NACEP, the National Association of Co-operative Executive Pharmacists, celebrated its 50th anniversary at its annual conference at Stratford-upon-Avon on October 8 to 11
In order to play a more developed part in health care, pharmacists need to work in closer partnership with all who use, shape and deliver services in the National Health Service, the Vice-President of the Royal Pharmaceutical Society (Mr Marshall Davies) told the conference.
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Marshall Davies |
Mr Davies was convinced that the problem was not that pharmacists and doctors did not want to talk to each other, it was that, as busy people, they tended only to do it in a crisis. He admitted that this did not make for a happy relationship but was adamant that communication between members of the health team was not an option - it was a duty.
He added that the Society had been working with the National Health Service Executive on winter planning issues and on a campaign on antibiotic resistance.
The Vice-President was sure that working with the National Pharmaceutical Association, the Pharmaceutical Services Negotiating Committee and the Company Chemists Association had given pharmacy a united voice for the first time. This, he believed, would make a significant difference to the level of understanding of pharmacy issues at Westminster.
Asked about registering pharmacy technicians with the Society, Mr Davies said that, although no final decision had been made, there were strong arguments for registration.
"The role of pharmacy has and will in the future require a close working relationship with technicians," he said. "If they are going of in tangents with allegiances to other bodies that will exacerbate the difficulties."
Mr Davies added that the Crown report offered wide-ranging opportunities for pharmacists in the role of dependant and independent prescribers. The first area in which one was likely to see pharmacists prescribing was emergency contraception.
"Now these opportunities are available to us, it would be a sin to waste them," Mr Davies said.
A passionate plea for more hard evidence of the detrimental effects that the abolition of resale price maintenance would have was made by the Community Pharmacy Action Group secretary (Mrs Susan Sharpe).
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Sue Sharpe |
Giving an example of the type of facts she would urge people to come forward with, she described a project that had been carried out with Mr Derek Drurie, a NACEP member.
To prove that the loss of RPM on over-the-counter medicines would affect more than the 25 per cent of pharmacy business that they comprised, Mr Drurie had surveyed the customers of 15 pharmacies. Seven out of 10 of those who had bought OTC medicines had also bought toiletries.
"We need to get to a level of evidence that gets past 15 pharmacies, but it has given us a good sign of where to go," said Mrs Sharpe.
She explained that the case was being fought through five gateways, each of which had to be proven if RPM was to be retained. They were:
To be successful, the CPAG would have to prove not only that a gateway was detrimental to consumers, but also that this outweighed the detriment of RPM.
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David Sharpe |
Pharmacy did not necessarily spring to mind when one was talking about the Co-operative movement; banking or retailing sprang to mind more readily, said Mr Bill Shannon (head of corporate affairs, Co-operative Wholesale Society).
However, the CWS was involved in pharmacy and its chief executive (Mr Graham Melmouth) was very much involved with RPM and related competition matters.
Mr Shannon described co-operatives as the real "third way" which offered a modern, appropriate, and viable alternative to the public and private sectors.
Being a co-operative, with co-operative ownership, had many advantages, such as not being subject to immediate stock market pressures, he said. This allowed the business to take a long-term view. One thing, however, did not change and that was the need to be successful as a business.
"We are not interested in running a successful business which is not a co-operative, nor a co-operative that is not a successful business," Mr Shannon said.
Pharmacists have led that way against fraud in the National Health Service, according to Mr Jim Gee (director of counter fraud services, NHS Executive).
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Jim Gee |
This was an example of basic, streamlined checks that were needed in every area of the NHS.
"Countering fraud in the NHS is not just about having a counter-fraud directorate, you all have a role to play." Mr Gee said.
The results of studies into how effective point of dispensing checks had been would be published in a report due out in December.
Mr Gee illustrated the "mammoth" task and how little was known about the scale of fraud in the NHS by recalling his first press conference after he had been appointed. He had been briefed that prescription fraud alone accounted for losses to the NHS of around £76m. By the time he actually started his job three months later this figure had almost doubled.
"Even in areas we did know something about, we did not know nearly enough", he said.
By the end of the year he intended to have hard facts that were better than in any other public sector organisations about the scale and nature of fraud in the NHS.
Early successes included the investigation of around 150 cases of fraud, some of which had been sent to the Serious Fraud Office. There had also been a recent arrest.
"Our function is to provide a professional service to the NHS, to NHS managers and patients, freeing up as much resource as soon as possible to focus on patient care," Mr Gee concluded. The NHS was finding itself in the novel situation of being able to allocate recovered resources. The practicalities of where the recovered money should go were still being worked out.
Mr John D'Arcy (director, National Pharmaceutical Association) told participants to focus on pharmacists' core strengths and to work towards being recognised as part of the managed health team. He stressed that any new role pharmacists wanted to take on needed to be connected to medicines.
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John D'Arcy |
He then considered why it was that pharmacy was so often marginalised and side-lined. His explanation was that pharmacy was considered to be part of the free market and not part of the managed health team.
"This is the task ahead for the next few years - getting ourselves recognised. To be in a position that if somebody is writing a document on anything involving medicines, the pharmacist is in there as a matter of right," Mr D'Arcy said.
The NPA director said that, while there had been progress in terms of getting pharmacy mentioned in the "NHS modern, dependable" White Paper, they still needed to achieve greater involvement in primary care groups. This was because the real danger would be the establishment of primary care trusts, which would govern budgets of over £60m.
"We need to be able to develop our services to make sure that we are consistent with what PCTs want," he said.
Clinical governance was a key issue which needed to be taken seriously, Mr D'Arcy went on. Clinical governance was about quality assurance and the problem with pharmacy was that it could not assure consistent quality.
"It is essential that we get our house in order," he stated. "The message coming through to us from Government in respect of pharmacy is the concern about variability. That is something we as a profession need to get to grips with," he said.
Turning briefly to the long-awaited new Government strategy for community pharmacy, the NPA director said that there were two rumours about why it had not appeared. They were either that the Government did not know what to put in it or that it was so long term that Ministers wanted to get it absolutely right.
Mr D'Arcy opted for the latter.
Contacting the Pharmacists' Health Support Scheme does not amount to shopping a colleague. It is asking for help for someone who cannot ask for himself."
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Joe Mee |
Addiction was disproportionally high among intelligent, well qualified individuals, because knowledgeable people were good at coming up with reasons for denial. Denial played a big part in the problem. About five years could pass between the time when addiction started to affect performance and the final stage when it became obvious. "The last thing to go is job performance," Mr Mee said.
The choice of the substance of addiction was often related to the addict's field of expertise. Pharmacy was the profession that came top of the field when looking at addiction to drugs.
Mr Mee assured pharmacists of total confidentiality. Finishing on an upbeat note, Mr Mee said that recovered addict were very efficient members of the communities in which they lived and worked. The PHSS had a 90 per cent success rate.
The Pharmacist Health Support Scheme can be contacted on 01926 315138.