Visions in 2003

Pharmacists could offer services traditionally only available at GPs surgeries, including medication review and patient monitoring, under proposals published by the Department of Health today.

Following hospital pharmacists' pioneering work, pharmacists will be prescribing by the end of the year.

A Vision for Pharmacy in the NHS – a strategy document setting out what high street pharmacies could look like in the future aims to:

* Provide patients and the public with high quality professional advice in making the best use of medicines – both prescribed and those bought over the counter;

* Give patients more choice and convenience – including making it possible for people to get their repeat medicines for up to a year without having to contact their GP surgery;

* Deliver more pharmacies with longer opening times; and

* Make the best use of pharmacists, for example so that they provide advice on healthy eating, smoking, sexual health and so that they are involved in the wider promotion of health.

A progress report on discussions on a proposed new contractual framework for community pharmacy is also published today. This will support:

* updating arrangements under which pharmacies provide NHS services;

* delivering further improvements to the range and quality of services that community pharmacists will offer patients in the future; and

* the integration of community pharmacy within the NHS family.

The issues that should be considered when setting up a minor ailments scheme have bee considered in a briefing paper produced by the RPSGB.

Minor ailment schemes usually allow pharmacists to supply patients with medicines, without the need for a GP consultation or prescription.

Better Management of Minor Ailments: Using the Pharmacist lists the dozen schemes that are already in place in England and Scotland and explains the rationale behind the establishment of such schemes. The benefits for pharmacists are described as: “making better use of professional skills and working in a more integrated way with other members of the primary healthcare team.”

In the foreword, Dr David Colin-Thome, the primary care ‘tsar’ says: “Pharmacists have an important role to play in providing alternative support for patients in a convenient and accessible manner from their local community pharmacy.”

The paper will be distributed to primary care trusts and key health bodies.

July 2003

Visions in 2002

Conflict of Interest
After generations of sneering at dispensing doctors for their "conflict of interest" the National Pharmaceutical Association (NPA) seems to have hypocritically changed its tune.   John D'Arcy, NPA Chief Executive, told the Young Pharmacists' Group meeting recently, that the conflict of interest should not be a barrier to pharmacist prescribing.   Dispensing doctors already had such a conflict, as did community pharmacists over OTC sales and pharmacists don't exploit this conflict, he said.  Exonerating dispensing doctors stuck in his craw.    Realising the problem, he said that community pharmacists should not prescribe that would not be very clever thinking, he continued and this principle has to be sacrificed if the chemist is to take up the role of supplementary prescribing.   Mr D'Arcy has abandoned pharmacy principles for profit.
19/12/02 - Pharmacy Magazine

Supplementary prescribing
Lord Hunt tells pharmacists they will be prescribing early in 2003 yet the Pharmaceutical Services Negotiating Committee (PSNC) Chief Executive Sue Sharpe says community chemists could face a problem accessing training for the task.

Pharmacists say that supplementary prescribing will improve care for patients but is this evidence based or just more propaganda?

Independent prescribing
Chemists have been told by Gul Root, principal Pharmaceutical Officer at the DoH that although independent prescribing for chemists in on hold it might happen later.   I must have missed something.  When did all those chemists enrol in Medical School?

Pharmacy Medication Review
The world is being told that pharmacists can play a key role in reviewing medications.   There will be four review levels:
Level 0: opportunistic and unstructured
Level 1: prescription and repeat prescription review without chemist access to patient's notes
Level 2: treatment review with patient's notes.  This assumes, daringly, that the chemist knows what he's doing and has been through 5 years medical education.
Level 3: A full clinical review with the patient and his notes.   It includes OTCs.

Pharmacists says they can do everything - even without a medical education - and are prepared to visit patients at home.  Meanwhile their dispensing will be left unsupervised but, of course, that is not a problem to today's hypocritical, principle abandoning chemist.

Pharmacy diagnosis
Sample this for arrogance:
"Supplying chronic medicines through pharmacies raises a question over who makes the diagnosis - the doctor or the pharmacist?  Few would argue in favour of moving this responsibility to pharmacists immediately:  doctors are trained to diagnose, pharmacists are not.   And if it is the doctor who diagnoses pharmacists will need access to patient records in order to confirm the diagnosis.  Otherwise pharmacists will need significant new training in diagnosis."

No doubt the chemists will push a couple of keys on his computer and out pops a diagnosis.  he will have had two weeks training to learn which keys to push and how to choose a larger till for the extra fees from the NHS.

As part of these changes chemists are pushing for an increased number of medications to be removed from the POM list to the P list.   It is possible that these "improvements", hastily made for pharmacy profit and delusions of grandeur, may well be lethal to more than one patient if granted to all community pharmacists many of whom work in professional isolation.

Pharmacy strategy for the future
Mr mark Collins, East Lancashire LPC secretary says "There is a ladder of pharmacist involvement:  repeat prescribing management with the next rung medicines management, then supplementary prescribing and the top rung is independent prescribing"

So, it's not just dispensing doctors they are trying to get rid of but GPs also.  What an intolerable bunch.