The National Pharmaceutical Association's board of management agreed its approach to the pharmacy plan at its November meeting. Wherever possible, the NPA would collaborate with other pharmacy organisations to ensure more effective working and to strengthen the community pharmacy message.
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One-stop centres A consortium approach for the provision of pharmacies at the proposed 500 one-stop centres by existing local contractors was favoured. The NPA would work with the Pharmaceutical Services Negotiating Committee to provide advice and to help members develop local pharmacy consortia. The Government's statement that it would not allow contract rules to hinder new pharmacies at one-stop centres or major retail complexes indicated that it still recognised the value of a controlled pharmacy network. Out-of-hours After discussing the report "Raising the standards for patients: new partnerships in out-of hours care" (PJ, November 18, p745), it was decided to explore areas of commonality with the National Association of GP Co-operatives and to discuss issues such as out-of-hours formularies. Models for out-of-hours pharmacy services would be developed. Local pharmaceutical services schemes The NPA would promote the benefits of local pharmaceutical service pilots being operated through the existing community pharmacy network. Collaboration with the PSNC in order to influence the development of LPS pilots at local level would be the best way forward. The NPA's professional development department would develop resources to help members who wished to be involved with LPS pilots. |
 NPA to provide support resources for pharmacies |
Electronic transfer of prescriptions Electronic prescription transfer would enable community pharmacists effectively to manage repeat dispensing, medicines management and referrals from NHS Direct or walk-in centres. It would be a top priority for the NPA to influence the development of pilots. Systems had to allow for the development of additional pharmacy roles. Any ETP solution should provide a robust platform upon which to base pharmacy led repeat dispensing and medicine management services. The NPA would ensure that the EDI pilots benefited from the knowledge that had already been gained from the repeat dispensing pilot. Concern remained that the implementation costs could fall on pharmacy.
E-Pharmacy Board members were concerned that the only financially viable solution for e-pharmacy and mail-order dispensing was the warehouse model. This would seriously undermine the community pharmacy network. Nevertheless, the NPA would continue to work towards a pharmacy shop on the web concept. A logical extension to the "Ask your pharmacist" web site, which directed people to local pharmacies, would be links to existing pharmacy websites.
Repeat dispensing Repeat dispensing could provide a platform for medicines management and electronic prescribing. It should involve face-to-face consultations.
Medicines management The NPA would continue to provide input into the PSNC-led medicines management project and would seek representation on the medicines management action team and the joint task group on partnerships in medicine taking. It would continue to gather and disseminate good practice and to provide resources to help pharmacies make the case for investment in, and development of, services locally. The NPA would contact the primary care development team and would form links with the NHS modernisation agency. An NPA pharmacy health improvement framework for older people would help pharmacists review how best to develop services to meet their needs.
Skill mix There was little research to identify what community pharmacists actually did with their time which could inform the skill mix debate. Work to be commissioned by the Community Pharmacy Practice Research Consortium (CPPRC) would help address this deficiency.
NHS Direct The announcement that NHS Direct's roll-out of referral to pharmacy would be based on the work done by the Essex pilot was welcomed. The development of NHS Direct information kiosks in pharmacies would be monitored. There was concern that the possibility of ordering prescriptions and arranging for delivery through NHS Direct would threaten community pharmacy and medicines management and repeat dispensing services. This had been taken up with NHS Direct and the NHS, both of which had confirmed that they wished to continue working closely with the pharmacy profession to find acceptable solutions. Pharmacists who had paid for copies of the NHS Direct health care guide should contact the wholesalers from which they had bought them for a refund. Future guides could be obtained free from
NHS Direct on 0113 254 5606 or by e-mail from jane.bird@doh.gsi.gov.uk. NHS Direct in Scotland would go live in December, 2000. The NPA would push for pharmacy referral in Scotland.
Nurse prescribing The main concern was that public safety should be paramount. Board members who had been involved with training nurse prescribers had found that nurses' knowledge of medicines was limited and that they lacked confidence. Board members supported the proposed conditions which the extension of nurse prescribing might cover (PJ, November 4, p673), but felt that nurses should only be able to prescribe within disease areas for which they were specifically trained and only for patients with simple pathologies. Nurse prescribing formularies should include appropriate general sale, pharmacy and prescription medicines.
Pharmacist prescribing The first step towards pharmacist prescribing would be supplementary prescribing. Independent prescribing status could follow for appropriate pharmacists. In the meantime, pharmacists could use patient group directions to supply prescription medicines. The NPA would press for appropriate community pharmacists to be included among independent prescribers. The wider use of PGDs for different POMs would be explored and schemes would be evaluated.
Smoking cessation The pharmacy plan supported the prescribing or supply by pharmacists of nicotine replacement therapy on the NHS and presaged opportunities for pharmacists to offer counselling and support as part of local smoking cessation services. The NPA would provide new resources and up-date existing resources for members. NRT could safely be prescribed by pharmacists and the NPA would promote this.
OTC medicines The NHS Executive had confirmed that the statement in the NHS plan that "a wider range of over-the-counter medicines would be available" encompassed the use of PGDs in community pharmacy to supply prescription medicines, the use of vouchers for the NHS supply of pharmacy medicines as well as POM-to-P switching. More P to GSL switches had not been envisaged.