LPC Conference 17th November 2010
Lancaster London hotel
Dr Chris Hodgesopening CONFERENCE SPEECH
Good morning Conference. I am delighted to welcome you all to the 2010 LPC Conference.
I hope you have had a chance already to visit the exhibition with our PSNC Partners. Sincere thanks to AAH, Alliance Healthcare, GSK, IMS, Novartis, Pfizer, Sanofi Aventis and Teva for their tremendous support.
The exhibition will be running over lunch so please do visit the stands and perhaps explore some opportunities for working together locally.
We have the usual announcement: mobiles, BlackBerries or any other device likely to make an irritating noise – please do the necessary now.
Fire alarms. Fire exits are marked; l hope we don’t need to use them but please note the nearby exits in case we do need to evacuate the building.
So let us move on. A reminder that we have the pharmacy press here with notebooks and cameras at the ready.
There will be lots of opportunities for your contributions during the day. For the resolutions please use the lectern; for the Q&A sessions there will be roving mics- on all occasions please preface your comments with your name and the LPC that you are representing.
This is the first time we have held the annual LPC conference in the autumn. It was a fortuitous decision to move the date of this event, as so much changed in the Spring of this year.
This Conference, and the dinner, are important events in the community pharmacy calendar.
We examine the pressures and concerns affecting contractors and LPCs, learn about the work of PSNC and the policy context affecting our role, and take the opportunity to communicate some important messages to the minister and other key contacts and stakeholders who join us in the evening.
Had we held the dinner in mid-March this year, and communicated those messages, we might by mid-May have concluded that we were not going to get full value for the investment of time and effort.
The new government announced – in mid-July, a policy of radical reform in the operation of the NHS, particularly in primary care.
Much of this was unexpected, and nothing in pre-election health policy prepared us for the abolition of PCTs and the new commissioning consortia. But Andrew Lansley had been very clear that he wanted to see a GP led , locally driven NHS, and that he wanted the Department of Health to become the Department for Public Health.
As the policy has been developing in the months since July, more questions are emerging, and although many remain unanswered, some of the implications for community pharmacy are becoming clear.
Commissioning of services from pharmacy: there will be three different commissioners: the NHS Commissioning Board, which will be responsible for the national contract; local authorities for public health; and the GP consortia. The balance of responsibilities between these three will take some years to emerge.
PSNC worked closely with Conservative and Liberal Democrat shadow health teams before the election. That paid off, and the government recognised the potential value to the NHS of developing and expanding the services provided by pharmacy.
This chimes with our own aspirations to develop a service-led contract for the future.
It is reflected in elements of the policy papers that have been published since the election. In Liberating the NHS; Commissioning for patients the government makes clear its expectation that Consortia will involve relevant professionals from all sectors to develop care pathways that deliver more integrated, higher quality care, making more efficient use of NHS resources and giving better patient experience.
Liberating the NHS: greater choice and control sets out the “Any Willing Provider” principle that will be a basic presumption – applying to all healthcare services at all stages in the care pathway.
Liberating the NHS; regulating healthcare providers states that Monitor, the economic regulator, will have a duty, where relevant, to promote competition. The NHS Commissioning Board will also have important functions, promoting patient choice, implementation of any willing provider, and issuing guidance on commissioning and procurement.
This is radical stuff, as are many other provisions of the policy. And it is no wonder that as the implications of the policy become clear some, including GP leaders, are becoming rather troubled.
Last week, commenting on plans to change the role of NICE, Laurence Buckman, chair of the BMA GP committee, said that whilst GPs are comfortable in their role as GP advocates, they are not trained or interested in rationing.
A week or so before that, the BMA’s opposition to Any Willing Provider provoked a firm and uncompromising response from the Health Secretary.
Pharmacy, as well as general practice, will also be challenged by the policies.
We need to ensure that the national contractual framework, that will be set by the NHS Commissioning Board, encompasses the core roles pharmacies offer today, and builds on them to support delivery of convenient accessible and high quality services.
GP Consortia will commission services to meet local needs, but where the need for services is found across the country, in all communities, it should be nationally commissioned.
Liberating the NHS: Local democratic legitimacy in health proposes to increase the responsibilities of local authorities in leading needs assessments, supporting patient choice, promoting joined-up commissioning and leading in health improvement and prevention.
Local Authorities become very important stakeholders for pharmacy. The current contractual framework includes some service elements targeted at Public health and promotion of healthy lifestyles, to prevent avoidable disease. There is a great opportunity for the pharmacy team to play a far greater role in helping local authorities, and the National Public Health Service, to meet its goals. This afternoon we have a session on healthy living pharmacies and an insight into local authority working.
At the heart of the government’s policy is the mantra – no decision about me without me. This is predicated on giving people greater choice and control.
The policy, set out in Liberating the NHS – an Information Revolution, encompasses a range of sources of information to support people making choices, including control of their own records, information prescription, and technology to support self care.
Community pharmacy must become integrated into the resources that deliver this policy.
Information is also one of the fundamental building blocks of the drive for outcomes based commissioning. The NHS Outcomes Framework will set outcomes goals, and will provide the main engine for driving up quality.
NICE is targeted to produce around 150 Quality Standards; quality measurement will include not only effectiveness but also patient experience. The NHS Commissioning Board will determine how best to deliver improvements, working with GP consortia.
PSNC at national level, and LPCs at local level, will need to ensure that pharmacy embraces this framework; there will be no prospect of developing, or even retaining, services that are not evaluated for outcomes.
Last week PSNC met for its annual planning meeting, to develop its plans for addressing this radical new policy environment.
In the next 12 months we will see the flesh being put on the bones of the policy, but the Committee identified some vital steps that we at PSNC, and you in the LPCs, and indeed contractors at pharmacy level, must do now.
Building relationships that will be fundamental to success in this new environment. This includes, but is not limited to the GPs who are emerging as leaders of the nascent consortia. Every pharmacy should seek to establish a better dialogue with their local practices. LPCs will need to help them, and we will provide the support.
A new relationship – or at least new for many – will be with local authorities. It is tremendous to see that a number of local authority representatives are coming to the dinner tonight.
As directors of Public Health move to local authorities and they begin to assume their new functions, we need to ensure that the resources pharmacy offers are firmly in their near vision.
The future for community pharmacy lies in development of services aligned to and beyond dispensing. Funding growth for the NHS over the next 4 years averages just 0.4%. Yet demand will increase at around 5% per annum. It will feel like a cut. The government talks of the need for more for less.
With the financial squeeze the NHS faces, it has never been more critical for pharmacy to build on its supply role by extending its role in medicines optimisation, and also by ensuring that it develops systems for gathering data, so the contribution it makes can be verified. In an outcomes driven NHS, evidence will be key.
Information services, and support for healthy lifestyles, are already incorporated into the current contractual framework, but we need to build on them, and again develop the evidence base to support our case for the value they deliver.
Funding structures need to be aligned to fully incentivise this role growth, and to reward those who are able to demonstrate that they provide these services. We must demonstrate, and prove, the value for money we give the NHS, when money will be very tight.
We need to address the many frustrations and obstacles that affect contractors today: supply difficulties, which are not improving, branded generic prescribing and other measures that distort income among contractors. And of course pricing accuracy.
There is no doubt that PSNC, which has had an extremely busy and demanding eighteen months, since we last met, has an equally demanding year ahead. Sue will present her report to you in just one minute.
But before I hand over to Sue I wanted us to pay our respects to two LPC colleagues who have sadly passed away since out last Conference. Steve Brill, a former contractor and Chair of Hertfordshire LPC and John Vooght, a former contractor and Secretary of Buckinghamshire LPC. Both have attended this conference in the past and have made tremendous contributions to community pharmacy. They are sadly missed.
So we move on and over to PSNC Chief Executive Sue Sharpe for her report to Conference.