Primary care partnerships
Published on: 10th February 2022 | Updated on: 20th August 2023
Primary care is the main point of entry to healthcare services, acting as the ‘front door’ to the NHS. It includes general practice, community pharmacy, dental, and optometry (eye health) services.
Given their accessibility, community pharmacies are a key part of the primary care sector. In recent years, it has become more important for pharmacy teams to engage with their fellow healthcare professionals.
The NHS Long Term Plan has increased focus on local leadership and commissioning with the objective to bring care closer to home. As a result, a significant part of primary care funding will flow through Primary Care Networks (PCNs).
A PCN consists of groups of general practices working together with a range of local providers, including across primary care, community services, social care and the voluntary sector, to offer more personalised, coordinated health and social care to their local populations. They are the ‘building block’ of local healthcare systems and generally cover local populations of 30-50,000.
The future development of local services will be influenced by PCNs, and they will be the local focus for primary care provision and potential future local sub-contracting. Community pharmacies are engaging with their PCN through a pharmacy lead who works with the PCN leadership. Local Pharmaceutical Committees (LPCs) also drive this work through discussions with PCN leaders on developing pharmacy services to help meet key public health objectives.
Whilst a community pharmacist could undertake additional training to work as a clinical pharmacist in a PCN, the position would be separate from their role working in a community pharmacy. A key benefit of community pharmacy is that it sits at the heart of communities.
In 2016, the NHS and local government came together in 44 areas across England to develop proposals to improve health and care. They formed new partnerships – Sustainability and Transformation Partnerships (STPs) – to run services in a more coordinated way, to agree system-wide priorities, and to plan collectively how to improve peoples’ day-to-day health. STPs have subsequently evolved into 42 Integrated Care Systems (ICS), a new form of even closer collaboration between the NHS and local government.
ICS are responsible for planning and funding health and care services in the area they cover. Since 1st July 2022, within each system, there is an NHS body – an Integrated Care Board (ICB) – which took over the responsibilities of the former Clinical Commissioning Groups. The ICS also contains an Integrated Care Partnership, which is a joint committee between the ICB and the upper-tier Local Authorities within the system.
Pharmacy representation in ICS
Community Pharmacy England has been working with the other primary care contractor representatives to press for fair representation for all primary care providers, including pharmacy, in new health and care systems.
The Health and Care Bill, currently being considered in Parliament, would shift the responsibility for managing contracts for primary NHS services to new Integrated Care boards (ICBs). In its current form, the Bill specifies that ICBs include a member nominated by General Practice, with no representation from any of the other primary care professions. This is despite GPs accounting for only about a third of the primary care workforce in England.
In summer 2021, we joined with the leaders of the British Medical Association, British Dental Association, Optometric Fees Negotiating Committee and National Community Hearing Association, in writing to the Health and Care Bill Committee members to raise concerns about these proposals.