Incentives are needed to encourage pharmacists to provide services in deprived neighbourhoods, the Royal Pharmaceutical Society says in its response to a Department of Health consultation document on improving shopping access for people living in such areas.
The Society's submission was approved by the Council's Practice Committee at its meeting on January 11. The committee agreed that the main part of the submission would emphasise the importance of maintaining a well-distributed network of community pharmacies to enable all members of the public to have equitable access to a range of pharmaceutical services. The services provided by pharmacists, often at no cost to government, formed an essential part of the network supporting a community. It would make sense for pharmacies to be grouped with other essential services in local centres.
The response would point out that easy access to a pharmacy was particularly important for the more vulnerable members of society. Furthermore, where a pharmacy served a community with a range of ethnic backgrounds, pharmacy staff often shared those backgrounds and could help to promote understanding in terms of language spoken by, and cultural beliefs of, people within the locality.
Noting that the discussion document highlighted a need to give much higher priority to tackling neighbourhood retail crime, the response would point out that community pharmacies faced particular challenges in this area, being often open for long hours and known to have both money and drugs on the premises. Theft, violence and aggression all needed to be addressed. Other particular security issues for community pharmacies were that they were frequently staffed by women and that a high investment was required to reduce the likelihood of crime.
On incentives to encourage pharmacists to provide services in deprived neighbourhoods, the response would recommend an extension of a scheme in parts of Scotland in which rural pharmacies were eligible for partial or full rates relief. It would also suggest that consideration be given to the impact on small retailers of systems where the rates per square metre decreased as the size of the premises increased.
The Practice Committee agreed that, subject to funding being available to support the work, the Society should continue to contribute to the development of international standards for information technology relevant to pharmacy.
The Society's head of information management and technology policy (Mr Ian Shepherd) told the committee that during 1998-99 the Society had received external funding amounting to about £13,000 to support work with the European Committee for Standardisation (CEN) and the International Organisation for Standardisation (ISO) to develop international standards. Achievements to date had included international prescription message standards and a set of referral and discharge messages for use between primary and secondary care. Ongoing involvement by the Society would entail attendance during the coming year at several CEN and ISO meetings. However, no funding had as yet been promised by the Government's new information authority.
The committee recognised the importance of continuing to contribute to international IT standards, which would also help to support the Society's input to Government debates. The committee also agreed that the potential for support from an international pharmacy body be investigated. Such a body might be willing to nominate a United Kingdom representative to provide input to international IT standards on behalf of its members.
The Practice Committee was informed that the pharmacy sector committee of the Science, Technology and Mathematics National Training Organisation had put together a bid for Qualifications and Curriculum Authority funding to review the existing level 3 Scottish/National Vocational Qualification in pharmacy services and to develop a new level 2 qualification. However, the potential QCA funding would not cover all the project costs and the pharmacy sector committee needed to identify other sources of funding to help meet the development costs.
The committee identified some possible sources of funding and agreed to pass the suggestions to the Society's representatives on the pharmacy sector committee.
The Practice Committee agreed that the next topic for the Society to address in preparing practice guidance on long-term conditions should be the role of the pharmacist in treating and preventing coronary heart disease and stroke. The guidance would reflect the pharmacist's contribution to patient care in both the primary and secondary sectors. It could also include smoking cessation, which had been identified by the Department of Health as one of three priority areas in its national priorities guidance for 2000-01 to 2002-03 in addition to the priorities set out in the "Saving lives" White Paper.
The committee noted that the National Pharmaceutical Association had recently published a pharmacy health improvement framework for CHD, and it was agreed that discussion should be held with the NPA before a proposal was drawn up and costed for commissioning the practice guidance.
The committee also agreed that a proposal should be drawn up for producing guidance to pharmacists on services to drug misusers and on emergency hormonal contraception, since drug misuse and teenage pregnancy were the other two additional priorities identified by the Department.
The Practice Committee agreed that the Society should develop generic guidance for pharmacists on counter prescribing for self-limiting minor illness and common conditions, and then move on to consider condition-specific guidance.
The committee recognised the general move towards clinical decision support systems to promote consistency and quality of advice, and it was suggested that algorithms for responding to symptoms similar to those used in NHS Direct might provide a useful starting point. While computer based systems facilitated data collection and audit, it would also be important to examine the scope for paper-based systems. A practical, effective approach was needed that would not deter people from seeking advice in community pharmacies.
The committee agreed, as a first step, to request a presentation of NHS Direct algorithms. It would also seek examples of algorithms already in use for responding to symptoms that would support a consistent approach while not being overprescriptive.
The Practice Committee agreed that a document should be produced to increase the focus on pharmacy's contribution to public health. It would take into account the outcome of discussions that were to be held in February with the chairman of the Health Education Authority (Ms Yve Buckland).
The Practice Committee agreed that the Society's response to a Medicines Control Agency proposal to allow non-pharmacy sale of topical mepyramine maleate should express reservations about such a change.
In a recent consultation letter (MLX256), the MCA had proposed that 2 per cent mepyramine maleate for external use, in packs of no more than 25g, should become a general sale list medicine for the relief of stings, bites and nettle rash in adults and children aged two years and over.
The committee noted that sensitisation was a problem associated with mepyramine and that sales through pharmacies would provide an opportunity for members of the public to be warned of this possibility and advised on alternative products where appropriate. In many cases, mepyramine would not be the treatment of choice. In view of these concerns, the committee agreed that the MCA should be asked to take full account of the views of dermatologists before making any decision on the proposal.
The Society's response would also express the committee's belief that a maximum pack size smaller than 25g would be appropriate for this product.
The Education Committee noted that additional Government funding might be made available to improve pay and conditions for academic staff in higher education through implementation of the recommendations of an independent review committee, chaired by Sir Michael Bett.
Following the committee's meeting in September, 1999, a letter had been sent to the Secretary of State for Education (Mr David Blunkett), calling for the full implementation of the Bett report. The reply from the Department for Education and Employment and a statement in the House of Lords had given some cause for hope. In addition, the committee had been informed of a recent suggestion from within the Government that any improvement in pay and conditions would be accompanied by a move to "individualised pay bargaining".
The committee resolved that the Society's secretaries in Scotland and Wales should consider writing to the Scottish Executive and the National Assembly for Wales, respectively, in the same vein as the chairman's letter to the Secretary of State.
The Education Committee agreed to recommend that, should a proposed restriction of the "master" degree title to postgraduate qualifications be implemented, then extended first degrees such as the four-year pharmacy degree should be given a compound title including the word "bachelor". The committee would also recommend that the change should be made simultaneously across the United Kingdom, so that no institution, school, department or programme was relatively disadvantaged, and that attention should be paid to students who were already engaged on undergraduate masters programmes.
The recommendations were to be made as part of the Society's response to a consultation by the Quality Assurance Agency for Higher Education (QAA). Restricting the use of the masters title was part of a QAA proposal for establishing qualifications frameworks setting out definitions of qualifications applicable throughout the UK.
Among other things, the Society's response would also welcome the suggestion that generic qualifications should be distinguished from specific ones, suggesting that for pharmacy it would be logical to use "Pharm" or "Pharmacy" in the registerable first degree title.
In addition, the response would welcome a proposal that the MPhil title should be reserved for masters programmes of work requiring the equivalent of at least two years' full-time study and assessed solely by final dissertation.
The Education Committee approved a two-stage approach to reviewing policy on the Society's accreditation of pharmacy degrees. First, a working party would be appointed immediately to carry out a rapid review of current procedure, followed by any necessary reform. Secondly, once the QAA's new system had emerged, a more fundamental review would be carried out, taking the QAA system into account.
It was also agreed that the degree accreditation working party should be asked to consider the place of an institution's research assessment exercise rating in relation to the acceptability of a pharmacy degree course to the Society.
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Branch observers The following observers from the Society's branches attended the meetings of Council committees on January 11: Mr Charles Flint (secretary of the Society's North Hampshire branch); Miss Lynne Hodgson (representative of the Society's Bath and West of England region); Dr Catherine McKean (representative of the Society's Glasgow and West of Scotland branch); Mrs Francesca Shearcroft (representative of the Society's Reading branch); Dr Brian Wells (representative of the Society's Hull branch); and Mr Peter Wilson (secretary of Society's Burnley branch). |