This is, as the title suggests, a report on an advisory group.  The government has no commitment to take notice of it and is already showing signs of ignoring some of its recommendations.

Only the sections relevant to dispensing or general practice have been included in this extract.

Section 11 covers the OFT Report of 2003 and has some relevance for doctors who wish to own their own pharmacy through a limited company.

Section 15 relates to the DDA Ltd's attempt to appease pharmacy in order to close the "loophole" in the dispensing, Clothier, regulations.  Not surprisingly, as pharmacy achieves marked gains from those efforts, the Advisory Group supports them.

Editor.

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Advisory Group on the reform of the NHS (Pharmaceutical Services) Regulations 1992 Report

Executive Summary

1. This report sets out the conclusions and advice to the Secretary of State for Health of the Advisory Group on the Reform of the NHS (Pharmaceutical Services) Regulations 1992.

2. We met five times to consider the Government's reform proposals announced on 17 July 2003 and further elaborated in the Department of Health consultation document published on 29 August 2003. We also considered views received in response to the consultation.

3. As regards the concepts of competition and choice, the effect of the National Health Service Act 1977 (as amended) currently requires Primary Care Trusts (PCTs) to assess the adequacy of NHS pharmaceutical services in a given neighbourhood. If a PCT has determined that the current position is inadequate, it then considers whether it is "necessary or desirable" to award NHS dispensing rights to an applicant pharmacy. These provisions have been the subject of extensive testing in the Courts. We noted that unless exceptions to the necessary or desirable test are specified, the current framework means it is easier for a PCT to refuse an application than to approve one.

4. We noted the Government had proposed that two key questions should be assessed positively. The intention was that applications should proceed unless, when considered in conjunction with such other factors the PCT deemed relevant to take into account, they would be clearly detrimental to the adequate provision of pharmaceutical services in the neighbourhood.

5. The first key question is designed to ensure an application meets the minimum expected levels of service provision within the proposed new contractual framework for community pharmacy. Our conclusion and advice is:

• We support the introduction of the first key question so that a PCT shall not accept any application which does not meet the "essential" tier of services (to be met in due course by all pharmacies) under the new contractual framework when that has been agreed. However, we consider this can be achieved administratively and does not require amendment to the Regulations. We do not consider it necessary to reflect the next tier of "advanced" services within this provision.

• We commend the adaptation of criteria such as those being developed by the Sheffield PCTs for use in their NHS LIFT assessments to help PCTs in their evaluation of applications.

• The Department of Health should give further consideration to the transitional arrangements needed for introduction of this approach.

11. For applications from members of a consortium to establish one of the new one-stop primary care centres, our conclusion and advice are:

• The criteria defining one-stop centres should be based on the range of services offered and such centres should be part of the PCT's Strategic Service Development Plan.

• Such services should be provided at a level substantially above that of a normal GP practice, offering a range of primary care and related services to a substantial patient list, on a frequent, regular and continuous basis.

• This should not, however, preclude a range of providers who may not provide services "full-time" but who collectively offer services to a similar degree.

• However, arrangements where a number of practices are working together to provide a range of services but are not physically co-located on a single or "campus" site should be excluded from this exemption.
   
• The Regulations will need to cover situations where a service provider withdraws from a centre so that this does not require the closure of the pharmacy.

• The Regulations should define what a "consortium" is for those seeking to make use of this exemption and should specify governance arrangements.

• This should be backed up by clear guidance to PCTs.

15. Finally, we also considered work already developed by the Pharmaceutical Services Negotiating Committee, the General Practitioner's Committee of the British Medical Association and the Dispensing Doctors' Association to reform the rules governing rural dispensing which they reviewed in the light of the Government's proposals. We recommend these measures are taken forward in tandem with the other reforms planned.

(3/5/04)