Commissioning services and the new community pharmacy contract: (3) uptake of enhanced services

Aim: To identify (i) the enhanced services primary care trusts had commissioned, (ii) whether the service had been commissioned before the start of the new community pharmacy contract, (iii) the contractual option used, (iv) the number of community pharmacies providing the service and (v) their plans for commissioning in the future. Design: A self-completion questionnaire. Subjects and setting: All PCTs in England. Results: The response rate was 74%. The enhanced services commissioned by most PCTs were supervised administration (88%), needle and syringe exchange (85%) and stop-smoking (77%). The services commissioned least by PCTs were gluten free foods (2%), home delivery (2%) and schools service (1%). In terms of the number of community pharmacies providing enhanced services, stop-smoking was the most widespread, provided by 2,118 community pharmacies (36%). 81% of all enhanced services commissioned across all PCTs had been commissioned before implementation of the new contract. In terms of numbers, stop-smoking was the service commissioned by most PCTs after the implementation of the new contract (43 PCTs). The service with the highest level of commitment to commission in the next 12 months was minor ailments. Service level agreements were by far the most frequently used contractual arrangement by PCTs (69% of all enhanced services). Conclusion: The impact of the new contract on enhanced service commissioning levels has been modest. Commissioning of services for substance misuse and smoking cessation are high, mapping onto national priorities for public health.