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Local councils and local politicians will appreciate the need to have pharmacists as allies, says Graham Jones, who is both a pharmacy proprietor and a councillor.

The changing of the commissioning landscape for public health has led to accusations of bias and flawed decisions by politicians... so how can pharmacy plot a way through what, for many, will be a very unfamiliar culture?

Commissioning

The commissioning of public health services will be done either through the public health team at the council or the health and wellbeing board. The board will be politically led (councils are allowed up to 50 per cent of the representation) but will encompass membership from CCGs, the director of children's services, as well as representation on behalf of patients (local Healthwatch).

The board, which meets in public and is responsible directly to the local authority, will usually be chaired by a senior councillor (often the leader). All councils will adopt and publish a health and wellbeing plan. Unlike any other area of council expenditure, public health budgets are ring-fenced and growing.

€Associating with pharmacy services has many positives for a media hungry local politician€

Understand politicians

It has been observed in the past by some that €politics is show business for ugly people€ (I have a face for radio). Sidestepping the subjective issue of attractiveness (and in fear of upsetting friends and colleagues), politicians at whatever level share a trait with show business in that they want to get themselves noticed. They have egos (myself included) that need to be filled.

Local councillors will also want to (and want to be seen to) deliver for their communities, be it their ward/town/district/borough/ city/county. A backbench councillor will focus very heavily on his/her ward, whereas a cabinet member will take a broader view. Politics is competitive and the wish to score points off other political parties is usually strong.

Councillors and councils will want to be able to demonstrate their achievements. This may be by hard data (smoking cessation success rates) or visibly by associating themselves with high profile initiatives. They hate being associated with failure, such as being at the bottom of the league for any particular indicator (e.g. teenage pregnancy).

Public health professionals

The professional support for the politicians and the HWB will come from qualified public health consultants, many of whom pharmacists will have established relationships with when they worked for PCTs.

They will have objectives set by the board and politicians, and will advise the board. Any well-run authority will be €member led and officer advised€.

Local dynamic

When considering bidding for a public health service it is important not just to know the local plans and priorities but also to have a feel for the local political dynamic. Make sure local politicians at all levels buy into what you are seeking to achieve.

As well as building up a relationship with the movers and shakers on the HWB, consult your local ward councillors €“ they will appreciate being asked for advice and pharmacy will gain buy-in by allowing them to help shape the service.

Politicians would give their right arm for the level of trust community pharmacists have with their customers and patients. Associating with pharmacy services has many positives for a media hungry local politician.

At a time of austerity and diminishing budgets, the temptation for councils to use public health money for other areas loosely associated with €wellbeing€ (such as libraries) is huge. One strength of local councils and councillors being held responsible for public health decisions is that they are accountable to the electorate. If there is a failure to commission pharmacy services, be prepared to ask questions as to why. If money is not used on public health, work with LPNs across pharmacy, dentistry and optometry to apply pressure.

It may well be worth consulting the local Healthwatch group and discuss concerns with them. As the watchdog for local health provision, they can be powerful allies if resources are not going where they should.

Above all politicians, at whatever level, are interested in delivering for their electorate. Community pharmacy is all about community engagement and service delivery €“ things which are highly complementary to local authorities generally and essential for the delivery of high quality public health.

_{Graham Jones is chair of the Thames Valley LPN, a councillor for West Berks Council and an independent pharmacy owner.}