The Royal Pharmaceutical Society's "Over to you" roadshow finished its nation-wide tour on June 25 at the Society's headquarters in London - having previously visited Nottingham, Manchester, Dundee, Cardiff, Taunton, Leeds, Merseyside, Sunderland, Birmingham, Cambridge and Winchester.
As at its previous venues, the roadshow was chaired by a member of the Society's Council - in this case Mrs Pat Hoare, who explained that the roadshows were designed to help pharmacists think about their professional future and work towards that future in a constructive way.
Mr ROGER ODD (the Society's head of professional and scientific support) told the audience that more than 2,000 pharmacists had already seen the roadshow. Feedback had been positive and revealing. Most of those attending had previously known little about the New Age and for many it was their first meeting about it.
Mrs ANNE ADAMS (the Society's national co-ordinator for Pharmacy in a New Age) described the establishment of local pharmacy development groups, with membership from across the profession. They worked closely with local pharmaceutical committees, and had the potential to take pharmacy forward, giving individual pharmacists support and the profession a concerted voice at local level.
Any pharmacists interested in setting up a PDG could contact her on the PIANA help-line (tel/fax 0115 939 6465).
A system for organising shared care and treatment of substance misusers who were prescribed methadone was described by Ms MARION WALKER (local co-ordinator for the scheme), giving the first of two presentations on pharmacy initiatives in the London area. She said that the scheme involved a four-way agreement bringing together pharmacists, general medical practitioners, the local drug team and the patients. It had been implemented across the four primary care groups in West Berkshire. |
Marion Walker: four-way agreement in methadone therapy |
Remuneration was the key to success, since if those participating had confidence in the payment system they would have confidence in the alliance itself. The remuneration system worked as a "slot" system of payments. Each payment slot was for 12 months for which the GP and pharmacists were both paid. This avoided the need for individual GPs and pharmacists to submit separate claims for each patient. It also acknowledged the difficulties of linking payment directly to treatment time, which could vary widely.
A patient wishing to enter the four-way agreement would be assessed by a key worker from the drug support service and then asked to nominate a GP and a pharmacy. The key worker would liaise with the GP and pharmacist on behalf of the patient and complete the relevant paperwork that formed the four-way agreement.
Pharmacists did not have to accept a patient as part of the agreement. They were simply advised that a patient had identified their pharmacy. The choice to take on that patient was entirely that of the pharmacist.
The agreement had been a resounding success, with all four West Berkshire PCGs meeting the Department of Health target that 20 per cent of GPs should prescribe for drug misusers - in fact the average across the four was 44 per cent.
Ms Walker warned that to get involved with a project of this type one needed to be professional, persistent and patient. But there were clearly opportunities for pharmacy out there. The key was making any new project fit the health agenda.
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Beginning a joint presentation on the Barnet primary care development fund, Mr MICHAEL BEAMAN (pharmacy adviser, Barnet health authority) said that the scheme had the simple purpose of improving the health services available to Barnet residents. This was achieved in a number of ways, including developing the quality and range of care provided, enhancing skills within primary health care teams, and funding developments in primary and community care settings to provide high-quality, cost-effective and accessible alternatives to those services provided in hospitals. |
Michael Beaman (left) and Gerald Zeidman: improving health care for local residents |
The key to the success of all of the projects was training. The most successful schemes to date was High Street Health, the first of its kind in Britain, which offered pharmacists training in the wider issues of health care.
Training included areas that were often overlooked, such as interpersonal skills and communication. It also gave pharmacists confidence to play a wider role in health care promotion.
Pharmacists who wished to become involved with similar projects in their own areas needed to network and demonstrate their value. They should establish relations with the local health authority and primary care group (or trust). They should also find out what the health priorities were for their area. The local health improvement programme would determine these. If they could show that pharmacy could help meet these priorities then they would have taken an important step to extending their role.
Giving a Barnet community pharmacist's experience of the development fund, Mr GERALD ZEIDMAN said that one project he was involved with was running training sessions for residential and home carers. The courses helped carers to learn more about the medicines they gave to residents. They gained a better understanding of the issues, including administration, storage and side effects, and a basic understanding of conditions such as asthma and diabetes.
It was not only the carers who benefited: the patients benefited from a better standard of care; GPs benefited from better information because carers learnt to look out for possible side effects of the medicines administered; and Mr Zeidman himself benefited because the course helped him make better use of his skills and training.
Mr Zeidman said that he was able to spare the time away from his pharmacy because he had a good locum who was known to his regular customers and who could maintain the relationships he had developed.
Pharmacists wanting to know what was happening in their own areas should attend health authority and primary care group board meetings, which were held in public. They were a real eye opener, giving an insight into the wider health issues and helping pharmacists to identify areas where they might be able to get involved.
Other useful points of contact were the PCG pharmacists, the LPC and the local area pharmaceutical adviser, all of whom could give one an idea of what was happening locally.