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In recent months, community pharmacists have been urged to act on the Pharmacy Call To Action. Of course it's right, proper and extremely important to the future of pharmacy that we should all play our part in responding to this key initiative. In fact, we're increasingly living in a 'must-do' world of things to act on and actions to be taken, all of which are urgent and not to be ignored. But some actions cannot be ignored if we are to maintain focus on fairer and more equitable pharmacy services in the future.

Publishing a pharmaceutical needs assessment (PNA) is now a statutory responsibility of every health and wellbeing board (HWB) in England. The NHS uses this document to decide which services should be provided by local pharmacies. It also provides NHS England's area teams with guidance on whether a new pharmacy is needed when responding to contract applications. Ensuring your local authority produces a relevant, helpful and legally robust PNA is therefore of paramount importance.

Aligning with the PNA

I recently met with the director of public health for my area and we discussed at length how the PNA would be aligned with the county's joint strategic needs assessment, as well as the health and wellbeing strategy. Each HWB must publish its own PNA by April 2015. This will require board-level sign-off and a period of public consultation beforehand. The LPC has a right to be consulted on this considerable piece of work. If the LPC acts in good time, it will have the opportunity to work with commissioners and key local stakeholders. It means an opportunity to identify gaps in the healthcare economy and take action to allow pharmacy to fill these without the need for new contracts that would dilute already limited funding. I would urge you as a contractor to make sure your LPC is involved in this process.

Engaging with pharmacy

You may recall from December's issue the sorry tale of my BBC Radio encounter with the chair of my local HWB. Despite his 'disappointment' at my comments about the local authority's lack of engagement with pharmacy, the councillor did promise to include pharmacy in the future commissioning of public health initiatives. After months of trying to engage with him personally, we did finally meet and I wasted no time in enquiring how he expected his local administration to engage with pharmacy services in the future. I wanted to understand his commissioning intentions and how pharmacy could fit into a local authority's vision of caring for the adult population in the county. The answer was typically vague and based around pharmacy becoming part of a community-focused integrated approach to health and wellbeing services. Aspirational health and social care partnerships were about €being better together€, he advised me.

"Pharmacists are the experts in medicines and that is our unique selling point"

So how will this be better commissioned together? €Not through individual service delivery contracts,€ was the swift reply. Local authority commissioning has, in effect, become a standard EU procurement process and completely different to anything we've encountered previously in the NHS. Bids for tenders will be assessed against an outcomes framework with delivery and achievement targets. The intention is quite clearly to procure two or three large providers, and community pharmacy will have to find its own way of engaging with these 'lead providers'.

However, in one of our neighbouring counties things seem very different. Senior public health managers and procurement officers there recently held an open forum event for pharmacy contractors to outline their commissioning intentions. Discussions were concise and focussed with a clear indication of actions to be taken to secure pharmacy's position in delivering this county's public health services.

The common theme

Despite these two differing approaches to procurement, there is nevertheless one common theme: local authority procurement teams have no intention of dealing with hundreds of individual contracts.

No business model can sustain the administration costs of over 300 contracts to deliver 1,500 smoking quits. The anticipated return on investment from these interventions simply doesn't justify the resources or capacity necessary to continue operating as in the 'good old days' of individual local enhanced service contracts.

How to compete

This means a serious and urgent shift of direction for independent pharmacy contractors. Do we act or should we be called to action? How do we compete in this daunting new world?

Quite simply, we have to act now and collaborate among independents to form a legal commercial entity capable of bidding on behalf of all the group members for locally commissioned services. I've already been leading on this action in more than one county where we've now achieved bidding status thanks to our collaborative actions. This is a very important development as it means we've acted on, and are preparing to enter, the new healthcare world that's emerging around us.

In formulating our LPC response to the recently completed Pharmacy Call to Action, I realised the importance of initiating local networking and collaboration in order to secure our place in primary care. I cannot impress enough on independent contractors the need to think innovatively and creatively. An eminent colleague and reader of pharmacy pointed out that we need to 'own pharmaceutical care'. Ownership would guarantee we'd always be requested to provide it by commissioners and the public alike.

The necessary investment

In order to achieve this, we need to invest time, energy and money into being the best providers of the best pharmaceutical care. That would therefore render us not only the experts in medicines, but also the best healthcare professional to provide the best services in the best use of medicines and how to get the most benefit from them. Pharmacists are the experts in medicines and that is our unique selling point. No other professional in the healthcare team can make a similar claim. And this makes the pharmacist the best person to make expert interventions to support the all-important self-care and independent living agendas that are the top priority of every health and wellbeing strategy.