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Local pharmacy leadership is essential if pharmacy is to move forward at the local level. That was the key message from each of a series of presentations in the morning session of the conference.
Pharmacy had the opportunity to begin to contribute more fully to the delivery of local health improvement programmes, speakers said. Local pharmacists should start to work with the key decision makers at the local level and explore how pharmacy could deliver improvements in health to local people. No national strategy for pharmacy could be anywhere near as effective as local action.
Challenges
Setting out the challenges for pharmacy in the North West, Mr PETER ROWE (head of primary and community care, NHS Executive North West) said that the population in the North West had the lowest life expectancy in England. Five North West health authorities were in the lowest 10 HAs for life expectancy for men; and the figure increased to eight HAs when one looked at the lowest 10 for women. The North West also featured badly for all determinants of ill health, including unemployment and smoking.
The Government's modernisation agenda and the move to primary care trusts (PCTs) offered pharmacists many opportunities to help improve the statistics, Mr Rowe suggested. PCTs were the only organisations with all the powers needed to commission, provide, co-ordinate primary, secondary and community care and to work with social care.
The challenge was how to get pharmacy involved. It could only happen if local pharmacists got together and planned for the future.
Left to right, Carol Brooks, Peter Rowe and Jeanette Howe: local leadership essential
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Modernisation
Expanding on some of Mr Rowe's thoughts, Ms JEANETTE HOWE (acting chief pharmacist, Department of Health) said that pharmacy did not function in isolation. To be realistic, it needed to be set in the context of policy for health and social care services as well as changes in consumer expectation and retailing.
Ms Howe set out the main points of the Government's modernisation agenda to remind the audience of the priorities for health and social services. She said that modernisation was the theme running throughout the Government's policies for the public sector. The expectation for health and social care was no different.
National Health Service funding was to grow by more than 6 per cent a year, over and above inflation, from now to 2004. But if this extra investment was to make a real difference, the way in which it would be spent was very important.
Two conditions had to be met. The first was that the service had to be organised efficiently. The second was that it had to deliver preventative as well as sickness services. To do this, the NHS had to modernise to deliver better, faster, fairer and more convenient services.
While grounded in health and social policy, the vision for pharmacy would be created bottom-up as well as top-down. Local developments were just as important as national developments.
While Ms Howe acknowledged that some changes, such as those requiring legislation, could only be achieved nationally, she said that local leadership, local initiatives and local developments groups could also make a difference. There was nothing to stop local pharmacists moving ahead and making that difference themselves.
A vision for pharmacy
Ms CAROL BROOKS (senior fellow in health services management, Manchester Centre for Healthcare Management) described early work on a project she has been involved in, examining local leadership in the 21st century. Working with a team of North West pharmacists, she was hoping to provide the template of a vision for pharmacy that could be used as a resource by local pharmacists.
Ms Brooks said that pharmacy had to change. Drivers for change included the pharmacists' expanded role, the move to primary care trusts, information technology, clinical governance and the NHS modernisation agenda.
The pharmaceutical profession had to start to plan the future workforce to achieve this long-term vision. It needed to look at the potential new roles for technicians and assistants. It needed to make itself a key member of the health care team, seizing new opportunities and involving itself in strategic planning.
Information technology opened up possibilities to achieve seamless care across the sectors. Pharmacists had to start thinking outside the box of their own area of expertise.
In summary, local leadership was essential to making thing happen. In some areas there might not be obvious pharmacy "leaders". It would be up to local pharmacists to work together to decide who would take the process forward.
Local action
Following the three main presentations, the audience had the opportunity to hear how three successful projects in the North West had got off the ground (see panels below).
The afternoon session provided the participants with the chance to develop action plans for implementation within their own health authority areas. The key factor that featured in most of the action plans was the need to establish communication networks between local pharmacists.
Committed
Speaking after the meeting, Mr BILL BROOKES (secretary of the Society's Mersey region), who was one of the meeting's organisers, said that the turnout of 140 people showed how committed North West pharmacists were to making a difference. The organisers acknowledged the difficulty in taking a day out of everybody's busy schedule to attend a meeting like this, particularly where locums were at a premium. But the key message from the meeting was that local pharmacists had to make the time to become involved in the wider health care agenda or it would be those same local pharmacists who lost out in the long run.
The organisers hoped that a similar conference in 12 months' time would be able to show real achievements across the region. - contributed by Helen McKnight (secretary of the Society's Northern West region).
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Emergency hormonal contraception through pharmacies
Ms KAREN O'BRIEN (community liaison pharmacist, Manchester health authority) gave the background to the Manchester, Salford and Trafford health action zone project on emergency hormonal contraception. She said that the project had started on December 24, 1999, following the realisation that there was a need for patient access to emergency contraception over the millennium holiday period.
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Karen O'Brien: pharmacists should "just go for it"
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"It was not the community pharmacists' first choice of project," she said, "but the opportunity was there for community pharmacy to meet a local health need. There would not be another opportunity like this for quite some time".
Initially 18 pharmacists had "gone live" on December 24, 1999. More than 70 pharmacists were now trained to deliver the service.
Supply via a group protocol had only been able to take place following the approval of the protocol by both Manchester health authority and Salford and Trafford health authority and completion of a training course and background reading organised in conjunction with Centre for Pharmacy Postgraduate Education. Accredited pharmacists had also had to pass a multiple-choice examination.
The project had been an example of true multidisciplinary working, with family planning practitioners, health action zone colleagues and the local medical committee all contributing to getting the project up and running in a very short time.
Challenges had included constraints in how the project could be promoted initially, due to nervousness about public reaction, and sensitivity in dealing with girls under 16.
More than 1,500 women had received emergency contraception since the start of the project. The median age for supply was 23 years, so the group would next be looking at how to raise awareness of the scheme in teenagers. The pharmacists involved believed strongly that emergency contraception should be free at the point of supply.
Interest in the scheme had been phenomenal from patients, health professionals and ministers. Even patients from as far away as Southampton had asked if they could travel to Manchester to receive emergency contraception.
When asked by other pharmacists for advice about getting similar projects off the ground locally, Ms O'Brien's advice was "just go for it".
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