Chairman of the LIPCO federated group Mukesh Lad discusses the options for independents and LPCs considering forming provider companies

After months of consultation, PSNC issued its much-anticipated template of suggested amendments to LPCs’ constitutions in October, and the document proposed an LPC fit for purpose in the new NHS era. Some LPCs will have already held contractor meetings to approve any changes they have decided to take on, but it is for individual LPCs to decide whether they use the PSNC template or not.

Changes in the template likely to affect pharmacy contractors are the constitutional requirement for collaborative working between LPCs, the preparation of an annual operational budget to be presented to NHS England, and support for the formation of pharmacy provider companies to bid for procured services. Further proposed changes look to improve LPC election processes and open communication channels through information sharing with NHS England.

Forward thinking

There is a burgeoning need to future-proof the role of LPCs, which now have to be recognised by NHS England, but also to protect the interests of contractors who fund them. I welcome the amendments, which will provide greater transparency of management and finance, and responsibility from LPC members. Many forward-thinking LPCs have been operating for some time with a lot of the proposed changes already in place.

Regular readers of my column will know I’ve been extolling the virtues of pharmacy provider companies for some time now. The three trail-blazing pharmacy federations of Leicestershire, Kent and Croydon that formed provider companies last year have started to reap the rewards of successful bidding. It’s thanks to the foresight, commitment and energy of people like Kevin Cottrell in Kent and CJ Patel in Croydon, as well as this Coalface Contractor in Leicestershire, that these independent pharmacy provider companies are already firmly established, successful and operating for the benefit of local communities as well as pharmacy contract holders.

PSNC’s proposals recommend the ‘provision of appropriate levels of guidance and support to pharmacy contractors or groups of pharmacy contractors in the formulation of bids for funds held at any level and advise on submissions for LPS and local commissioning.’

Working together

As more independent contractors come to terms with the need to bid for services, they’ll realise the advantages of working together through a formal entity specifically created for their benefit. So it can only be positive if the constitutional amendment allows LPCs to ‘establish or assist in the establishment of a body corporate formed for the sole purpose of supporting the interests of pharmacy contractors’.

There is a burgeoning need to future-proof the role of LPCs ... but also to protect the interests of contractors who fund them

This constitutional review provides the ideal opportunity for independent contractors to engage with LPCs to discuss how they can best move forward. I led the charge in Leicestershire to form our independent pharmacy company and there is considerable complexity involved to ensure that all members get a fair and equitable return.

The process requires effective leadership, good understanding of corporate legislation, knowledge of local commissioning landscapes and commitment to engagement and communication at all levels. It’s a lot of work in addition to your day job, but you should seriously consider this route.

Follow the GP lead

GPs have long known about the need to get organised and form federations, since the introduction of practice based commissioning. They certainly have a head start on community pharmacy and I would urge you all to engage in this debate with your LPC and fellow independent colleagues. This will ensure we remain key partners in the provision of clinical services with all the various commissioners.

The proposed new LPC constitution will need the vote of pharmacy contract holders. Extraordinary or special LPC meetings provide an opportunity to discuss in detail the implications of each amendment. One option proposed by PSNC is the creation of LPC-managed provider groups, at a suggested cost of £250 per pharmacy. You need clarity, though, around long-term sustainability and the management of this body. Writing successful procurement bids is not for the faint-hearted, neither are the resources, infrastructure and commitment required to maintain them efficiently.

Alternatively, the independent federated groups I referred to earlier have proved to be successful, as well as financially beneficial to their members. Those of us at the leading edge of this innovation welcome the opportunity for guidance and support from the LPC in relation to local commissioning.

Meeting the challenge

General practice has spent the past 10 years looking into the implications of tendering and how best to meet the challenge. I, on the other hand, have dedicated the past two years to researching the way forward for pharmacy, while the LPC is just starting out on its journey.

In the meantime, the NHS is formally recognising the value of federated provider organisations with the creation of a multidisciplinary National Association of Provider Organisations. The federated pharmacy companies in Kent, Croydon and Leicestershire are at the forefront of this activity and we look forward to more new federations joining us in the future. Either way, and for progress to take place, pharmacy contractors need to attend the LPC public meetings, ask for clarification and vote for change. The choice is yours.