From Dr A. Shallal, MRPharmS
SIR,-The recent tragic "peppermint water case" (PJ, March 11, p390) represents a defect in the procedure of preregistration training. This tragic experience, in my opinion, highlights the necessity for hospital-community training for all preregistration students (six months in each). Training in both hospital and community pharmacies within the year would have many advantages and serve many useful purposes. The trainee would benefit from the stringent procedure for extemporaneous preparations that is followed in hospital training. Those who have a career as hospital pharmacists would know more about community pharmacy. This would help them to cope with the pressure of community dispensing and variations in dispensing techniques such as the use of parallel imports and generics, should they take locum vacancies.
Those who have a career as community pharmacists would have a better understanding of procedures in hospital pharmacy. This would reduce the shortage of hospital pharmacists by filling the gaps with locums from the community sector; although their main training is in community, they would have also had some training in hospital. Community pharmacists would learn more about the different types and uses of dressings, an area where they lack experience.
I do not suggest that such training is going to eliminate the incidence of cases like the "peppermint water case" but such an incident highlights the necessity for a different regime. The withdrawal of extremporaneous preparations from the community pharmacy is not a solution. The most useful approach is to widen the scope of training as I have suggested. This would have to be compulsory and, to facilitate its implementation there would have to be a "swapping procedure" in place. This procedure would have to be promoted by the Royal Pharmaceutical Society through its education division, which currently has neither an active role nor a strategy in the selection and filling of preregistration vacancies.
Asaad Shallal
London NW9