A current perspective of British community pharmacy was outlined to the conference by Professor Ian Jones (professor of pharmacy practice, Portsmouth university) on October 13. He told Numark pharmacists that prescription numbers and total National Health Service costs were increasing while gross profit per prescription in 1998 was the worst it had been in real terms since the inception of the NHS.
Loss of remuneration based on reimbursement operating costs and of cost-plus had meant an estimated loss of at least £150m gross profit from United Kingdom community pharmacy in 1998. Only by substantial increases in productivity could contractors hope to regain the position they had attained 10 years ago, said Professor Jones.
Theft from the NHS was substantial, but antifraud measures would be successful and would be extended, Professor Jones suggested. He pointed out that a 1 per cent switch from exempt to paid prescriptions would save the NHS £36m.
He went on to call for urgent attention to be given to the community pharmacists' NHS contract, both terms of service and remuneration. He called to mind the 1986 Nuffield report, which had suggested that "payments under the NHS contract in respect of prescriptions dispensed should be reduced and separate payments made for other professional services".
Turning to medicines management, Professor Jones said that it could be a choice for community pharmacists in the future, but it was possible that patient registration with a pharmacy or an individual pharmacist might be a prerequisite for it to work. He added that the concept of accepting pharmaceutical responsibility for patients required detailed study. Formal and substantial involvement by community pharmacists in continuing education in clinical pharmacy might also be necessary.