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Exclusive: A grouping of contractors in the north of England are demanding answers from their respective local pharmaceutical committees regarding their “lamentable” progress in integrating a currently “fractured” network of five LPCs.  

Twelve business owners representing a total of 52 NHS pharmacy contracts co-signed a letter on April 11 to the chairs and chief executives of the five LPCs falling with the North East and Cumbria Integrated Care Board region (NENC ICB) urging them to poll local pharmacies on a proposal to create “a single regional body” aligned with the ICB’s geographical footprint. 

The LPCs cover the following areas: Tees Valley; Durham & Sunderland; North Cumbria; North of Tyne; and Gateshead & South Tyneside. 

The owners who put their names to the letter – several of whom have served on these LPCs themselves in the past – complained that despite contractors in England having voted “overwhelmingly” in favour of the Wright Review Steering Group’s (RSG) proposed overhaul of pharmacy representation in 2022, progress in the NENC region has been “lamentable”. 

Following a number of mergers, there are currently 50 LPCs active in England compared to 70 when the ‘transformation programme’ was launched in 2022. The same year saw the creation of England’s 42 ICBs. 

‘Trivial discussions’

The April 11 letter acknowledged the perceived threat a merger could pose for existing committee members and LPC employees but said pharmacy owners are facing “significant financial threats” to their own businesses and are ill-served by their levies being spent on “excessive duplication, communication and meeting expenses”. 

“The rationale for a fragmented LPC network is exceptionally weak,” the authors said as they accused the LPC executive teams of a “perceived inability or unwillingness to challenge inadequate funding”. 

“There appears to be no evidence of constructive engagement with the ICB,” they wrote, commenting that with NHS England soon to be abolished the role of ICBs will become ever more important.  

They add that “many” LPCs are “predominantly composed of non-contractors with no financial stake in outcomes”.

Mark Burdon, a signatory of the letter who was an LPC member for over 20 years and who sat on the RSG, told P3pharmacy that LPCs are “still having discussions about things that are relatively trivial”.

“My fear is that they’re missing out on the big-ticket items,” Mr Burdon said, citing the failure to develop direct lines of communication with the ICB chief executive as a key example: “We’re not even on their radar.”

He commented: “For me it boils down to one specific issue, which is governance – particularly the cost of governance.

“The LPCs haven’t done enough to address this issue; doing it five times is very inefficient and costly. That governance should have all been moved upstairs to one central place where it can be done properly.

“What we need now is for the LPCs to take an objective view… they’ve had three years to do this and they haven’t yet done enough.”

‘Nightmare’ over fee imbalances

Durham contractor Kevin Simpson told P3pharmacy that part of the impetus for his signing the letter came when contractors asked why successful efforts in Gateshead & South Tyneside to negotiate a 100 per cent fee increase for methadone provision were not being replicated across the NENC region. 

“To be truthful, the response was not what I would have expected as a contractor who’s paying a levy to these representatives,” Mr Simpson said.  

“Lots of us now have pharmacies across those different regions, and having different schemes with different pay rates is a nightmare.

“Why should someone in Sunderland get paid more for doing an emergency contraception than somebody in Middlesbrough?”

He added that having previously sat on LPCs himself, “you’re giving up your time to discuss local pharmacy issues but the results never materialised”. 

‘Our good people are too spread out’

Mr Simpson told P3pharmacy: “We’ve got some good people in the North East, but they’re spread out over a large geographical region. 

“With the demise of NHSE, the ICB will be the place to be – but I don’t think there’s any pharmacy representation on the ICB board.”

Merging the five LPCs into one body would benefit the pharmacy network through lowering governance costs and contractor levies as well as more “strategic and focused engagement” with ICBs, the letter argued.

And it claimed a merged LPC would also be in a better position to put pressure on Community Pharmacy England to be “a more pro-active, effective and transparent structure than is currently the case”. 

Representatives for Tees Valley, Gateshead & South Tyneside, North of Tyne and Durham & Sunderland all said the letter and its proposals will be considered at their next LPC meetings. 

North Cumbria LPC did not respond to a request for comment.