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In the April 2013 edition of CPN and on the PSNC
website, a short contractor briefing on the new
healthcare system was published.
This PSNC PowerPoint presentation accompanies
the contractor briefing and may be used by LPCs to
undertake training for contractors on the new
healthcare system.
Feedback on the presentation can be sent to
alastair.buxton@psnc.org.uk.
22nd May 2013
Pharmacy’s new commissioners
A simplified guide to the new healthcare
system
Pharmacy and the new
system
Four levels at which services
can be negotiated
NHS England national - CPCF
NHS England local - Enhanced
Local Authorities
Clinical Commissioning Groups
The Third Pillar –
supporting future NHS
provision
Optimising the use of
medicines
Supporting people
to self-care
Supporting people to
live healthier
lives/public health
Supporting people to
live independently
Community
Pharmacy
GP led
primary care
Hospitals
Community Pharmacy
Contractual Framework (CPCF)
• Three players in negotiations
– PSNC
– NHS England / NHS Employers
– Department of Health (DH)
• NHS England and DH have specific areas of
responsibility
DH’s role
• Leading the nation’s health and care
• Sets legal framework for system, including
regulations for pharmacy
• Secures funding from HM Treasury
• ‘System steward’
• Determines NHS reimbursement price of
medicines & appliances
PSNC Community Pharmacy Conference - 24 April 2013
NHS England
Three distinct, but interconnected roles:
1. A leader and enabler of the overall commissioning
system – supporting CCGs to commission services for
their communities
2. A direct commissioner – securing continuously
improving quality from the services we commission,
including primary care
3. A system wide leader for quality improvement –
collaborating with other parts of the system, including
Public Health England and Health Education England
NHS England’s Mandate
• High quality care for all, now and for future
generations
• Success will be measured through the NHS Outcomes
Framework:
Domain
1
Preventing people from dying prematurely
Domain
2
Enhancing quality of life for people with long-term
conditions
Domain
3
Helping people to recover from episodes of ill health
or following injury
Domain
4
Ensuring people have a positive experience of care
Patient
experience
Domain
5
Treating and caring for people in a safe environment
and protecting them from avoidable harm
Safety
Effectiveness
NHS England
• NHS Community Pharmacy Contractual
Framework
– Commissioning Development Directorate (working
with Operations and Medical Directorates)
negotiates with PSNC on remuneration for
pharmacy contractors and new national service
elements within the contract
– NHS Employers will undertake some negotiations
on behalf of NHS England
NHS England - local
• 27 Area Teams (AT) which are part of the Operations
Directorate
• ‘Local’ office of NHS England
– Direct commissioning of primary care
– Specialist commissioning (e.g. offender health)
– ‘Supervision’ of CCGs
• Single operating model
• Performance management of CPCF
• Commissioning of Enhanced services (including on
behalf of CCGs and LAs)
NHS England - LPNs
• Local Professional Networks (LPNs) for pharmacy,
optometry and dentistry within each AT
• They are intended to provide clinical input into the
operation of the AT and local commissioning decisions
• They will:
– support implementation of national strategy and policy at
local level
– work with other key stakeholders on the development and
delivery of local priorities, some of which go beyond the
scope of primary care commissioning
– provide local clinical leadership
NHS England - LPNs
• Pharmacy LPN specific functions include:
– supporting local authorities with the development of the
Pharmaceutical Needs Assessment (PNA)
– considering new programmes of work around self-care and
long term conditions management in community pharmacy
to achieve Outcome 2 of the NHS Outcomes Framework
– working with CCGs and others on medicines optimisation
– ‘holding the ring’ on services commissioned locally by local
authorities (LAs) and CCGs, highlighting inappropriate gaps
or overlaps
Local authorities
• 152 top tier authorities
• Public Health and Social Care Outcomes
Frameworks influence their commissioning
• Responsible for commissioning the majority of
public health services
– Using a ring-fenced budget
– Can use standard public health service contract
• A Health and Wellbeing Board (HWB) for each LA
– providing strategic oversight and bringing
together all local commissioners
Local authorities
• LAs and CCGs develop the Joint Strategic Needs
Assessment (JSNA), working through the HWB
• The JSNA is used to develop a Joint Health and
Wellbeing Strategy…
• …and informs the development of the
Pharmaceutical Needs Assessment
• Which is used by the NHS England Area Team to
determine some pharmacy market entry
decisions
Clinical Commissioning
Groups (CCGs)
• Responsible for commissioning health services (as
opposed to public health services) using the
standard NHS contract
• All GP practices within the area of the CCG are
‘members’
• Early focus on hospital contracts
• May wish to commission minor ailment services,
palliative care schemes, MUR+ and other
medicines optimisation services from community
pharmacy
NHS Pharmaceutical Services – System Map
Department of Health
Public Health England
Sets legal framework, secures funding
Executive agency of the Department of
Health
NHS Pharmaceutical Services
Product
reimbursement
Services
remuneration
Division of roles
Department of Health
NHS England
Determines NHS reimbursement price
of medicines & appliances
Commissions NHS Pharmaceutical
Services – including Essential,
Advanced & Enhanced services, plus
Local Pharmaceutical Services
Inform market entry
& commissioning
decisions
Local Authorities
Health & Wellbeing Boards
(produce pharmaceutical
needs assessments)
Commission public health
services
Clinical Commissioning
Groups
Commission other
services
Pharmacies
Health Education England
Dispense medicines & appliances &
provide associated & other services
Local Education & Training
Boards
Dispensed prescriptions submitted with
claims for other services
Health & Social Care
Information Centre
Collates & provides
information
NHS Business Services Authority
Calculates and makes payment to
dispensers. Provides management
information
Charged for product
reimbursement
NHS Connecting for Health
functions
Charged for service
remuneration
The role of your LPC
• Add content on the local work the LPC is
undertaking
Questions
&
discussion