Local Pharmaceutical Committee chairman Dilip Joshi reports on a month that shows the benefits of collaboration among LPCs and with others charged with delivering healthcare

Thursday October 2

We have our local pharmaceutical committee AGM today and the CEO and I make sure everything is in place before people arrive. This year, we have three external speakers from our area: a CCG chair, an LMC chair (who is also a London- wide LMC member) and a director of public health. Their brief is to speak to our contractors about how they see community pharmacy helping to deliver the local healthcare agenda from each of their perspectives. It is always heartening to see external stakeholders talking positively about pharmacy and illustrating their talks with personal experiences. The LMC chair admits that pharmacy has made a real contribution to the flu vaccination programme and has no objections to provision of other services where pharmacy’s strengths could be best exploited. The director of public health is very enthusiastic about our role in disease prevention and health promotion, commending pharmacy’s contribution to health checks and Vitamin D distribution in Lewisham – in both cases greatly improving on existing supplier performance. The CCG chair is a partner at a surgery near me; however, it is fair to say I see more of him at meetings than in our places of work. He has always been a supporter of pharmacy and regularly invites local pharmacists to practice meetings to discuss issues such as EPS implementation. The LPC meeting ends with the routine business of accounts approval and calls for support in delivering what we promise.

Monday October 6

I am at a meeting of South London LPCs with NHS England’s South London Area Team and the focus is on holding discussions with an invited guest – the chief officer of Southwark CCG, who has recently taken on an additional, South-East-London-wide role, as director of the Community Based Care Transformation Programme. Simply, this is a programme that all six South-East London CCGs have signed up to and is about providing more care in the community. Delivery across the six CCGs, we are told, will be driven through a single programme to coordinate existing work in the area, as well as new approaches to be adopted on the basis of ‘Shared Standards, Local Delivery’.

As an example, Southwark may have a high deprivation score overall, but areas such as Dulwich are more affluent and, therefore, have different healthcare needs. Under the programme, similar areas (affluent and deprived) across the six CCGs will be identified to target healthcare more effectively. Investment is expected to be in the region of £690,000 per year in addition to planned CCG investment in QIPP (quality improvement) schemes. We are informed that there are also pump-priming start-up costs of £42m over three years with a view to achieving savings of £128.7m. Once the programme is fully implemented, ongoing recurrent costs of redesigned services are estimated to be £30m per annum, which, in part, are to be met from reinvestments of QIPP savings. I look around the table and see gentle shakes of heads, suggesting a lack of wholehearted belief in the seemingly precise numbers quoted. We have seen many schemes come and go with the initial enthusiasm ultimately ending in review and change without delivering the benefit promised. With all six CCGs signed up, this is a ‘done deal’ and the purpose of the meeting is to impart information as well as stating that pharmacists have a key role in helping to deliver the agenda.

Thursday October 9

I am attending an evening engagement hosted by the Day Lewis chief executive, Kirit Patel, at his home. A good number of the great and the good are there, including members of LPCs and national pharmacy bodies, many with their partners. Kirit speaks of collaborative working and, in spite of his success and ownership of a multiple, his affinity for independent pharmacy is as strong as ever. It is a very pleasant evening with an informality that encourages goodwill and open speaking, unlike other meetings I often attend where comments are guarded and influenced by politics. Everyone I speak to agrees that we, in the pharmacy world, do indeed have a common agenda and can work for the greater good. I reflect on the extent to which the free-flowing wine has contributed to the mood and comments as I head home.

Monday October 20

I am co-chairing a meeting of Southwark pharmacists this evening with the Southwark CCG chair. This is the first meeting where we’ve had expressed commissioner interest translated into action by all commissioners in Southwark.We have speakers representing local authorities, public health, NHS England and the CCG (my co-chair) all at the same meeting. The event is well attended, with over 50 pharmacists present. We have a Q&A session with the panel of speakers after their presentations and then group discussions about how commissioners can best use community pharmacy to help deliver their agenda in dealing with Southwark residents’ healthcare needs, followed by feedback to the whole meeting. The event is a great success, with the speakers joining the groups and, in one case, even acting as note-taker. My co-chair from the CCG acts as scribe to note feedback received. We conclude with a promise of the notes being written up and used as a basis for further discussions with the LPC to develop joined up (and possibly joint) commissioning across the represented commissioning bodies.