Visions in 2003
... and there's more
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
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
19/12/02 - Pharmacy Magazine
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?
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
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