Local pharmaceutical services
pharmafile | October 22, 2003 | Feature | Sales and Marketing |Â Â LPS, local pharmaceutical services, medicines management, pharmacyÂ
Pharmacists are recognised by the Government as having a crucial role to play in developing better patient care within the NHS. Local pharmaceutical services (LPS) pilots are intended to increase pharmacists role in primary care by awarding contracts for new pharmacy-led services such as medicines management services (MMS), supplementary prescribing and, eventually, independent prescribing.
Local pharmaceutical services were first unveiled in April 2002 to develop and demonstrate innovative ways of providing high quality, cost-effective services to patients.
It was initially met with suspicion by contractors, who considered it a ploy by the Department of Health to undermine pharmacy and erode funding. However, this attitude has largely changed, judging by the overwhelming response by contractors to PCTs' recruitment of LPS providers.
Under LPS, pharmacists are paid to provide pharmaceutical services to patients, improve compliance and help doctors choose cost-effective products. As prescribers, pharmacists will have considerable influence on what medicines are prescribed and how they are used in the future.
Encouraging innovation
David Lammy MP, Parliamentary under Secretary of State for Health, speaking at the Pharmaceutical Services Negotiating Committee annual dinner in February, said he was in no doubt that LPS will encourage innovation, provide flexibility and help pharmacists make better use of their skills. "I am enthusiastic about LPS as it could and should liberate the NHS and pharmacists to provide services where theyre most needed," he said.
Progress so far
A total of 18 LPS pilots were approved by the Department of Health by February 2003, seven of which were preliminary approvals where PCTs had yet to identify suitable LPS providers (see below).
PCTs with full approval were expected to start pilots in April 2003, while PCTs with preliminary approval will be given longer to complete the process as this will have to include a consultation period of 30 days, the recruitment and training of LPS providers, and, in some cases, refitting of premises.
Department of Health LPS implementation manager Theresa Prendergast says pilots should ideally be implemented within three months of approval (an additional four to six weeks for preliminary approved bids) so that they do not become outdated, as any changes to the original proposal would need to be resubmitted.
The DoH has now commissioned a national evaluation of LPS pilots by the School of Pharmacy and Pharmaceutical Sciences at the University of Manchester, led by Prof Peter Noyce. The evaluation is intended to shed light on the effective use of LPS in modernising health services provision. An evaluation report will be presented to the D0H in 2005/6.
The contractors' view
Pharmacy contractors have responded enthusiastically to LPS. Lambeth, Lewisham and Southwark PCTs received 50 expressions of interest for five LPS sites; North, Central and South Manchester PCTs received 54 contractors for 12 sites; and Brighton and Hove City PCT received 30 for three sites.
LPS offers contractors a more secure and longer-term arrangement for offering services. Many have had their fingers burnt in the past, with successful pilots ceasing abruptly because of lack of funds. Pharmacists were then left with the dilemma of whether to continue offering the service at their expense, or withdrawing a much needed service from deserving patients.
Pharmacists are generally in favour of LPS because it allows them to be more clinically involved and gives them the opportunity to make an impact on medicines management. LPS can even lead to involvement in other services such as management of minor ailments and prescribing.
LPS is also financially rewarding because payment is based on service not script volume. Pharmacists are allowed to run the LPS contract alongside their old contract for dispensing and can even opt out of LPS if they find that it does not suit them.
A way forward for pharma companies
Pharma companies can get actively involved with LPS by:
- identifying PCTs and pharmacists with priorities that match their core therapeutic areas
- establish medicine management programmes
- help develop and support LPS bids
- provide training for pharmacy LPS providers
- facilitate communication between community pharmacists, PCTs and pharma companies.
The deadline for the next wave of LPS bids is 1 September, 2003.
PCTs with approved LPS bids
Four proposals were given preliminary approval in August 2002 and this was
followed by full approval in February 2003. These PCTs were:
- North, Central and South Manchester PCT
proposed implementing waste reduction, compliance aids and medication review services
minor ailments service and medicines management on the National Service Framework for Older People
The second wave of approvals was announced in February 2003. Some 14 pilots were approved, although half were only given preliminary approvals. The 14 were:
- Northumberland Care Trust (Berwick-on-Tweed and Belford)
prescribing advice and medication review on NSF for Older People;
clinical pharmacy service for acute care
- Lambeth PCT (across PCT)
drug misuse services
- Southwark PCT (across PCT)
drug misuse services
- Lewisham PCT (across PCT)
drug misuse services
- Camden PCT (Somers Town)
pharmaceutical care monitoring targeted at ethnic minorities
- Trafford North PCT (Lostock)
medication review
- St Helens PCT (St Helens)
medication review for older people
- Blackpool PCT (across PCT)
out-of-hours service
- Chesterfield PCT (Chesterfield and North Derbyshire Royal Hospital NHS Trust)
out-of-hours service
- Brighton & Hove City PCT (across PCT)
service for assessment of need for
compliance support
- Harrow PCT (Stanmore South)
medication review for older people; training of pharmacists
- South Liverpool PCT (West Speke)
- Central Liverpool PCT (Vanhall and Everton wards)
- Wandsworth PCT (Fairfield ward)
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