Decommissioning of locally commissioned services
Published on: 3rd August 2013 | Updated on: 15th March 2022
Where a community pharmacy contractor is concerned about the potential for a locally commissioned service to be decommissioned, they should initially contact their LPC.
Community Pharmacy England guidance for LPCs
Healthcare financial constraints are prompting the review of many locally commissioned services with the risk that some may be considered for decommissioning. Where this is occurring in your area, it would be helpful if you could inform Rosie Taylor, Head of Service Development, in order that Community Pharmacy England is able to monitor this threat to pharmacy services from a national perspective.
If your service commissioner is considering decommissioning a locally commissioned service, we suggest that you consider the following:
- Contractual terms – what does the service contract or SLA say about termination of the service? Does the service commissioner’s proposal fit within the contractual terms?
- What is the underlying reason for the decision to decommission? What can we learn from this for the future if it is a legitimate decision?
- How are other service providers being treated by the commissioner? Is a fair and transparent approach being adopted?
- How is pharmacy performing in relation to targets set for the service? Are the targets realistic?
- What is the cost, including opportunity cost, of decommissioning the service? What are the possible unintended consequences that may add to costs elsewhere in the health and care system?
- Have you or the service commissioner reviewed the service recently or undertaken a service evaluation (including assessment of patient satisfaction)? What does this data show? If it shows patient benefit, can you use this data to defend the service?
- What is the impact on the Pharmaceutical Needs Assessment of withdrawal of the service? Could it create gaps in service?
Where you intend to fight against a decision to decommission a service, you may want to consider the following options, in addition to detailed discussions with the commissioner:
- Discussions with the other LRCs in order to garner support for the ongoing commissioning of the service;
- Discuss the decommissioning proposal with the Health and Wellbeing Board, presenting evidence on how the withdrawal of the service will impact on care;
- Discuss the proposal with the local Member of Parliament;
- Where appropriate seek support from local authority councillors, particularly the Cabinet member with responsibility for health and the members of the Overview and Scrutiny Committee covering health;
- Where appropriate seek support from relevant patient groups and individual members of the public; and
- Where appropriate seek support from the local media.
Where you are faced with the potential for a service to be decommissioned, please let Community Pharmacy England know so we can monitor such activity at a national level and provide you with support to try to prevent decommissioning.
Community Pharmacy England Briefing 094/13: Local commissioning challenge checklist (September 2013)
Community Pharmacy England receives requests for advice from LPCs each year on how to tackle commissioner’s decisions to decommission a service or determinations not to commission a service from community pharmacy. This Community Pharmacy England Briefing provides advice on how to challenge these decisions.