Commissioning made simpler
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Mukesh Lad, chief executive of Mr Pickford's Pharmacy, has helped 55 independent contractors in Leicestershire to form a single provider company. He explains the benefits
What does local commissioning mean to you? Are acronyms like AQP starting to sound familiar? What about procurement and tendering with use of the standard NHS contract?
Gone are those heady PCT days when our contracts portfolio simply arrived in the post without the need for copious bureaucracy and negotiation. Oh how I long to return to the days of the much maligned contract 'roll- over' €“ a term which these days is synonymous with the riches of a national lottery. The only lottery we pharmacists will ever see in our day-to-day business is the one that determines who will win the tenders to provide local clinical services such as EHC and stop smoking.
In our brave new NHS world, commissioners are legally obliged to abide by the European procurement rules even for local processes. This ultimately results in the issue of a standard NHS contract that may include additions in accordance with local authority requirements. Don't be fooled by the use of 'standard', as that merely represents the starting point of a document that is 70-80 pages long before any addition or amendments.
Dazed and confused
Procurements are almost always managed on behalf of the commissioning authorities by a third party organisation via an online portal. I'm sure you're already feeling confused by what you've read so far €“ and that's without taking into consideration your time and skills in completing what is usually a very complicated tender application requiring huge amounts of detail.
In order to face these challenges in Leicestershire, some 55 independent pharmacy contractors created a provider company under my guidance. This has taken 10 months of understanding trust deeds, Companies House articles, and a lot of legal jargon, but we managed to bring it to life. Having already won a CCG-commissioned H pylori testing service earlier in the year, we recently submitted a tender for a slate of public health services. These include EHC and sexual health screening and an alcohol risk reduction scheme. It also included the provision of NHS Health Checks, although this particular tender was aimed exclusively at GP surgeries.
Attention to detail
The online application process was extremely onerous and required not only well- researched answers but also very specific writing skills in order to 'sell' the value and competence of community pharmacy. Department of Health specifications are a necessary inclusion in the description of the services we intend to provide, and great attention to detail is necessary in order to provide a thorough and robust response to the invitation to bid.
Our investment in specialist consultants proved fruitful as we were awarded the contracts we were hoping for
Successful bids can result in three-year contracts that will have significant financial impact on your business. It's therefore vital that independent contractors recognise the need to arm themselves with experienced consultancy and support for this complex process.
Multiple pharmacy groups have for some time employed staff with a back office function specifically aimed at writing procurement bids. Independent contractors have until now not had the need for this type of specialist support. I would now urge all readers to seriously consider the use of specialist consultants in the way I did with the Leicestershire group of independents.
Our investment in specialist consultants proved fruitful as we were awarded the contracts we were hoping for. Now all 55 pharmacies within the group have a contract that is valid for a minimum of two years and no need to repeat the process again 12 months down the line.
There's no time for euphoria though. Unlike those golden PCT years when everything was done for us, we now have to produce SOPs and service level agreements (SLAs) in-house for each of the 55 contractors. Contractual specifications must be followed and the service must be delivered to a high standard. With planned training sessions, we will guarantee a consistent quality of service and deliver all outcomes specified in the terms and conditions of the original bid. Our expert consultants now need to become efficient project managers to ensure all contractual outcomes and criteria are met without fail. Otherwise, penalty payments will be enforced.
As independent contractors, you need to take these opportunities very seriously, otherwise multiples like Boots or Lloyds will wipe the floor with the procurement and then turn you into a sub-contractor. Tempting though it may sound, the primary contract holders will always give preferential terms to their own first and there will be little or no 'wriggle-room' to negotiate remuneration rates.
A challenge and a threat
This new commissioning route is already posing a serious challenge and even a threat to some LPCs based on their constitutional modus operandi. I've seen first-hand the level of internal debate with regard to the need and provision of support to pharmacy contractors.
I have to be honest €“ I don't like what I'm hearing from LPCs and have decided to step down and to continue supporting our glorious independent businesses, in this constantly evolving NHS landscape, on a one-to-one basis in future. Starting next month, I'll be talking to and working with contractors to identify and resolve any issues and then share the learning with all my readers through my monthly Coalface feature.
As CEO of Mr Pickford's Pharmacy Group, I understand the challenges you're all facing to ensure we all remain competitive in a very difficult market. If you have a particular problem or issue, or even want to find out more about my federated independent pharmacy model, then get in touch with me at info@smartindependent.com.