The Pharmaceutical Journal Vol 264 No 7089 p484
March 25, 2000 Forum

Local Pharmaceutical Committee Representatives' Conference

Clinical governance: funding concerns expressed

The LPC conference held a short debate on clinical governance issues for community pharmacy. During this some concerns were expressed about funding, the involvement of the Royal Pharmaceutical Society's inspectors in the process and on health authorities appointing staff to lead clinical governance.
Mr STEPHEN AXON (general secretary, PSNC) said that guidance issued by the Royal Pharmaceutical Society in January had stressed that the clinical governance lead position should be held by a community pharmacist. In Wales, the position would probably be held by the local health group board member. Despite this, there had been reports of some clinical governance leads being drawn from outside community pharmacy.
Mr Axon emphasised that clinical governance was about enabling pharmacists to compare their practice privately. It was not a policing function and the involvement of the Society's inspectors was a minor, advisory one.
The time commitment for the lead role was estimated at two to three sessions per week and might require the appointment of several leads per primary care group.
No specific funding had been provided to health authorities for clinical governance in community pharmacy, Mr Axon said, but, since health authorities had accountability for the process, funding would need to be made available. Some outside funding had been provided for training purposes.

Mr JEREMY CLITHEROW (Mersey group of LPCs) said that he had found a conflict between the pharmacy view of clinical governance, which was about looking at what was being done and learning from that, and the health authority or primary care group view, which was focused on reducing overspends on drugs budgets. General medical practitioners were to be forced to have meaningful appraisals every year under new proposals for the medical profession. This would be forced on pharmacy contractors, too, if they did not actively participate in clinical governance. Mr TONY CARSON (Kensington, Chelsea and Westminster) said that he supported the concept of clinical governance, but he was unsure how far to go with it without funding. He also expressed a number of concerns about the baseline assessment exercise being undertaken by the PSNC, citing, in particular, confidentiality as a problem area. Ms MARGARET HOOK (Avon) said that in her area GPs had held a discussion about how they would cope with pointing the finger at colleagues who were failing and how they could be helped to practice better. Pharmacists, too, needed to hold such a discussion. One way forward which she suggested was the use of critical incident monitoring in pharmacies. This would cover not only bad things, such as dispensing errors, but also good things, such as when staff handled difficult matters in a positive way.

Jeremy Clitherow: health authorities and PCGs do not share our view of clinical governance

Correction (PJ, April 1, 2000, p522)

The baseline assessment exercise for clinical governance in community pharmacy discussed at the local pharmaceutical committees' conference was produced by the Royal Pharmaceutical Society and was distributed to LPCs by the Pharmaceutical Services Negotiating Committee for local use.