Until autumn last year, few pharmacists had heard of pharmacy development groups (PDGs), although the concept had been around for a while. PDGs are groups of pharmacists established to develop the profession locally. The need for them occurs particularly in England, since other mechanisms for developing pharmacy locally are available in Scotland and Wales.
PDGs were developed as part of the Society's Pharmacy in a New Age (PIANA) initiative, and it was a conference at the Society's headquarters last November (PJ, December 11, 1999, p960) that really helped to establish their potential role, particularly in the minds of the 80 or so pharmacists who attended.
The main aim of pharmacy development groups is to take the profession forward by harnessing enthusiasm and expertise. Although this is an aim that pharmacists have always eschewed, only so much can be achieved on an individual basis. Working in a group, with the commitment, co-operation and collaboration which that involves, is crucial to taking the profession further forward. And that is what PDGs are all about.
In the words of Mr Peter Curphey (a member of the Society's Council), who chaired the November conference, PDGs represent a way in which pharmacy can make a real difference over the next few years. PDGs co-operate with local pharmaceutical committees (LPCs) to respond to strategy documents, work up bids for new and extended pharmaceutical services and get pharmacy integrated into local strategies.
An integral part of their role is, of course, to convince others of the value of pharmacy's contribution. And as a significant pharmacy network, they have the potential to offer a concerted pharmacy voice at a local level.

How to get involved

Because the pharmacy development group concept is relatively new, and experience in establishing groups is relatively limited, guidelines to help in setting them up are being produced by Ms Anne Adams (project manager, Building the Future, PIANA).
Although the pharmacy development groups now in existence have been formed in different ways in response to local needs and interests, and as a result, have different objectives from each other, they are all concerned with development of the profession and, as such, they have more common elements than differences.

Networking

The Society's guidelines remind pharmacists that forming a pharmacy development group is above all about networking - both with other PDGs and other interested parties in the locality.
PDGs are currently at different stages of development - some are functioning as subcommittees of LPCs or have evolved from health authority working groups, while others are freestanding groups with no particular allegiance to any pharmacy organisation. Anyone wanting to establish a new PDG can save themselves a great deal of time and effort by finding out what other groups are doing and how and why they have established their objectives and priorities.
One way of getting in touch with other groups is to telephone the Society's "Pharmacy in a New Age help desk" (tel/fax 0115 939 6465). However, as part of a new development due for launch in late April or early May this year, pharmacy development groups will be able to talk to each other on a national website - Pdgtalk.net - so helping to disseminate ideas and information rapidly and spread best practice.
This initiative will also enable pharmacy development groups to develop their own web pages, where they can, for example, publish minutes of their meetings, post notices or hold closed discussions. The group itself will decide which pharmacists can have access to the site, and a local PDG member will be appointed to be the key "net" contact person for the PDG. He or she will have the job of adding or removing information from the site, and each pharmacist registered as a member of the group will be able to initiate and contribute to discussions within the group.
Where pharmacy development groups have relatively few members with internet access, national discussion could be initiated through one key contact person, or it may be possible to participate through Ms Adams at the PIANA help desk. This important initiative will do much to foster that vital ingredient of any PDG - ie, communication.

Getting started

The Society's guidelines identify key decisions that should be taken in the early stages of setting up a pharmacy development group. One of the first is to decide your geographical boundary. This can be an area covered by the local health authority, primary care group or trust.
Having decided on your area, you can then think about whom to include in your group. PDGs involve building relationships, often with people with whom you have had little previous contact. Membership can be flexible, but it should be cross professional and involve all stakeholders. In particular, a PDG should include the health authority pharmaceutical adviser and a member of the local pharmaceutical committee, and ideally also a member of the Society's local branch committee, the Centre for Pharmacy Postgraduate Education local tutor as well as pharmacists from every branch of the profession - owners, employees, community, hospital, primary care groups, academia and industry.
Another early decision to be taken is your strategy. Without clear aims and objectives, your chances of success will be limited. As always, vision and effective leadership are key to strategy development. Clearly, however, a strategy cannot be developed out of thin air. You need to get to know the agendas in your locality. Again this involves networking, with PCGs, trusts and health authorities.
In considering potential service development, focus on areas on the primary care group agenda, including issues relating to prescribing, clinical governance and the health improvement programme. The Society guidelines provide a reminder to do your research thoroughly and to aim to fill gaps in local services, while matching the agendas of local stakeholders. Some PDGs have found an audit or SWOT (strengths, weaknesses, opportunities and threats) analysis of community pharmacy in their locality to be a useful starting point. Be careful about duplicating effort in a locality and ask pharmacists what they consider to be feasible in terms of service development. Not only does this identify local needs, but it also seeks to involve everyone.
Wide involvement and wide consultation are, of course, important to the work of a PDG, but to get a job done, you need some structure to your group and a small steering group to take things forward. It is also important to appoint subgroups to work on separate agendas. Decide who should take the lead, and as your group gets off the ground, think about appointing a secretary and treasurer.

Funding

Having a treasurer, of course, assumes having money, something which has so far been difficult for PDGs. However, groups have obtained money from sources such as PCGs, pharmaceutical manufacturers and health authorities. It is not impossible.
Moreover, the Society has been offering professional development awards to help the development of professional services locally. There are two levels of awards. At the lower level, an award of up to £500 will be made to help develop a PDG infrastructure. At the higher level an award of up to £3,000 will be made to help extend the contribution of pharmacy in a locality.
The closing date for the current round of bids for professional development awards was the end of January. According to Ms Adams, 32 applications have been received for the lower level awards and 46 for the higher level awards. The adjudicating panel meets this month to decide who will receive awards and will consider the views of a PCG in deciding on the suitability of the bids.

What can go wrong?

There are several pitfalls to pharmacy development and pharmacy development groups have already experienced some of them. So, talking to others may help you to avoid the worst of them.
Lack of time, money, commitment and confidence are familiar barriers to taking the profession forward in any context, but professional rivalry, poorly researched and badly planned initiatives and working on too many initiatives at once can all hinder progress. And as anyone who is involved in groups such as churches, golf clubs and school parents' associations knows, there is the ever present problem of relying on the same small group of enthusiasts to do all the work.
Above all, an inability to involve and communicate with other pharmacists and other health professionals will do more than anything to stop progress. Not surprisingly, the Society's guidelines identify communication, co-operation and commitment as the keys to success.

West Surrey experience

Raising the profile of pharmacy, developing services and bringing together pharmacy organisations in the locality were the key drivers for the establishment of the West Surrey pharmacy development group, according to Mr Leigh Machell (professional development pharmacist, Moss Chemists). "We recognised that a PDG could help us develop the profession locally in a way that other bodies could not," he says.
Although in its formative stages, the group already has a wide membership, representing a broad spectrum of pharmacists within the area, including the Society's branch, the health authority, the local pharmaceutical committee, three acute trusts, a community trust and the Centre for Pharmacy Postgraduate Education, as well as multiple and independent contractor pharmacists. However, Mr Machell is aware of the need to spread the net even further and a mailing to all pharmacists in the locality is planned.
One area the group wants to work on is secondary care discharge of vulnerable patients. "These patients often receive a great deal of pharmaceutical care in hospital, but this work can be lost when they are discharged, simply because of the patient's need for ongoing support to understand and comply with their medication - support which is not always there." The group has already obtained some primary care development money from West Surrey health authority to carry out preliminary work in this area.

Bury and Rochdale experience

Established 12 months ago, the Bury and Rochdale pharmacy development group has 30 regular members, with 60 pharmacists on its mailing list.
Ms Leanne Hannah (primary care pharmacist, Boots), who is joint co-ordinator of the Bury and Rochdale group, says that the group has just completed a consultation process with the aim of deciding how to take the group forward. The main things to come out of this process are that members want a more formal structure to the group with pre-set meeting programmes, subgroups and greater contact with the primary care group. And their aim in working with the group is to increase their job satisfaction.
The Bury and Rochdale pharmacy development group has submitted a bid for health action zone funding to conduct an aspirin audit and Ms Hannah says they are expecting to hear soon. Other areas the group is looking at include services to patients with diabetes and older people. One member of the PDG is currently negotiating remuneration for supervision of methadone administration.
The pharmacy development group has representation on the prescribing area subcommittee and from recent meetings with primary care group executives, has found that the local PCGs are "very supportive".

Milton Keynes experience

Enthused by the Society's conference in November last year, Ms Louise Cowan (community pharmacy adviser, Buckinghamshire health authority) spoke to the director of public health at the local health authority, and a decision was taken to establish a group based on Milton Keynes, which had just moved to trust status. Having identified from the conference the importance of getting all the appropriate people on board, Ms Cowan set up a preliminary meeting which included the primary care group pharmaceutical adviser, the health authority pharmaceutical adviser, the local pharmaceutical committee secretary, other LPC representatives, the local Centre for Pharmacy Postgraduate Education tutor and representatives from the trust and the local branch.
A meeting in February this year, to which all local contractors were personally invited by telephone, was convened to explain what PDGs were and how community pharmacists could work with them. A decision was then taken to form a PDG and to develop a skills questionnaire to identify special interests in the membership.
The group aims to develop a couple of projects initially, probably focused on shared care arrangements, because this is one way of getting maximum involvement locally from the start. Training is another area the group is considering and it may seek to provide courses covering generic skills relevant to service development.

Gloucestershire experience

The origins of the pharmacy development group in Gloucestershire date back to October, 1998, when a core group of 10 people met to consider the development of the profession in the area.
Ms Evelyne Beech (community pharmacist, Bourton-on-the-Water, Gloucestershire), who is involved with this group, says that a decision has now been taken to establish a pharmacy development group formally. The group will be a free standing one rather than affiliated to the health authority or the local pharmaceutical committee, although it will have representation from both bodies.
Of the 350 pharmacists in Gloucestershire, 35 have so far expressed interest in joining the group, and a database of the skills and interests of pharmacists from community, hospital, the trust and the health authority has been developed.
Areas that the group would like to work on include the supply of emergency contraception by community pharmacists, out-of-hours pharmaceutical care and setting up a directory of pharmacy services to be disseminated to the police, educational bodies and pharmacies across the county. A group protocol for emergency contraception has been developed, says Ms Beech: "If we can get money, we have a wonderful opportunity to get up and running,"