Ensuring that the Royal Pharmaceutical Society's work takes account of all aspects of the Government's strategy for pharmacy was the major topic at meetings of four committees of the Society's Council on October 31. The committees examined the implications of "Pharmacy in the future: implementing the NHS plan" (and other Government policies relevant to pharmacy) for the Society's work in the fields of education, practice, professional standards and science.
The Education Committee received a document mapping out in detail the education division's current or planned work relevant to the NHS plan for England and the NHS pharmacy plan. The document also took into account other "environmental" influences such as electronic delivery of public services, the growing impact of devolution and the emergence of regional development agencies in England. The document set out the many Government proposals with implications for pharmacy education and indicated their links with seven main activities of the Society in the education domain.
The first of these activities was the Society's input to the NHS Executive's common foundation programme for the NHS plan, which would be particularly relevant to proposals with partnership and team-working implications. It was not yet known how such input was to be achieved, but the head of the education division was soon to attend a multiprofessional brainstorming workshop.
The second activity was the reform of degree accreditation. The education division was working on a new set of criteria for degree accreditation and an appropriate new system of education that would take into account many of the Government's proposals with implications for pharmacy education.
The third activity was the reform of preregistration training. The division's work included research and development — including new training and assessment materials and methods — and consensus building. This too would take into account a large number of the Government's proposals.
The development of continuing professional development (CPD) systems was the fourth area of activity, and another area relevant to a wide range of the Government's proposals. The division's work included developing a prototype system for recording, evaluation and feedback of CPD, validating it and preparing for scale-up. The division was also working with the Health Act working party on regulations for CPD.
The fifth activity was a skills project, which involved collecting, collating, defining and disseminating competencies for important aspects of pharmacy practice. This was relevant to proposals for new and extended services provided by pharmacists.
Many of the Government's proposals would have an impact on pharmacy workforce issues, and the sixth activity was the division's significant input into the Society's pharmacy workforce advisory group, operating out of the office of the Secretary and Registrar. This group was being established to define future scenarios and their consequences for workforce supply and demand.
The seventh activity was involvement in education and training to support the Pharmaceutical Services Negotiating Committee's medicines management project. This was relevant not only to the Government's specific medicines management plans but also to other proposals such as those involving patient partnership and team-working.
The Practice Committee devoted virtually all its meeting to considering the implications for pharmacy of various topics within "Pharmacy in the future", in the light of discussions between committee chairmen and Department of Health officials earlier on the same day. The committee noted that the Department's representatives had said that the profession's input was needed if the Government was to achieve its aims.
The Department of Health had set out a list of issues that it wanted to begin implementing before the end of the year. One was to prepare for piloting electronic transfer of prescriptions (ETP) to ensure that ETP could do all that the existing paper system did. The committee noted that the Society was already involved in this through its representation on the Department's professional advisory group and technical group.
Another issue for early implementation was medicines management, for which a pilot was to go ahead based on the Pharmaceutical Services Negotiating Committee's proposals. A second strand of this development was integrating medicines management into the process re-engineering currently taking place in primary care.
Medicines management would be one of the early priorities for the new chief pharmacist at the Department of Health. Since medicines management had links to reaccreditation, continuing professional development, competence to practise and concordance, the Society would need updates on the project and a link with the national action team for the medicines management project. It was felt that the Society should write to the acting chief pharmacist seeking representation on the team.
A further issue for early implementation was improving out-of-hours access to medicines. Either community or hospital pharmacy could provide such services, but there was a need to consider whether the viability of existing pharmaceutical services might be undermined. In liaison with other pharmacy bodies, existing models should be explored with the aim of defining what was needed.
Also requiring early action was the matter of clarifying the role of pharmaceutical advisers. They would need support to help them ensure that "Pharmacy in the future" was on the agendas of health authorities and primary care groups or trusts.
Repeat dispensing and prescribing systems could be introduced as early as 2002, but it was unclear to what extent progress would be linked to electronic prescribing and dispensing. There was a need to review what had happened so far on repeat dispensing, assessing pilot schemes and identifying the benefits of different models.
Less immediate topics for consideration included legislation, workforce issues, clinical governance and self-regulation. The Society would have to consider what input it should have into the enabling legislation. It needed an organisation-wide plan for skill mix and workforce issues, including workforce planning and technician regulation. It
also needed to establish a link with the Department's working group on the primary care workforce (which was to include a pharmacist). So far as clinical governance was concerned, the Society needed to establish links to the chief medical officer's quality team, initially with regard to the hospital service. On self-regulation, the Society needed to be prepared for draft Orders on the disciplinary machinery and continuing professional development.
Several general issues also required action by the Society. These actions included: holding discussions on implementation with other professional bodies, including those for general medical practitioners, nurses and ancillary groups; stimulating pharmacists' interest in, and a broader awareness of, the NHS plan and "Pharmacy in the future"; taking account of any differences in the plans for Scotland and Wales; and encouraging dialogue locally between the Society's branches, local pharmaceutical committees and pharmacy development groups.
The Society also needed to find out how action teams were being appointed and who served on them. It should facilitate networking of pharmacists serving on such team
The Law and Ethics Committee considered a paper identifying aspects of the "Pharmacy in the future" document that were relevant to the work of the Professional Standards Directorate. The committee was content that action was in hand on all aspects.
The first issue was that the Government's proposals would lead to pharmacists providing a range of services in different practice environment. The Society's ethics working party would deal with ensuring that professional standards were appropriate for all these environments. The working party would also work to develop standards for new areas of service provision for pharmacists. On e-pharmacy, the committee noted that professional standards had already been agreed and were under review as part of the revision of the Code of Ethics.
Another relevant issue was that the extension of medicines supply sources for the population could lead to a rise in inappropriate combinations of medicines for individual patients. The ethics working party would consider the role pharmacists might have in preventing this through the use of computer systems to gather information on all medicines being used by patients.
On repeat dispensing services, the committee noted that there would be a need for professional requirements, while pharmacists providing such services would need appropriate skills and training. The ethics working party would work with the education division to develop these.
The directorate was already working with the education division to secure amendments to legislation to provide for periodic competence assessment as a requirement of practice. As part of the work of the Health Act working party, this was a fundamental element of the Society's proposals for reforming its regulatory legislation. The latest indications were that the Department was receptive to the Society's requests for this to be included in the first Order under the Act
The Science Committee welcomed recognition in "Pharmacy in the future" that science and technology were the means to achieve great advances in health and health care. The role of science in assisting pharmacists to enhance their contributions to the NHS occurred many times in the document.
A number of topics already on the committee's agenda were relevant to the pharmacy plan. Some were short-term initiatives; others, such as the use of diagnostic agents, had long-term implications, but work on them would nevertheless start immediately.
Some specific areas for which a science input could provide support were pharmacogenetics and diagnostics (to assist in individualising treatment and in effective and safe use of medicines), monitoring of drug blood concentrations, developing science-based clinical algorithms (eg, in anticoagulant therapies) and increased availability to the public of effective medicines (by switching from prescription-only to pharmacy sale).
The Education Committee resolved to accredit the master of pharmacy honours degree of Liverpool John Moores university for the academic year 2000-01. The committee and the university had worked towards this outcome since a meeting between representatives of the Society and the university on August 15 (PJ, August 19, p256).
Proposals for revising pharmacy's disciplinary procedures and for continued registration based on demonstration of competence were being drafted by the Health Act working party for consultation early in the new year, the Law and Ethics Committee heard.
The committee was told that the Government's thinking on discipline and competence had been clearly illustrated in the recent consultation papers proposing a new Nursing and Midwifery Council and a Health Professions Council. The Government wanted fast, effective and more transparent procedures that had meaningful accountability to the public and the NHS and were brought about by measures that included far greater lay representation on the committees and governing councils of health care regulatory bodies. Any significant departure from the Government's thinking could result in delay and possible rejection of proposals put forward by the Society.
The Department of Health, following pressure from the Society, had decided that powers to impose competence provisions should be included in the first Order under the Health Act 1999. At the request of the Council, the working party was therefore focusing all its immediate efforts on the areas of discipline and competence, both of which would require an Order. The current aim was to have an Order in place facilitating the necessary changes by the end of 2001. To meet this deadline, proposals would be put to the December Council meeting, with a view to consultation early in the new year.
The Science Committee agreed that the Society should subscribe to an alerting service that would draw attention to any attempts by pharmaceutical manufacturers to register "co-names" as trademarks. The Society opposed such names on grounds of public safety, believing that their similarity could lead to confusion. The committee made its decision after considering a position paper on "co-names". It was noted that, while the British Pharmacopoeia Commission was not likely to approve any further generic "co-names", manufacturers might still try to register them as trademarks. The Society had already successfully opposed one such name and was currently objecting to two more.
Briefly HEFCE review The Education Committee
resolved to respond to a consultation paper from the
Higher Education Funding Council for England on the
subject of future Government funding for academic
research. While offering general support for the paper,
the response would also set out opposition to, or
reservations about, a few of the specific proposals. |
Branch observers
The following observers from the Society's branches attended the meetings of Council committees on October 31: Mrs Joyce Keegan (Slough branch); Mrs Michelle Marshall (Scunthorpe branch); Mr Martin Orpin (Jersey branch).