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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

Local Authorities

Clinical Commissioning Groups

NHS England local - Enhanced

The Third Pillar – supporting future NHS provision

Community Pharmacy

GP led primary care

Hospitals

Optimising the use of medicines

Supporting peopleto self-care

Supporting people to live healthier lives/public health

Supporting people to live independently

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

PSNC Community Pharmacy Conference - 24 April 2013

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

NHS England

Three distinct, but interconnected roles:1.A leader and enabler of the overall commissioning system – supporting CCGs to commission services for their communities2.A direct commissioner – securing continuously improving quality from the services we commission, including primary care3.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:

Preventing people from dying prematurely

Enhancing quality of life for people with long-termconditions

Helping people to recover from episodes of ill health or following injury

Ensuring people have a positive experience of care

Treating and caring for people in a safe environment and protecting them from avoidable harm

Effectiveness

Domain 1

Domain 2

Domain 3

Domain 4

Domain 5

Patient experience

Safety

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

PharmaciesDispense medicines & appliances & provide

associated & other services

Division of roles

Department of Health

Determines NHS reimbursement price

of medicines & appliances

NHS England

Commissions NHS Pharmaceutical Services – including Essential,

Advanced & Enhanced services, plus Local Pharmaceutical Services

Charged for service remuneration

Charged for product reimbursement

Clinical Commissioning Groups

Commission other services

Local Authorities

Health & Wellbeing Boards (produce pharmaceutical

needs assessments)

Commission public health services

Inform market entry & commissioning

decisions

NHS Business Services Authority

Calculates and makes payment to dispensers. Provides management

information

Dispensed prescriptions submitted with claims for other services

Health Education England

Local Education & Training Boards

Public Health England

Executive agency of the Department of Health

The role of your LPC

• Add content on the local work the LPC is undertaking

Questions &

discussion