I attended a very helpful PSNC conference for LPC Chairmen and Secretaries in London last week; and we had an update on LPNs - and I thought I'd share current thinking...
 
LPNs are the future for local professional clinical leadership. So, once Clinical Commissioning groups (CCGs) get up and running, the Pharmacy LPN will provide this leadership
 
They are committees that represent professional groups (in our case - pharmacy) - which will give advice to, and will influence the thinking of, Clinical commissioning Groups (CCGs).
 
LPC members must be part of this group - along with other stakeholder representatives - such as (but not exclusively):- secondary care, university pharmacy departments, commissioners, the LPF, medicines management teams and perhaps pharmacy technicians...The LPC cannot be the LPN, or part of it, as the LPN is actually part of the local area team (which is itself part of the National Commissioning Board). Clearly "governance" will play a major part to ensure conflicts of interests are managed carefully.
 
The Pharmacy LPN in our area will have a core membership and will draw on other expertise when required and will, as a consequence, be the "think tank" for clinical service re-design.
 
The LPN will be funded by the NHS. 
 
Outputs from the LPN will undoubtedly lead to commissioning of appropriate new services. As CCGs are not up-and-running yet, LPNs are being led by the PCT. Very little is happening at the moment in our locality, however, and the clock is ticking...which is worrying, particularly as our area was chosen as a pilot site, - and, in any case, we must have one by April!

At the PSNC conference last week for LPC Chairmen and Secretaries, Sue Sharpe told us that 9000 of the 11,000 community pharmacies in England and Wales, at the last count, had delivered the New Medicines Service (NMS) to patients.
 
This is indeed something to be proud of! Great for patients and an important income stream for community pharmacy.
 
The service is only funded, however, until March 2013 - and it is really important that the service evaluates well if it is to be continued...so my plea to contractors is to "keep up the good work!"
 
 The more evidence of service success at evaluation, the better... 

Community pharmacists everywhere have clinical interactions with patients every day; yet most of these interventions are never recorded anywhere. Perhaps this is because, unlike other health-care professionals, we have no need to so, and there's no incentive either - as we haven't got "registered patients."  As a consequence any data collected - as the result of an intervention - is sketchy at best (and localised in the pharmacy).

The LPC has been hoping for some time now that the PCT would see the light and invest in Pharmabase modules that would allow community pharmacists to make such records as they make their enhanced service claims. Such Pharmabase modules will allow contractors to record details of transactions efficiently on their computer systems; and as a consequencecollect data based on these interactions for use by the PSNC, and the LPC, to develop and maintain services. In addition, perhaps more importantly to contractors - this simple form of recording will make it easier to claim the fee for providing the service - cutting out most of the laborious paperwork (and posting) associated with making the claim. 

It was most encouraging, then,  to get an agreement from the PCT at last month's LPC meeting, such that they will invest in pharmabase allowing pharmacists to make EHC claims and Methadone supervision claims. We have a agreed a 6 month window to allow pharmacists to gradually adapt procedures, and ways of working, to facilitate a smooth transition to this paperless system of claims - as the LPC recognises that this will take time. Hopefully this is the thin end of the wedge, and over time we will migrate over to an electronic solution for all local enhanced service claims taking some of the stress out of paper claims?

The PSNC are constantly telling us, and quite rightly so, that the LPC must be fit-for-purpose. 

In order to fulfil this obligation the LPC often pauses in its deliberations to ensure it's the right size - and that it provides all the contractor support that it can. The talk of merger with neighbouring LPCs often comes up. 
The advantages of merger include "economy of scale" and the consequent ability to support full time paid officials to run the LPC.  The disadvantages are also obvious - merger would mean losing good committee members and local expertise - "throwing the baby out with the bathwater!" 

It's not an easy decision and historically we have come close to merger with Sunderland LPC twice already...but each time we agreed "if it's not broken, why fix it." 

Moving forward, things will change - nothing stays the same - and the LPC will find itself in uncharted water. From next April, in a world with no PCTs, we know that South Tyneside CCG will exist alone; but we also know that Gateshead CCG will be clustering with 2 Newcastle CCGs - very different to the cluster of PCTs that exist today in South of Tyne. 

The LPC will need to build strong links with local authorities - because this is where future public health services that we will offer our patients will be commissioned; as well as facilitating direct contracting between CCGs and willing pharmacies. 

As a consequence, in the coming months, your LPC will need to consider, once again, the possibility of merger, perhaps with all the other LPCs in the Northern Region to form a massive LPC with localities. This will only happen if the LPCs believe the subsequent entity will be more fit-for-purpose (and be able to serve contractors better) than what we have today - and that the benefits outweigh the negatives. We will keep you informed, as we move onwards, and the reformed NHS takes its shape.

The PSNC have agreed with the DOH to simplify the way we are paid for dispensing Methadone Prescriptions to patients from July 1st. 

This sounds great in principle - we are to be paid for "patient interactions" and not for putting the medication into measured bottles. 
We have been told that the swings will equal the roundabouts; and that the total remuneration for methadone dispensing remains about the same. 

The devil, however, is in the detail...opponents to this simplification have noted that the fees you will receive from July 1st may be significantly lower than you currently receive - if you are fortunate to dispense in daily dose bottles in advance.

 There is a lot of chatter around at the moment about this; and contractors are doing the maths - and many that have invested significantly in their methadone service think that they will lose thousands of pounds a month. There has been a calculator published by East Riding & Hull LPC - which we have hosted on our site.   I urge you to use it, and let us know how you think you will be affected by these changes...