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The challenges facing ICBs – learning from early adopters

Pharmacy News

The challenges facing ICBs – learning from early adopters

From 1 April, as every LPC knows, responsibility for commissioning pharmaceutical, general ophthalmic services and dentistry (POD) has been delegated to integrated care boards (ICBs) with the aim of moving towards primary care services that are more joined up, locally led and locally responsive.

A report from the NHS Confederation has looked at the experiences of nine early adopter systems which took responsibility for commissioning some or all POD services in July 2022. It concludes there is an opportunity to transform care for patients but that ICBs will need to operate to realistic timetables and manage the transition smoothly if the desired changes are to be achieved.

Early adopter POD commissioners identified immediate transition challenges including ensuring adequate governance is in place, understanding and meeting commissioner and provider data requirements and developing effective engagement mechanisms with local providers.

NHS Confederation says support from NHS England needs to avoid risk aversion, permit innovative approaches to improving health outcomes and reducing health inequalities, and not create barriers to implement different approaches.

For ICBs, the report says their immediate task will be to manage the logistical and governance challenges of shifting the management of existing contracts and that they should invest time and effort in building relationships with POD service providers.

In pharmacy, the report notes, there is a stronger track record of local commissioning than for dentistry or ophthalmic services, alongside well-established links between community pharmacy and ICB medicines management teams. In many areas pharmacies have been providing locally commissioned public health services for some time.

One of the most pressing tasks for ICBs taking on POD commissioning management functions will be to ensure that they have access to the full data sets they need. The report found variance in what data different adopter systems could access, and says that for pharmacy, access to data is a mixed picture.

“For the community pharmacy sector, generating high-quality data is important to demonstrate the impact of new services in reducing pressure in other parts of the primary care landscape such as general practice,” the report says.

“For instance, when patients with a particular condition are diverted away from general practice to pharmacy for an aspect of condition monitoring, it is important for both providers and commissioners to understand what outcomes were achieved for that cohort of patients.

“This is a vital component of ICSs’ ability to look at the financial impact of interventions across the whole system and drive NHS productivity.”

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