The
Pharmaceutical Journal Vol 266 No 7130 p40-42
Daily Mail criticism of EHC scheme rejected
Compulsory treatments for mental health outpatients proposed
PSNC sponsorship
Pharmacy plan supported
Nurofen theft appeal
Which? criticises NHS walk-in centres
Llps to start
PPRS compliance rises
Drug abuse rises
MSPs look at prescription charges
NHS hospital pharmacists offered 3.7 pc?
NHS fraud hotline launched
EC appeals over Bayer fine
New PGEU president
EU aid for Bolivia
Contacting The Journal by e-mail
Criticism by the Daily Mail of community pharmacists offering emergency
contraception services under a patient group direction has been rejected by
the Lambeth, Southwark and Lewisham health action zone.
The January 6 issue of the newspaper (p7) included the subsidiary headline “Morning-after
rules broken by chemists for girl of 15”. The report named seven pharmacies
to which the newspaper sent a 15-year-old on a Friday to try to obtain emergency
hormonal contraception based on a false claim of having had unprotected sexual
intercourse the night before. Six of the pharmacies supplied her with Levonelle-2.
The newspaper described the ease with which the client obtained what she needed
as shocking and accused the pharmacists of flouting guidelines that restricted
supply to people aged at least 16 years. It also suggested that the client should
have been told to see her general medical practitioner rather have been provided
with treatment by the pharmacies.
A statement issued by the health action zone on January 9 said: “Despite the
claims made by the Daily Mail, we wish to make it clear that all the
pharmacists involved acted within the patient group direction for this scheme
and used their professional judgment appropriately.”
The PGD used by the 33 pharmacists who are accredited by the HAZ to provide
emergency contraception imposes no lower age limit on supply, nor does it require
referral as an alternative to supply. It says that clients should always be
advised to visit a GP or family planning clinic regardless of whether Levonelle-2
is supplied.
The HAZ statement also said that pharmacists should make their own judgment
about supplies to under-16-year-olds based on the balance between the consequences
of not supplying and the risk inherent in emergency contraception and the availability
of alternative routes of supply should pharmacy supply be declined.
Mrs Beth Taylor (pharmacy manager, Community Health South London NHS trust)
told The Journal: “The Daily Mail did its research for this story
on a Friday. If the woman had been turned away she would have had to rely on
getting a clinic appointment before Monday. It is clear from comments from the
pharmacists concerned that they were, at all times, acting in the woman’s best
interest in deciding to make these supplies.”
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Changes to the Mental Health Act 1983 will allow for the compulsory treatment
and medication of patients who are not being detained in hospital.
The changes were outlined in a Government White Paper “Reforming the Mental
Health Act” published on December 20, 2000. The foreword to the White Paper
says that the way in which mental health services are provided has changed drastically
since the last review of the legislation. In particular, most patients are now
treated in the community and powers restricted to patients in hospitals are
failing to provide sufficient protection and reassurance for the public.
Under the new proposals, a patient who has been assessed as needing compulsory
treatment will receive treatment set out in a formal care plan for an initial
period of no more than 28 days. After this, further treatment will have to be
authorised by a new, independent mental health tribunal. The tribunal will be
able to make orders lasting for six months initially and 12 months after the
first year.
A new Commission for Mental Health will be established to look after the interests
of people who are subject to care and treatment under powers in the new Act.
The commission will monitor the use of formal powers for detaining and treating
people.
Reforming the Mental Health Act (two volumes), The Stationery Office, London.
ISBN 0-10-150162-5. Price £14.20.
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Astrazeneca is the third company to join the Pharmaceutical Services Negotiating
Committee’s community pharmacy development programme. Other companies involved
with the partnership are APS Berk and Norton.
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Almost all elements of the National Health Service pharmacy plan are popular
with pharmacists, according to a small survey conducted over the internet (www.private-rx.co.uk/pharmacystrategy/).
The most popular proposal is to enable patients to get more help from pharmacists
with the correct use of medicines. Only the proposal to enable e-pharmacies
received less than 50 per cent support.
Respondents were asked to rank the plan’s propositions as being high (achieve
urgently), medium (within two to four years) or low priority (at some time)
or as being of no concern.
All proposals bar two were rated as being of high or medium priority by 80 per
cent or more of participants in the survey. The only two that received less
than this level of support were the e-pharmacy proposal (42 per cent) and the
suggestion that contract controls might be relaxed where they hindered the development
of out-of-hours services or one-stop primary care centres (64 per cent).
Just over half of the 192 respondents to the survey were non-members of Private-Rx.
Some respondents were not pharmacists.
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Pharmacists have been asked by the Leicester police to be on the lookout for
packs of Nurofen offered at reduced prices following the theft of £40,000 worth
of the product from a lorry trailer parked at the Leicester Forest East service
station on the M1 on December 19, 2000. Anyone who can offer information can
call the police on 0116 222 2222.
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Which?, published by the Consumers’ Association, has criticised National
Health Service walk-in centres for providing widely varied levels and quality
of care.
The January issue of the magazine carries a report based on the experiences
of three researchers who pretended to be patients at eight walk-in centres using
the same research technique that has resulted in a number of critical reports
on the performance of community pharmacies. Experts commissioned by Which?
(three medical practitioners and a professor of nursing) concluded that, although
there were glowing successes, the overall standard of treatment was disappointing.
They considered that the manner in which the researchers were dealt with was,
in some cases, potentially dangerous.
One researcher posed as an angina patient away from home who had had a heart
attack six years previously, was now experiencing angina with increasing frequency
and was running out of his relief spray. The Which? experts considered
that he should have been urgently referred to his GP and given a replacement
spray or have been told how to get one. At five of the eight centres he was
not recognised as a potential emergency and got no further than the reception
desk. The other three dealt with the problem.
A second investigator pretended to be taking the antidepressant Prozac along
with propranolol to control panic attacks. He claimed to have developed a wheezy
cough which he wanted stopped. The expert view was that the cough was probably
a propranolol side effect which could culminate in an asthma attack and that
he should be sent back to his GP to have the treatment reviewed. Only one centre
made the link between propranolol and the cough. Two took no medication history
at all and the remaining three failed to recognise that the cough could have
been due to propranolol.
The third inquirer posed as a university student who had had two epileptic fits
nine years earlier and had been taken Tegretol ever since, but had never been
reviewed because she avoided review appointments. She claimed to be getting
increasingly bad headaches with occasional flashes before her eyes. The expert
view was that walk-in centres should identify the headaches and epilepsy as
separate problems and realise that the treatment for epilepsy had never been
reviewed. Only two centres identified the two problems, one of which gave advice
on migraine and follow-up, while the other only gave advice on migraine.
Which? said that the reaction of the NHS Executive to the study was to
criticise the Consumers’ Association research for being based on too few visits
and atypical walk-in centre patients.
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Business partnerships with limited liability will be possible from April 1.
The Limited Liability Partnerships Act 2000 comes into force on that date and
makes possible for partnerships the legal protections that are available for
companies, while retaining the organisational flexibility and tax status of
a partnership.
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Pharmaceutical companies are showing an increased rate of compliance with
the Pharmaceutical Price Regulation Scheme since changes, backed by legal sanctions,
were made to the scheme in 1999, according to the Department of Health.
In the Department’s fourth report to Parliament on the PPRS, published on December
20, 2000, it says that one of the failings of the previous version of the scheme
was that companies were slow to provide an annual financial return of their
sales. In 1998, for example, only 25 per cent of companies had submitted the
appropriate information within six months of the end of their financial year.
Reserve powers in the Health Act 1999 would allow the Secretary of State for
Health to force companies to submit the relevant data and impose fines on companies
which did not comply. Although these powers have not yet been used, the Department
said that by November 30, 2000, it had received 37 of the 39 returns (95 per
cent) due by that date.
The report says that all pharmaceutical companies with sales to the National
Health Service greater than £1m per year have elected to join the new
scheme voluntarily and none has made unauthorised increases in prices since
October 1, 1999. The new PPRS, and the 4.5 per cent cut in prices which marked
its introduction, have provided annual savings of £200m to the NHS.
Pharmaceutical Price Regulation Scheme, fourth report to Parliament, Department
of Health, London (www.doh.gov.uk/pprs.htm).
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Drug misuse in England rose by 8 per cent in the six months to March 31, 2000.
The profile of drug abuse changed little during the period, with 51 per cent
of abusers being in their twenties, and 14 per cent being aged under 20 years.
The ratio of male to female misusers was three to one and heroin (63 per cent)
was the most frequently abused drug. Other drugs abused were cannabis (10 per
cent), methadone (9 per cent), cocaine (6 per cent) and amphetamines (4 per
cent).
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The Scottish Parliament may be about to follow the Welsh lead and change local
arrangements for exemption from prescription charges.
During a brief discussion on December 12, members of the Health Committee decided
to ask the Scottish Executive whether it had any plans for the area. Dr Richard
Simpson (Lab, Ochil) suggested that if the Executive indicated that it did not
consider the matter to be a priority then the committee should discuss what
it might be able to do.
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Hospital pharmacists working for the National Health Service are believed
to have been offered a 3.7 per cent pay rise for 2001-02.
The Government announced on January 5 that the 300,000 National Health Service
staff who are not covered by pay review bodies would get a pay rise of at least
3.7 per cent. This, it said, was in line with increases for nurses.
In addition, NHS laboratory staff are to receive further increases of between
3 per cent and 13 per cent because of problems with recruitment and retention.
The Minister of State for Health (Mr John Denham) said: “We are taking targeted
action to tackle specific problem areas where we know there are difficulties
in recruiting and retaining the right staff.”
The chairman of the Pharmaceutical Whitley Council staff side (Mr Ron Pate)
told The Journal on January 9 that he was awaiting confirmation from
the NHS pay unit that the offer applied to pharmacists. He said that he understood
that the 3.7 per cent increase would apply to emergency duty payments and allowances,
as well as to basic pay.
If that was the case for 2001-02, Mr Pate said that he would want to know why
it was not also true for 2000-01, which was still under negotiation.
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A hotline for people to report suspicions of fraud in the National Health
Service in England has been launched by the Department of Health.
Anyone who suspects that a fraud is being perpetrated can call 08702 400100
to report details of their concern.
When the hotline was launched, on December 13, Mr Jim Gee (director of counter
fraud services) said: “We are now equipped with secure and confidential arrangements
to receive information about suspected fraud and corruption.”
The Department of Health estimates that fraud in the NHS in England has been
reduced by £48m since 1999.
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The European Commission has launched an appeal against a European Court decision
to quash a euro3m fine imposed on Bayer by the commission for an alleged anticompetitive
practice (PJ, November 11, 2000, p706).
The court recently ruled that the commission had failed to prove the existence
of anticompetitive agreements between Bayer and pharmaceutical wholesalers in
Spain and France that restricted supplies so that there was no surplus available
for parallel trade with Britain.
The launch of the appeal has been welcomed by the European Association of Euro-Pharmaceutical
Companies, which represents companies engaged in parallel trade in pharmaceuticals
in Europe.
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The Pharmaceutical Group of the European Union has a new president, He is
the Irish community pharmacist Mr Aidan O’Shea. Mr O’Shea has been president
of the Irish Pharmaceutical Union and a long-serving member of country’s pharmaceutical
contractors committee, which negotiates terms and conditions for pharmacists
with the Irish health department. In addition, he has served as a Council member
of the Pharmaceutical Society of Ireland and as a pharmacy practice lecturer
at Trinity College, Dublin.
Mr Bill Darling (head of the United Kingdom delegation to PGEU) has been appointed
vice-president and is expected to take the presidency in 2002. Mr Darling is
a member of the Council of the Royal Pharmaceutical Society.
The PGEU is the official body representing the interests of community pharmacists
in all 15 EU member states, and in a further 11 European states outside the
EU.
In all, the PGEU represents over 600,000 community-based pharmacists and their
employees throughout Europe. The PGEU liaises directly with the European Commission
and European Parliament, and with health professional interest groups at EU
level.
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An aid package of euro30m, which will improve dispensaries, hospitals and
the general availability of medicines in the Bolivian Andes has been announced
by the European Commission. The money will be focused on the Potosí and Tarija
areas and will also pay for the drafting of local health plans. The Bolivian
government will add euro5m to the scheme’s budget.
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