To stand a better chance of success, LPCs need more help from PSNC when making bids for services. This is one of the conclusions drawn by Advocate of the Year Dilip Joshi during an especially busy month

Sunday June 8

I have generally been a great believer in keeping Sunday for myself and my family, but I have to make an exception for today’s NPA Conference. Our new chairman, Ian Strachan, opens with a motivational address and reflects the views of the board on meeting the needs of independent pharmacy in a practical way. Smaller businesses do not have the back office support of our multiple colleagues and the regulatory burden has become onerous. Colleagues are telling me that it impacts on their ability to do their professional work effectively.

Monday June 9

I attend a Lambeth Prescribing Committee meeting where discussions on making better use of supplementary and independent prescribers take place. The focus is on how nurse prescribers can be better supported in using GP software that recommends switching medicines. It is suggested that medicines optimisation is complex and a practising nurse should prepare a talk. Initially – and annoyingly – there is no thought that a pharmacist, as a recognised expert in medicines, should be involved.

I make the usual comments, which result in a ‘light bulb’ moment for several members of the committee and it is agreed that a pharmacist should help deliver the talk. I reflect on two matters: first, how important the contributions of community pharmacists are on such committees and, secondly, the lamentably low usage of independent pharmacist prescribers in primary care other than as adjuncts to GP surgeries.

With resistance to making board-level appointments of pharmacists in the former PCTs (and now CCGs), we must make sure our voice is heard at other levels in the best interests of our patients and our profession. My ideal scenario is for pharmacist prescribing to take place in pharmacy consulting rooms with an allocated NHS prescribing budget. I believe this, together with shared care records, would make a significant contribution to the management of long- term conditions.

Tuesday June 10

I attend a Pharmacy London strategy meeting. Pharmacy London, comprising the capital’s LPCs, is increasingly gaining in stature and importance, as evidenced by the willingness of high-level stakeholders to engage. It is becoming clearer that NHS England and others wish to speak to one large representative body rather than individual LPCs on public health initiatives, and perhaps see Pharmacy London as a body that might negotiate London-wide services on behalf of London pharmacy contractors. It remains a disappointment that Pharmacy London has one notable missing member representing some 300 London contractors – North-East London LPC. It must surely make sense to present a united front to all external stakeholders!

Wednesday June 11

The annual LPC chairs and secretaries meeting takes place today and this year’s focus is on local commissioning. Pharmaceutical Services Negotiating Committee executives are present in force and make scene-setting presentations. We are informed – against a background of austerity and a ‘more-for-less’ culture – that there is still no remuneration/contract settlement and negotiations with the Department of Health continue.

]Having done a 12-year stint, I know PSNC does its best in challenging circumstances for contractors. Local support, however, could be better. Rather than a passive database of locally commissioned services, I would like to see PSNC develop a menu of services for the ‘big-ticket’ items such as diabetes, mental health, cardiovascular disease, and smoking cessation that are ideally negotiated centrally but commissioned locally. This would help ensure high quality and consistency of service and avoid variable and patchy post- code commissioning based on ticking boxes and cost rather than value.

Thursday June 12

I’m at an awards event. Pharmacy London is shortlisted for innovative commissioning and delivery in flu services; my LPC (Lambeth, Southwark and Lewisham) and Lewisham CCG are also shortlisted for a service that offered free vitamin D supplements through Healthy Living Pharmacies to eligible pregnant mothers and infants. Before pharmacy’s involvement, distribution amounted to less than five per cent of the eligible population. Within three months, all expectations were exceeded with the enrolment of 5,500 pregnant mothers and infants. Awards ceremonies such as this are a wonderful way to raise awareness, showcase excellence and recognise achievement.

Tuesday June 24

I am at the NPA Board meeting today and there is a real ‘feel-good’ atmosphere around the table following a successful conference. Evaluation shows a high satisfaction level for NPA support services and motivates the board and executive alike to build on this and not to rest on our laurels.

Wednesday June 25

It is useful to check from time-to-time whether what we do and how we do it compares with others and so I attend a PSNC ‘Bids and Business Cases’ seminar. We see examples of successful bids and there is an exercise at the end when each table is asked to work up and present a bid for a hypothetical service. The highly variable quality of bids and presentations reinforces my belief that PSNC needs to do much more centrally in order to support LPCs to achieve better commissioning outcomes.