Published in March 2009 by the Department of Health and NHS Primary Care Contracting, the PrimaryCare&CommunityServices: Improving pharmaceutical services guide provides practical advice on how PCTs can assess their current performance, identify their vision for the future and commission pharmaceutical services that meet the needs of their local communities. This Guide is one of a series that offers support to PCTs in becoming world class commissioners of primary care services.
In April 2008, the Government published the White Paper, Pharmacy in England Building on strengths – delivering the future which sets out practical, achievable ways in which pharmacists and their teams can contribute to improving patient care through delivering personalised pharmaceutical services and care over the coming years. The World Class Commissioning programme was developed to closely align with the final report from the NHS Next Stage Review, ‘High Quality Care For All’ and ‘Our vision for primary and community care’. For community pharmacy this means a change to their traditional role of dispensing to one of providing a much broader range of clinical, health and wellbeing services. For other pharmaceutical providers it reinforces the appropriateness of the clinical services already being provided.
Pharmaceutical services are provided across primary and community care settings. Community pharmacies are offering an ever expanding range of clinical services, and are involved in roles to support the use of safer medicines, promote the health and wellbeing of individuals and communities and reduce health inequalities. Key to the development of such services is the need for effective commissioning of pharmaceutical services by PCTs.
This Guide brings together the key components of a comprehensive approach to commissioning primary and community care pharmaceutical services, drawing on expert advice from around the country, and includes some of the many examples of best practice that already exist. Details of key publications and resources relevant to the commissioning of pharmaceutical services can be found on the NHS Primary Care Contracting website.
What does this mean to medicines management?
As community pharmacies offer an increasing number of medicines management services to the public the role of PCTs in ensuring these are effectively commissioned is as important as it’s role in commissioning any other primary care services. Medicines management teams need to work closely with commissioners of primary and community care pharmaceutical services to understand how services are currently being provided and identify any gaps that can be addressed by improving existing services or commissioning new ones. To help support these developments there needs to be appropriate pharmacist support at Board level whenever decisions about commissioning pharmaceutical services are taken.
It is important that services within the community pharmacy contractual framework are provided appropriately to reflect local need. Using a combination of the Joint Strategic Needs Assessment (JSNA) and the Pharmaceutical Needs Assessment (PNA) to inform the commissioning process will help to target specific local needs and focus decisions on local priorities. To achieve these priorities PCTs need to ensure they have effective structures and processes to support the preparation of a comprehensive, well researched, considered and up to date PNA. Comparing needs assessment with an analysis of current provision will highlight areas that need to change. For medicines management teams this will involve considering capacity, access, patient experience, premises, quality, and advanced and enhanced services. PCTs also need to ensure that the commissioning of medicines management services does not happen in isolation from other commissioning decisions and that there is appropriate input from all stakeholders.
The NPC Guide, Moving towards personalising medicines management (April 2008) focuses on the design and delivery of medicines management services. It is written for commissioners and providers as a tool to support the development of more personalised services for patients. In addition the NPC section on community pharmacy development and commissioning may be of particular use for those wishing to find out more.