When a practitioner, Clare Mackie, was appointed as the head of the school of pharmacy at the Robert Gordon university in Aberdeen, our interest was immediately aroused. She was bound to do things that a dyed-in-the-wool academic would not do. It did not take long to find out what that might be. When we interviewed Professor Mackie in late 1998, we heard about her plans to replace the school's old dispensing laboratory, where generations of students had learnt the art of pharmaceutical manipulation, with a "pharmaceutical care centre" designed to simulate the practice conditions of today (PJ, October 3, 1998, p546). The centre would, among other things, have work-stations for general medical practitioners and practice nurses and create a hospital pharmacy scenario. This was the environment in which the practice of pharmacy was to be taught. The new facility was officially opened last week (p501).
As our report on the new development indicates (p515), the pharmaceutical care process being taught follows the now classical model of identifying patients' needs, formulating a care plan to meet those needs and monitoring and reviewing the progress of treatment. The problem is that this could create cohorts of graduates capable of fulfilling such a function before practice conditions have been changed to accommodate it, because pharmacy practice is still largely wedded to supply. Fortunately, however, there are signs that there could be change. The Scottish report on Clinical Pharmacy Practice in Primary Care (PJ, April 17, p527) is built round the model of pharmaceutical care that is found in the Aberdeen course. Since the report was produced by the Clinical Resource and Audit Group of the Scottish Office, it has an impeccable pedigree. All that is needed now is the political will to implement it. Little has been done about this so far. But it should not be too long before something is achieved. The demands of improved clinical governance will require the enhanced supervision of the medication process that is enshrined within the concept of pharmaceutical care.
The Robert Gordon university deserves the profession's congratulations for supporting the creation of the school's new centre. The school will now be able to produce practitioners able to provide a service that offers a great deal more to patients than the current supply-orientated system.
Fortunately, it is not alone in this. Similar developments are taking place in other schools, notably, Bath and Nottingham. Education is moving ahead of practice and policy. This really is a bottom up revolution.