With newspapers highlighting them, patients groups responding to them and local pharmaceutical committees (LPCs) scrutinising their every word, pharmaceutical needs assessments (PNAs) – although they may not sound like the most exciting reads – are difficult to ignore at the moment.
PCTs are at last starting to get to grips with the assessments and most either have, or are about to have, a version out for consultation. And with the deadline for having sign-off approaching in February 2011, and at least a two-month consultation period required before then, it’s probably about time they did.
But with the trusts on their way out under radical NHS reforms, pharmacists are right to ask just how much PNAs are going to matter in the future. Experts are unanimous in their response to this, however: they do matter, and you do need to look at them.
Simply put, the documents are going to be used as commissioning tools, identifying health needs so services can be planned around them, and industry leaders think for this reason they will always be useful.
Jonathan Mason, the Department of Health’s community pharmacy tsar, points out that, whatever the NHS looks like in future, needs assessments are always going to be an important function. It’s difficult to tell exactly how the documents will be used, but it’s possible GP consortia will need to consider them, for example. And as the documents are supposed to link to joint strategic needs assessments (JSNAs) produced with local authorities, they’re unlikely to be completely forgotten.
Furthermore, even if considering them isn’t vital in future, pharmacy could use them as evidence for services it would like to offer. As one PCT employee told C+D, the assessments provide real evidence-based documents showing the need for services: “Pharmacy has got a very powerful weapon here if they are used correctly – they can present these documents to commissioners as evidence for the need for services.”
Where they work, this should all bode well for pharmacy. And the good news is that C+D has found, using the Freedom of Information Act, that in the last 18 months 96 per cent of trusts have met with their LPCs to discuss the PNA (see p6), which must be a start at least. But multiples have told C+D the PNAs they have seen are not consistent, with some good and others “a mish-mash mosaic”
It’s clear where they are not good pharmacy needs to have a say – but how can you tell good from bad and what exactly should you look for when your PCT puts its PNA out for consultation?
If you can’t face reading the whole thing, the most important points to check are the ones about your own pharmacy, looking at whether they are accurate. For example, John Evans, superintendent pharmacist at Asda, says one PNA had commented that the nearest parking to an Asda pharmacy was over half a mile away, when in fact there were nearly 1,000 spaces in the store car park.
Errors or omissions can be dangerous. As Steve Lutener, head of regulation at PSNC, says: “If the PNA map of current providers does not show all pharmacy premises, then that could mean that the PCT has not taken into account services being provided by the pharmacy. If the public look at the PNA when they are seeking out services, then the ‘missing’ pharmacies could lose out.”
Furthermore, as PNAs may be used as the basis for entry to the sector in future, if it appears on the PNA that existing pharmacies are not meeting a need even if, in reality, they are, the trust could be obliged to allow new applications to succeed regardless of the existing businesses.
Things are tricky here as there is a delicate balance to be struck. On the one hand it could be good for the PNAs to identify gaps in service provision, giving scope for new services and possibly pharmacies, but on the other, these gaps need to be genuine or competition may become unsustainable. PSNC is urging contractors to look at the documents and where necessary align their offering to the needs identified, and multiples have told C+D this is their strategy.
This can be a useful business planning exercise to ensure you are really meeting your patients’ needs, and means you can respond to the consultation explaining your willingness to provide services in the future.
If you’re struggling, try contacting your LPC for help with a PNA. Mr Mason says you could also compare the assessments with JSNAs to ensure no key health needs have been missed. Colleagues and other local contractors may also be willing to discuss the document with you.
But, however you do it, you should take the time to respond to the consultation. As Mr Mason says: “Pharmacists should be reading what is in there and if they’re happy with it they can just say so. If they feel there are statements relating to their pharmacy that are wrong or questionable, it’s very important that they do respond.”
And with the deadlines looming, it’s probably now or never for the documents that may very well shape the sector’s future.