| The Government has announced that up to three pilot schemes to test
the electronic transmission of prescriptions from general medical
practitioners to community pharmacies will be approved no later than
March, 2001, and running by June, 2001. Also, in 2001-02 there will be a
national community pharmacy-based pilot of medicines management. These are two of a series of proposals contained in the Department of Health. s strategy for pharmacy for England, which was launched at the British Pharmaceutical Conference on September 12 (see p397). Pharmacists are highly qualified professionals whose skills have been under-utilised for too long. Our vision for pharmacy in the future is one where pharmacists spend more time focusing on individual patients. clinical needs, and in particular helping them get the most from their medicines,. Lord Hunt (Parliamentary Under-Secretary of State for Health) told the conference. The paper . Pharmacy in the future . implementing the NHS plan. is divided into four sections. They are: better access to services; helping patients get the best from their medicines; redesigning services around patients; and getting the most from staff (see panel). Better access to services The plan sets out a series of measures which are intended to support self-care. Medicines manufacturers will continue to be encouraged to apply for over-the-counter status for their products where it is safe and appropriate to do so. All NHS Direct sites will include referral to a community pharmacist as an appropriate disposition for callers and pharmacies will be among the places where patients will be able to use NHS Direct information points. There will be opportunities for community pharmacists in health promotion, with greater involvement with counselling and support under local specialist smoking cessation services. By 2004, there will be 500 NHS one-stop primary care centres. The Government expects to see community pharmacies located in a substantial number of these centres. Priority for investment will be given to areas where primary care services need to be expanded, such as inner cities. On repeat dispensing, the paper says that schemes will be operational as early as 2002, with national implementation by 2004. So far as electronic prescribing is concerned, it says that this will be routine in community practice, as well as hospitals, by 2004. Up to three pilots will run for six months during 2001, with evaluation by the end of 2002. The results will be used to develop NHS standards for the routine electronic transfer of prescriptions. Transfer of data between GPs, pharmacies and the Prescription Pricing Authority will be carried out via the NHSnet by 2008 in most cases. Electronic prescriptions will have the same legal standing as written prescriptions. The document also sets out the possibility of allowing e-pharmacies to dispense NHS prescriptions, albeit with a requirement for a paper prescription to be provided before medicines are dispensed, until such time as electronic prescriptions become acceptable. It says that the Government believes that distance selling of medicines is legal provided that supplies are made from registered pharmacies under a pharmacist. s supervision. . As the technology develops, it may open up ways in which NHS Direct could play a role in arranging for people to get their prescriptions conveniently, alongside its many other services,. the paper says. NHS rules are to be reviewed to remove obstacles to online dispensing. Getting the best from medicines Between 2001 and 2004, £30m is to be invested in helping patients get the best from their medicines. All health authorities and primary care trusts will be expected to provide medication review services and ongoing pharmaceutical support for patients who need it, along with other kinds of pharmaceutical care. A Department of Health action team will be established to promote such medicines management services. Discussions with the Pharmaceutical Services Negotiating Committee will start with a view to beginning a national trial of medicines management early next year. Some of the money, at least £1m in the next two years, is to be spent on the promotion of concordance. The professions, the pharmaceutical industry and patient groups are to be invited to join the Government in a national strategy to integrate partnership in medicines taking into the NHS at all levels. Redesigning services The paper says that when Parliamentary time allows, the Government will introduce legislation which will allow pharmaceutical services to be tailored to local circumstances outside the national remuneration system and NHS terms of service. Once the legal framework is in place, health authorities will be invited to submit proposals to test schemes, which could include dispensing, medicines management, health promotion and disease prevention. Contracts will focus on outcomes and quality of service. Typical schemes will take the form of collaborations between health authorities, primary care trusts and existing pharmacy contractors. The strategy adds that the Department is to discuss with the PSNC changes to the NHS terms of service and the distribution of the global sum to establish minimum standards and to promote and reward high quality services. . Pharmacies which provide the best services should gain at the expense of those which are prepared only to provide the minimum,. it says. The discussions will include: clinical quality; speed and efficiency; premises standards and private consultation areas; record keeping and information; continuing professional development; and clinical governance. In addition, the rules that restrict new pharmacy contracts will be changed where they obstruct better services, such as out-of-hours dispensing or one-stop primary care centres. Control of entry may be removed for major retail developments. Hospital pharmacy services, too, will come under review. NHS regional offices will introduce performance management frameworks for medicines management to ensure that changes are made which lead to greater use of self-administration schemes for patients, reuse of any medicines that patients bring into hospital when they are admitted and the elimination of prescribing and dispensing delays when patients are discharged. Prescribing rights will be introduced for groups of professionals, including some pharmacists. This could include empowering hospital pharmacists to prescribe discharge medication. Getting the most from staff By April, 2003, all NHS employers will be expected to be meet an . improving working lives. standard so that staff can feel that they belong to an organisation which values them. Pay will be modernised to reward clinical, as well as managerial, progression. The Royal Pharmaceutical Society will be expected to ensure that standards for undergraduate and preregistration training keep pace with changes to the core curriculum for other professions introduced in the NHS national plan. These changes relate to common training in communication skills and the principles and organisation of the NHS. Lifelong learning will also be promoted. The Centre for Pharmacy Postgraduate Education will produce training materials to meet new health priorities, such as medicines management. NHS employed pharmacists will receive support for their continuing professional development. When the Department appoints a new chief pharmaceutical officer (see below), the person appointed will be expected to take forward a debate on the roles and respon- sibilities of pharmacists and their staff so that best use is made of the skills of technicians and other support the staff in community, as well as hospital, practice. Finally, turning to professional regulation, the paper says that the Society. s regulatory procedures need modernising. New procedures will be implemented by mid-2001 to deal with, and support, pharmacists whose performance is impaired by physical or mental ill-health. There will also be consultation on an Order in Council to amend the legislation which governs professional discipline so as to speed up dealing with cases where there is a risk to the public. At the same time, the Society will be expected to improve the transparency of its system for dealing with complaints about pharmacists and to ensure that its registration requirements demonstrate public accountability. . Pharmacy in the future . implementing the NHS plan. is available free of charge from the Department of Health, PO Box 777, London SE1 6XH (fax 01623 724524; e-mail doh@prolog.uk.com. It can be found on the internet at www.doh.gov.uk/pharmacyfuture/index.htm. |
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The main points of the pharmacy planThe pharmacy plan is divided into four sections. The main points from each section are summarised below.
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Better access to services
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Redesigning services
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Getting the best from medicines
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Getting the most from staff
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