APTUK has responded to the Primary Care Networks Service Specifications draft document.
Please see below for all response:
Referring to the ‘proposed service model’ and ‘proposed service requirements’ sections of each of the services described in this document:
1. Is there anything else that we should consider for inclusion as a requirement in this service? For example, are there approaches that have delivered benefits in your area that you think we should consider for inclusion?
The service requirements are encompassing and reflect the ambitions of the 10 year plan.
Work to evaluate schemes that already have a clinical evidence base could be strengthened and included in the requirements. Using a contractual framework that enables tested and valued services to remain will provide some consistency and sustainability as services evolve. If funding is re-purposed these services may be lost. A mechanism for evidencing and applying for funding locally should be included within the PCN remit and decision making authority with oversight from NHSE.
2. Are there any aspects of the service requirements that are confusing or could be better clarified?
The service requirements are clear and concise but there should be the opportunity to reflect local population needs, for example flexibility to modify workforce model and services to align with local healthcare needs. Principles and core specifications could be agreed by PCNs with rationale as to where their focus will be. This will allow innovation and targeted resources for best local outcome.
3. What other practical implementation support could CCGs and Integrated Care Systems provide to help support delivery of the service requirements?
CCGs are experts in procurement, commissioning and contracting combining this expertise with PCN multiprofessional expertise will enable services to meet local population needs. Understanding why some CCGs deliver services and how these could integrate into PCN to share practice and innovation will support transition. CCGs are also well placed with organisational memory to share why something has been successful for patients and service outcomes.
4. To what extent do you think that the proposed approach to phasing the service requirements is manageable in your area?
The challenge is workforce, ensuring a sustainable supply that doesn't destabilise other areas of healthcare.
To ensure safe, effective practice, staff need to be recruited and trained appropriately with educational and clinical supervision. A focus on pipeline and not drain from other sectors needs appropriate planning and time to embed. This will support the full realisation of the knowledge and skills those additional healthcare professionals can contribute to patient care, rather than a generic workforce to plug a current workforce shortage.
For example, pharmacy technicians are well placed in terms of knowledge and skills to support patients with making the most of their medicines. They can manage case loads and refer complex clinical decision making to appropriate HCP. This would support a triage approach. Reviewing medication usage, discussing how patients manage their medicines including stock control, storage and use, identifying where shared decision making or referrals are required, identifying patients that fall into the service requirements and managing interventions such as inhaler technique, flu immunisations etc will enable HCP to focus on complex clinical outcomes aligned with their professional knowledge and skills.
Pharmacy Technicians complete a 2-year qualification to register, if a pipeline was supported on a national scale a sustainable regulated workforce could be implemented utilising an apprenticeship. Governance, supervision models could be built in utilising models already tested in other sectors.
5. Referring to the ‘proposed metrics’ section of each of the services described in this document, which measures do you feel are most important in monitoring the delivery of the specification?
No response as not best placed to answer.