The Pharmaceutical Journal Vol 265 No 7104 p65-66
July 8, 2000 Forum

Guild of Healthcare Pharmacists

The changing face of procurement

Over 100 delegates attended the summer symposium of the Guild of Healthcare Pharmacists' Procurement and Distribution Interest Group held on June 8 in Coventry. Among the topics discussed were the implications of the Competition Act for pharmacists and the usefulness of the Y2K Pharmaceutical Alliance. A new diploma for procurement staff was also announced

Pharmacy procurement diploma

A new diploma qualification for procurement staff was to be launched in the autumn, Mr EOIN LONERGAN (programme director, purchasing and logistics, University of North London [UNL]) announced.
The diploma in higher education, purchasing and logistics (pharmacy), or Dip HE P & L (Pharmacy), which should take two years to complete via guided learning and workshop attendance, had been specifically designed for pharmacy staff involved in procurement and supply. It was expected that the qualification would allow such staff to develop a more professional approach to their duties, bearing in mind the enormous changes taking place in supply markets and the fact that pharmacy staff were now dealing with highly trained sales representatives who were supported by huge training and marketing budgets.
According to Mr Lonergan, the need for such a qualification in pharmacy had been recognised after a survey in 1997 by Mr Allan Karr (PDIG chairman and pharmacy business services manager, University College London hospitals NHS trust) had revealed that universities offering pharmacy degrees in the UK did not provide sufficient procurement training (see Hospital Pharmacist, June, 1998, p155). In 1998, the PDIG had then commenced investigations into the provision of suitable education and training in procurement. A proposal had been formally presented by the UNL to the PDIG in July, 1999. It was expected that, after formal validation by the UNL and accreditation by the Chartered Institute of Purchasing and Supply (CIPS), UNL would receive the first students for the diploma course in September (foundation stage) and January (professional stage).

Eoin Lonergan: Need for diploma recognised after survey of pharmacy schools

Mr Lonergan said that the new diploma, which contained eight professional modules, would be based on the existing Dip HE (P & L) offered by UNL, but with an additional module in pharmacy procurement. The other professional modules were external resource management, commercial relationships, logistics, strategic operation management, international purchasing, legal aspects of procurement and supply chain management and a work-based research project. Candidates who did not qualify for exemptions would have to take some or all of five foundation modules (introduction to purchasing; management principles; quantitative methods; economics and accounting) before proceeding to the professional modules. The assessment of the professional modules would be by work-based coursework (40 per cent) and written examination (60 per cent). The foundation modules would only be assessed by written examination.
Answering a question from the floor on costs, Mr Karr said that the pharmacy diploma would be cheaper than a generic procurement diploma. The eight professional modules would cost around £2,600.
Further information on the diploma from Angele Cauthery at a.cauthery@unl.ac.uk.

Procurement of "specials"

Mr V'IAIN FENTON-MAY (Wales quality contol pharmacist) argued that the recently published MCA guidance note 14 (see PJ, May 6, 2000, p684), which required that those who sold or supplied "specials" should keep records of such supplies, did not apply to pharmacists who dispensed them. The only record keeping required of them were those which applied to other medicinal products.
Mr Fenton-May said his interpretation of the guidance was that it was issued to "specials" licence holders and the obligation to keep records of "specials" supplied applied to those who made the product. The obligations in the guidance were already required of those with such a licence anyway and he did not understand why they had to be re-stated.
The guidance note had required those who sold or supplied "specials" to record the source of the product, the person to whom it was supplied and the batch number. Such records were to be kept for five years. They were also to report any adverse reactions to the product within 15 calendar days.
On patient confidentiality, Mr Fenton-May said that there was no legal requirement for individual patients' names to be given to companies who supplied "specials". Indeed, it was unethical for companies to store patient information unless it was from a registered trial. Pharmacists had no right to give out such information to companies that requested it.

V'Iain Fenton-May making a point during the programme

Pharmacy and the Competition Act

Agreements for purchasing from one preferred pharmacy supplier could fall under practices prohibited by the Competition Act 1998, according to Mrs SUSAN SHARPE (director of professional standards, Royal Pharmaceutical Society).
Mrs Sharpe was discussing the implications of the Competition Act on the practice of pharmacy. Chapter 1 of the Act, which came into force on March 1, 2000, prohibited "agreements between undertakings, decisions by associations of undertakings or concerted practices which (a) may affect trade within the UK; and (b) have as their object or effect the prevention or restriction of trade within the UK". She said that potentially, such agreements between pharmacies and suppliers, especially when they involved a significant scale of purchasing, could only stand if the Office of Fair Trading (OFT), charged with enforcing the Act, considered that they fell within the exemptions laid down in the Act.

Susan Sharpe: Code of Ethics to be tested against Competition Act

The exemptions to chapter 1 included agreements that contributed to "improved production or distribution or promoting technical or economic progress, while allowing consumers a fair share of the resulting benefit".
According to Mrs Sharpe, other practices which might also come under scrutiny as a result of the Act were standardised formularies and the Society's Code of Ethics.
The Code of Ethics was a "concerted practice". Mrs Sharpe explained that in so far as any aspects of the code affected trade, they were prohibited unless they could be brought within the exemptions to the Act. Parts of the Code which could be challenged under the Act were those that dealt with the promotion and display of medicines and guidance on specific subjects, such as the supply of particular medicines. The Society was currently revising the Code of Ethics and, in setting any professional standards, it would be necessary to test "every single aspect against the criteria set by the OFT", Mrs Sharpe said.

Millennium alliance for pharmaceutical supplies

The main lesson learnt from the pharmaceutical alliance established to identify and resolve any Y2K supply problems that might arise was that co-operation worked to the advantage of patients, said Mr BRYAN HARTLEY (former chief pharmacist in the Department of Health).
The alliance included representatives of proprietary and generics manufacturers, parallel importers, wholesalers, the British Medical Association, the Royal Pharmaceutical Society, the Home and Cabinet offices, Medicines Control Agency and other interest groups with a stake in pharmaceutical supplies.
According to Mr Hartley, the issues which dominated the agenda of the alliance were anticipated supply problems for manufacturers, importers and distributors, the contingency arrangements for certain medicines deemed to be "essential", prescribing patterns and patient behaviour and how to communicate arrangements for supply over the millennium holidays without creating panic.
As part of its efforts to ensure a crisis-free holiday period, the pharmaceutical alliance had asked prescribers:

Bryan Hartley: Co-operation overcame potential problems

not to extend the period of repeat prescriptions because of millenium concerns and to maintain usual prescribing patterns for Christmas/New Year
to arrange for patients to obtain repeat prescriptions to be dispensed by December 20 to cover the holiday period up to January 10
to write prescriptions generically whenever appropriate, possible or practicable
make arrangements with pharmacists to provide for prescribing and dispensing of instalment prescriptions for substance abusers

Mr Hartley said that although there were non-players, they did not destroy the work of the alliance. This was because the co-operation of the many overcame the potential problems posed by the few.
Supply was a complicated issue which had to be managed if patients were to be assured of obtaining their medicines as and when they chose, Mr Hartley stated.
Those present at the symposium agreed that there was a future need for such alliances across the supply chain.

An audit of hospital pharmacy procurement and supply

Mr MIKE SUTTON (technical manager, Antigen Pharmaceuticals [UK]) presented the results of an audit of hospital pharmacy procurement and distribution carried out in the North West region of the country while he was serving as technical services pharmacist in the NHS Executive North West.
Mr Sutton said that the expenditure on drugs, which had risen faster in the North West than in other parts of the country, had been one of the developments that had led to the commissioning of the audit, which commenced in the autumn of 1997.
Thirty-nine hospital pharmacy sites had been visited for the purpose of the audit. According to Mr Sutton, a wide variation in practice had been observed in the sites when it came to service provision, staffing and facilities. Staffing of the procurement or purchasing unit had ranged from 0.6 to 10.8 whole time equivalents (WTEs).

Mike Sutton: Variation in practices observed at different sites

Mr Sutton also enumerated some of the problems that had been found in some of the sites visited. They included, in places, poor storage facilities, low staffing levels, lack of standard operational procedures, lack of specific training in procurement, poor use of computers, poor environmental controls and non-compliance with European Union and UK public sector purchasing legislation.
On the other hand, some good practices had come to light in the course of the audit. One site had total quality management (TQM) in operation. Another carried out risk analysis on new products coming into the pharmacy. One of the sites visited designed benches so that they were at the best height for staff while, in one hospital, bar codes were used to read products into the store. Other good practices observed had been the availability of adequate air-conditioning, good use of signs and the use of electronic data interchange (EDI).

The Pharmaceutical Journal Vol 265 No 7104 p65-66July 8, 2000 Forum