ANNEX E – Consultation Reply Form

Building on strengths: delivering the future – draft Regulations to the Health Act 2009 – Pharmaceutical Needs Assessments

Consultation Reply Form

Closing date for responses: 28 February 2010

Please fill in and/or tick the appropriate response.

Response form
Name:
Vanessa Taylor
Contact address including postcode:
East Sussex Local Pharmaceutical Committee
50 Rockington Way
Crowborough
East Sussex TN6 2NL
Organisation representing (if appropriate):
East Sussex Local Pharmaceutical Committee
Email


Freedom of Information

We manage the information you provide in response to this consultation in accordance with the Department of Health's Information Charter.

Information provided in response to this consultation, including personal information, may be published or disclosed in accordance with the access to information regimes. The relevant legislation in this context is the Freedom of Information Act 2000 (FOIA) and the Data Protection Act 1998 (DPA).

If you want the information that you provide to be treated as confidential, please be aware that, under the FOIA, there is a statutory Code of Practice with which public authorities must comply and which deals amongst other things, with obligations of confidence. In view of this, it would be helpful if you could explain to us why you regard the information you have provided as confidential. If we receive a request for disclosure of the information we will take full account of your explanation, but we cannot give an assurance that confidentiality can be maintained in all circumstances. An automatic confidentiality disclaimer generated by your IT system will not, of itself, be regarded as binding on the Department.

The Department will process your personal data in accordance with the DPA and in most circumstances this will mean that your personal data will not be disclosed to third parties. However, the information you send us may need to be passed on to colleagues within the UK Health Departments and/or published in a summary of responses to this consultation.

I do not wish my response to be passed to other UK Health Departments

I do not wish my response to be published in a summary of responses

Are you responding: - as a member of the public

- as a health or social care professional

- as a pharmacist/appliance contractor

- on behalf of an organisation

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Area of work:

NHS
Social Care
Private Health
Third Sector
Regulatory Body
Professional Body
Education
Trade Union
Local Authority
Trade Body
Other (Please give details)
Local Pharmaceutical
Committee / √
Independent Contractor to NHS [
Manufacturer
Supplier
Other (where relevant)

If you are responding on behalf of an organisation, please indicate which type of organisation you represent:

NHS
Social Care
Private Health/Independent Sector
Third Sector
Regulatory Body
Professional Body
Education
Trade Union
Local Authority
Trade Body
Other (Please give details)
Local Pharmaceutical
Committee / √
In which of the following areas do you live: (please tick one box only)
North East
North West
West Midlands
South East / √
London
Humberside/Yorkshire
East Midlands
East of England
South West
No answer

Organisations do not need to answer questions 1-7

1 What is your sex?

Tick one box only.

Male
Female
Prefer not to say

2 What is your Age?

Age
Prefer not to say

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3 Are your day to day activities limited because of any health problem or disability which has lasted, or is expected to last at least 12 months?

Tick one box only.

Yes, limited
Yes, limited, a little
No
Prefer not to say

4 Do you look after, or give any help or support to family members, friends, neighbours or others because of either long-term physical or mental ill-health/disability or problems related to old age?

Tick one box only.

Yes
No
Prefer not to say


5 What is your ethnic group?

Tick one box only.

A White
British
Irish
Any other White background, write below
below
B Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed background, write
belowbelow
below.
C Asian, or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background, write below
below
D Black, or Black British
Caribbean
African
Any other Black background, write below
below
below
E Chinese, or other ethnic group
Chinese
Any other, write below
F Prefer not to say

6 What is your religion or belief?

Tick one box only.

Christian includes Church of England, Roman Catholic and all other Christian denominations.

None
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Prefer not to say
Other, write below

7 Which of the following best describes your sexual orientation?

Tick one box only.

Only answer this question if you are aged 16 years or over.

Heterosexual Straight
Lesbian / Gay Woman Woman
Gay Man
Bisexual
Prefer not to say
Other, write below

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Draft regulations under the Health Act 2009: Pharmaceutical Needs Assessments - consultation


Building on strengths: delivering the future – draft Regulations to the Health Act 2009 – Pharmaceutical Needs Assessments

Consultation

Consultation Questions

1.  The Department welcomes comments and views from all interested parties on the draft Regulations for PNAs, draft accompanying guidance and consultation Impact Assessment.

2.  We would particularly welcome views on the following questions:

Chapter 2

1.  Do the requirements for PNAs adequately reflect the likely needs for pharmaceutical services locally?

(Yes) Please circle as appropriate

If not, what other needs for pharmaceutical services should be reflected?

2.  Are there any other elements which should be included?

(No) Please circle as appropriate

If yes please let us know which should be included and why.


Chapter 3

3.  Draft Schedule 3A sets out the mandatory information Primary Care Trusts need to include in their PNAs. Do you have any comments on these categories?

(Yes) Please circle as appropriate

Comments

As an LPC we are concerned about the identification of services for which there is an immediate need, as for the future, these will enable a mandatory granting of a new contract application – this may discourage PCTs from including services under this heading

As an LPC and a representative of contractors we are keen to see that services identified are those that the PCTs are ready, willing and able to commission and are appropriately funded and remunerated

Services that a PCT would like to provide for the future should only be highlighted in the PNA as valuable services to commission. This will prevent inevitable challenges if the service is identified as a “need” by those applying for a new contract.
Existing providers will be aware that in the future they may be asked to provide the service. Potential new applicants will be able to make applications when funding is available, if existing providers decide against providing the new service.

4.  Are there any other areas which should be mandatory?

(Yes) Please circle as appropriate

Comments:

Details should be provided of any pharmaceutical service provided by other providers.
This may be an NHS Trust, the PCTs themselves or any other provider.

Examples include NHS Trusts providing medicines to primary care, PCTs centralised procurement of dressings and work provided by pharmaceutical advisers or other personnel providing advice to care homes or medicines use reviews in patient’s homes
These are recognised in the NHS Act 2006 as being primarily the role of NHS pharmacy contractors (cont)


It would be helpful if these could be listed separately to enable the LPC to work with contractors to see if a service could be provided by existing pharmacies.

Chapter 4

5.  Are all relevant interested parties included in consultation requirements in draft regulation 3F?

(Yes) Please circle as appropriate

6.  Is a minimum 60 days adequate for consultees to make their responses to the relevant Primary Care Trust?

(No) Please circle as appropriate

If not, what would be reasonable?

Comments

We feel that a 60 day time limit is too short as it would be difficult for LPCs to fully
consult with pharmacy contractors. East Sussex LPC meets bimonthly and for us a 60day timescale would be too short
In line with other government consultation periods we feel that the timescale should be 90 days.

7.  Is there further information required on the consultation process?

(Yes) Please circle as appropriate

If yes, please provide examples.

Comments:

Consultation arrangements should be the same as those required by central government.

To ensure uniform standards, the cabinet office guidelines on consultation should be adopted.

8.  Is it clear what the scope of a PNA is and when it should be revised?

(No) Please circle as appropriate

If not, how could we make it clearer?

Comments:

It will be important to make sure that the PNA is revised if there are changes which would be relevant to the granting of a new contract.

This is one of the reasons why PCTs and LPCs need to take the market entry arrangements into their discussions during the development of the PNA or responding to the current consultation. It shows why the consultation cannot take place in isolation to the market entry arrangements.

The requirement to revise the PNA when changes occur will mean that PCTs will continually face challenges from potential new providers whose applications have been rejected on lack of need.

The LPC agrees with the principle of a supplementary statement but it should be through a full formal process, including consultation.

In view of the pressures that PCTs may face from challenges from new applicants it is important that there should be an appeal mechanism.

The LPC would be in favour that anyone can request that the PCT consider publishing a supplementary statement. The SHA or HOSC could provide a supervisory element.

If the PCT then considers the request and decides it is not appropriate to publish a supplementary statement, then no further requests should be permitted for a further 12months. This would avoid applicants making repeat requests.

9.  Is it clear what the scope of a supplementary statement is and when it could be produced?

(Yes) Please circle as appropriate

Further comments

10.  Are there any other relevant comments outside of the above questions?

Comments:

The proposed Regulations cover only the PNA it is difficult to understand how this can be considered in isolation to the revised market entry arrangements. The first PNAs need to be produced by February 2011 and this PNA will be used to determine market entry from April 2011.

This leads to a number of considerations:

There is no right of appeal to the PNA. The LPC suggests that it should have the right to take concerns to the SHA with regards to:

Any points which the LPC have raised during the consultation and have not been addressed
Any points in the final PNA which had not been included in the formal consultation

The SHA and or HOSC should be obliged to consider the representation and the authority to require the PCT to review the PNA if it is felt necessary.

The LPC is also very concerned that there is insufficient resource within PCTs to produce a robust PNA. It is also important that the PNA has a board level sponsor.

The LPC understands in some areas where a full pharmaceutical service may not be viable it is necessary to have a dispensing only service from a dispensing doctor.

The PNA will establish across the whole PCT the services currently available and any gaps in service provision. This will include where a dispensing only service is available.
PCTs may be reluctant to publish such information as this may exacerbate any tensions between dispensing doctors and community pharmacists in rural areas.

The NHS is facing a period of financial restraint and it is possible that payment for commissioned services could reach uneconomic rates, leading to pharmacy contractors

withdrawing from service provision this would then lead to the PCT ceasing to commission the service.

There is also the possibility that pharmacy contractors could be forced to provide services at an uneconomically low fee because of the fear that it will lead to the granting of a new contract to a contractor who is willing to provide the service.

Impact Assessment

11.  Do you agree our estimate of the likely costs and benefits?

Comments:

To produce a robust PNA will require collaborative working between the LPC and the PCT which will be at a cost to contractors. The costs appear to have been included in the impact assessment however we would respectfully suggest that consideration be given to factoring in to the development costs, to fully fund meetings between the LPC and PCT staff


Equality Impact Assessment

12.  Are there matters not included in the Equality Impact Assessment for consultation which should be?

Yes No Please circle as appropriate

If yes, please let us know what they are.

No comment

13.  What further information would support Primary Care Trusts’ own equality impact assessment of their PNA?

Further information

No comment

14.  What data and other local information will Primary Care Trusts use to reflect differing local health needs in terms of ethnicity, age, gender, disability or other specific equality issues?

No Comment

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