developing pharmaceutical services.
The Department of Health has published a number of documents related to the World Class Commissioning programme. There are four key elements to the programme; a vision for world class commissioning, a set of world class commissioning competencies, an assurance system and a support and development framework.
Although this guidance has been designed primarily for PCT commissioners, other groups – including pharmaceutical service contractors, local pharmaceutical committees (LPCs), local medical committees (LMCs), patients and local community groups – will also find it of interest.
PCTs should raise the quality of PNAs to drive higher standards of pharmaceutical services for the benefit of all.
The Pharmacy White Paper, 2008