The
Pharmaceutical Journal Vol 266 No 7129 p5-6
Bill paves the way for pharmacist prescribing and LPS pilots
NZ society accredits first internet pharmacy
New Zealand acts on internet pharmacy
GSL proposal for NRT
Pharmacist honoured for mountain rescue work
Scots pilot OTC medicines schemes
Safeway invests in CPD
Campaigning group asks pharmacists not to supply Levonelle
Levonelle supplies soon
Listening Friends scheme
Pharmacist prescribing under the National Health Service will come another
step closer when the Health and Social Care Bill becomes law.
The Bill contains clauses to amend existing legislation to allow prescribing
by pharmacists, ophthalmic opticians, osteopaths, dental auxiliaries, chiropodists
and practitioners registered under the Professions Supplementary to Medicine
Act 1960 or the Health Act 1999, or subgroups of any of these. New prescribers
may be restricted as to the drugs, medicines or appliances they can prescribe.
There are also provisions to allow health authorities to establish pilot schemes
for local pharmaceutical services (LPSs). No permanent LPS schemes will be allowed
until a pilot scheme has been undertaken and judged to be a success. Reviews
will have to take place within three years of the pilot starting.
Pilot schemes will be allowed to provide local pharmaceutical services, other
services under Part I of the NHS Act 1977, and education and training, but they
will not be allowed to combine arrangements for LPSs with personal medical or
dental services. Health authorities will be able to designate neighbourhoods,
premises or descriptions of premises where LPS pilots can be set up.
Pilots schemes may be entered into by individuals or bodies corporate and NHS
trusts. They will need to apply to become a health service body (PHS body) in
order to do this. Health authorities will have to maintain lists of PHS bodies.
Health authorities will be able to give financial assistance for preparatory
work to establish a pilot scheme, the details of which are to be set by regulation.
The explanatory notes to the Bill say that because potential providers of local
pharmaceutical services will become health service bodies some of the arrangements
they make with other health services bodies will be NHS contracts.
Clauses in the Bill seek to place a duty on health authorities to make arrangements
for the supply of medicines prescribed by both existing prescribers and the
new prescribers listed above. This will include arrangements for provision of
services other than at designated premises and outside the health authority
area. The explanatory notes say that this will provide a means to control the
development of internet, mail order and home delivery services and other arrangements
for dispensing across health authority boundaries.
Other clauses will allow the suspension or removal of contractors from pharmaceutical
and other lists on the grounds of efficiency, fraud or unsuitability, and an
equivalent right to refuse to include practitioners on lists. Supplementary
lists of deputies and assistants to contractors may also be established.
The NHS Tribunal is to be abolished and its work taken on by the Family Health
Services Appeals Authority which will become an independent body hearing appeals
against health authority decisions.
Health and Social Care Bill 2000-01, The Stationery Office, London, ISBN
0103009019. Price £6.70.
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The Pharmaceutical Society of New Zealand has accredited the first NZ pharmacy
to have met newly set legislative and professional standards for operating on
the internet.
Cyberchemist (www.chemist.co.nz) now
has the right to display on its website a hyperlink accreditation seal issued
by the society and which enables users to check the pharmacy’s details on the
pharmaceutical society’s website. Clicking on the seal takes users to a society
page which explains the terms on which accreditation has been granted. Another
click takes users to a page which identifies the pharmacy business which operates
the website and gives details of its address, telephone and fax numbers, the
responsible pharmacist and how to contact him or her, the accreditation date
and the date on which accreditation has to be renewed.
In addition to meeting legal and professional standards, accredited internet
pharmacies have to demonstrate compliance with patient rights to privacy and
confidentiality, compliance with codes and legislative requirements for the
advertising of medicines and the provision of factual and understandable information
about all medicines advertised. There must also be an opportunity for meaningful
consultation between patient and pharmacist.
The accreditation process involves a review of the website, a physical audit
of the pharmacy premises and a review of the pharmacy’s policies and procedures
for supplying medicines through the internet.
In a statement, Mr Euan Galloway (pharmacy practice pharmacist, Pharmaceutical
Society of New Zealand) said that the accreditation programme provided the public
with reassurance that any internet pharmacy which displayed the seal was a bone
fide, fully licensed operation using quality pharmacy practices and complying
with all regulatory and ethical requirements.
The society charges applicants for accreditation NZ$1,000 (about £300).
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It has been illegal since November 4, 2000, for internet pharmacies based
in New Zealand to sell prescription medicines over the internet unless the transaction
is based on a valid prescription issued by a New Zealand registered practitioner.
New Zealand’s medical council had previously ruled that doctors providing prescriptions
for dispensing via the internet should have met face-the-face with the patient
at least once (PJ, April 15, 2000, p568).
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The Medicines Control Agency has proposed the reclassification of nicotine
patches, lozenges and higher strength chewing gum as general sale list medicines.
A consultation letter (MLX 269) issued by the MCA on December 21, 2000, says
that the Committee on Safety of Medicines considers that nicotine patches that
release up to 21mg nicotine over 24 hours can, with reasonable safety, be sold
without supervision by pharmacists. The same recommendation is made for nicotine
lozenges containing up to 1mg nicotine and nicotine 4mg chewing gum.
The MLX says that the proposal has been made at the request of the products’
manufacturers and has Government support. It adds that manufacturers want GSL
status for their products because of the potential for widening the market and
increasing sales and that they are unlikely to pass on to the public the cost
of changing their labelling and packaging to meet regulatory requirements.
Subject to comments received and Ministerial approval, the MCA intends to implement
the change before the summer.
Comments can be sent to Dugan Cummings, MCA, Room 619, Market Towers, 1 Nine
Elms Lane, London SW8 5NQ until February 7.
The Government is currently seeking views on a proposal to remove all nicotine
replacement treatments from the NHS blacklist, so that they can be prescribed
by general medical practitioners.
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Mr John Allen, a community pharmacist from Kingussie, Inverness-shire, has
been made MBE in the Queen’s new year honours for services to mountain rescue.
Mr Allen has been a member of the Cairngorm mountain rescue team since 1972.
He was appointed deputy leader in 1984 and has been leader since 1988. He has
written about his mountain rescue work in The Pharmaceutical Journal
(December 24/31, 1994, p927).
Mr Allen runs the only pharmacy in Kingussie. He is chairman of the Highland
health board area pharmaceutical committee.
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Two pilot schemes have been announced for the free supply in Scotland of over-the-counter
medicines to people who are exempt from prescription charges.
From April 2, eligible patients at Patna, Ayrshire (one pharmacy), and Arbroath,
Tayside (five pharmacies), will be able to register to get certain OTC medicines
free of charge from pharmacies to treat about 18 different conditions.
Community pharmacies that take part in the projects will be remunerated on a
patient capitation basis plus the wholesale price of products supplied. A special
prescription form (CP1) is to be used to claim payment. The schemes are intended
to test benefit to patients in terms of access to advice and services, quality
of care and equity of service.
The pilots are expected to run for 12 months and will be evaluated by Professor
Peter Noyce (professor of pharmacy practice, Manchester university) by July,
2002. Professor Noyce will be asked to recommend a way forward for the initiative.
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Safeway has enrolled all its pharmacists, whether full-time or part-time employees,
as associate members of the College of Pharmacy Practice and has paid for their
college portfolios.
In a statement, Safeway’s superintendent pharmacist (Mr Paul Bennett) described
the move as a demonstration of the company’s commitment to CPD. He said: “We
reviewed a number of options to give the broadest access for professional development
and decided in the current climate that this was the best way to go.”
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The anti-abortion group Life, a registered charity, has asked its members
to distribute letters to pharmacies by hand asking them not to supply Levonelle.
The letter calls on pharmacists to refuse to supply the product, warning them
“Young girls, in particular, may inflict serious harm on themselves, in which
case you could find yourselves being sued for enormous damages.”
A Life spokeswoman told The Journal on January 3: “We are very concerned
that we do not know what the risks are with this medicine.”
The group claims that many pharmacists have been deeply angered by the change
in classification of levonorgestrel to a pharmacy medicine. It also claims that
the Government broke a promise of public consultation over the change, despite
the fact that consultation took place with 138 representative bodies including
Life and various consumer groups (PJ, May 27, 2000, p788).
Mr John D’Arcy (director, National Pharmaceutical Association) described the
Life letter as alarmist. Levonelle was a licensed medicine and the manufacturer
was responsible for its side effects, as with any other medicine, provided it
was supplied in accordance with the marketing authorisation. The Chemists’ Defence
Association would indemnify members, but it expected them to supply the product
in accordance with guidance from the Royal Pharmaceutical Society and to undertake
the training that was shortly to be provided by relevant organisations.
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Pharmacies and wholesalers should soon start to get supplies of Levonelle,
the new over-the-counter emergency contraception product.
A Schering spokeswoman told The Journal on January 2: “Pharmacists and
wholesalers will start being supplied this week and next week. We hope to have
everyone supplied within three weeks, which is earlier than we were originally
expecting.”
She added that there would be a low key press launch with invited speakers towards
the end of January.
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The Listening Friends Scheme exists to offer free confidential help to pharmacists
suffering from stress.
The scheme has been set up by the Royal Pharmaceutical Society but operates
independently so that help can be sought in complete confidence. The service
allows any pharmacist under stress to talk to a fellow pharmacist who has insight
into the particular pressures that apply in pharmacy. The service is not, however,
restricted to work-related problems, but offers help with all causes of stress,
such as family problems, illness and bereavement. The service is run by a team
of volunteer pharmacists, all of whom are mature and experienced in their field
of practice. All have been trained in listening skills and many have counselling
training and experience. They are also able to direct pharmacists under stress
to sources of specialist help where needed.
Contact with the Listening Friends is made initially by telephoning the scheme’s
automatic answering service on 020 7820 3387. Callers will be given brief
details of the service and asked to leave their name, the area in which they
live, a contact telephone number and a convenient time to call. A Listening
Friend will then call back to discuss the details of the pharmacist’s problem
in complete confidence. Further contacts are usually by telephone.
Information about the scheme and how it operates is available in the form of
a leaflet. This can be obtained by contacting the help-line number. Funding
for the scheme is provided by the Society’s Benevolent Fund.
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