The
Pharmaceutical Journal Vol 266 No 7131 p68-70
Steps towards the launch of medicines management
Telemedicine website launched
US kills parallel import bill
New opportunity for inventive pharmacists
PSNC to be led by non-pharmacists?
Medicines Act committee members wanted
PSNC highlights Health and Social Care Bill concerns
Pharmacist appointed Lord-Lieutenant
Guardian features pharmacy
Boots to appoint clinical governance head
Wales consults on NRT prescribing
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The first steps towards the introduction of medicines management to the
National Health Service are beginning to be made by the Department of
Health with the placing this week of an advertisement (PJ January
20, 2001 pA37) for a team leader to develop services under the auspices
of the National Prescribing Centre. |
 The Department of Health wants pharmacists to help cut the drugs bill by managing medicines for patients |
A website dedicated to providing information about telemedicine has been launched
by the British Library (www.tis.bl.uk).
Sponsored by the Department of Health, the website includes details of more
than 120 telemedicine projects being undertaken in the United Kingdom. None
of them appears to involve pharmacy.
The objective of the telemedicine information service is to bring together those
who are working in telemedicine in the United Kingdom, to encourage them to
share information and their experience and to provide an information resource
for the field.
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The United States government has killed off a programme which would have allowed
American pharmacies and wholesalers to import approved pharmaceutical products
from other countries.
The outgoing US secretary of health and human services (Dr Donna Shalala) wrote
to President Bill Clinton on December 27, 2000, saying that the International
Prescription Drug Pricing Act, signed into law by President Clinton on October
28, 2000, had at least three flaws or loopholes.
“These flaws undermine the potential for cost savings associated with prescription
drug reimportation and could pose unnecessary public health risks,” Dr Shalala
wrote.
Among the flaws she identified were a rule which would allow US manufacturers
to block importers from using the government-approved labels necessary for any
prescription drug sold in the US, and one which could have allowed manufacturers
to force importers to sell the drugs at high prices.
In addition, the import programme was limited to five years’ duration which
would have discouraged wholesalers from making the investment necessary to test
and distribute imported drugs.
Shortly before the Act was approved by Congress, a clause was inserted which
allowed the secretary of health and human services to veto the programme if
it did not show significant reductions in cost to consumers or if it posed additional
risks.
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Pharmacists who contribute their skills and expertise to the development of
new treatments in the National Health Service may be able to reap some personal
benefit as a result of changes to be introduced through the Health and Social
Care Bill (PJ, January 6, p5).
Clauses in the Bill propose amendments to the Health and Medicines Act 1988
and the NHS Act 1977 which will allow NHS trusts and health authorities to form,
or participate in the formation of, companies.
In a statement on January 11, the Minister for Health (Mr John Denham) said
that the change meant that innovators would be personally rewarded for their
work and that this would encourage them to remain within the NHS. He said that
the value of the intellectual property would be the only investment in companies
which the NHS would make. The funds to take ideas into production would be provided
by venture capitalists. NHS trusts would benefit from a percentage of any sales
income.
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Major changes approved by the Pharmaceutical Services Negotiating Committee
for the way it operates mean that the leadership of the organisation may be
entrusted to non-pharmacists.
At a press briefing on January 14, Mr Dove explained that leading the organisation,
which represents the interests of pharmacy contractors in negotiation with the
Department of Health, would be vested in a chief executive officer and a non-executive
chairman. Neither position needed to be filled by a pharmacist, although it
was hoped that one or the other would be.
Mr Axon is to retire at the end of July and Mr Dove has indicated willingness
only to continue as chairman until a non-executive replacement can be found.
The new chief executive, who is to receive a six-figure remuneration package,
will be expected to lead the PSNC’s negotiations at all levels of Government
and the National Health Service. The post is advertised on pA40 (PJ,
January 20).
The new non-executive chairman will not be a member of the PSNC and will be
expected to chair meetings and help build and foster relationships with NHS
organisations and others.
Explaining his decision to take early retirement, Mr Axon said: “The Government’s
plan for pharmacy and the NHS is a 10-year plan. The PSNC needs someone who
can carry on for a 10-year period. The committee has laid down a broad structure
and it is for the new people to decide how it works.”
Mr Dove added: “We want a smooth changeover with minimum effect on contractors.
The changes will not affect the broad thrust of negotiations, but they will
affect tactics and strategy.”
At the same time as approving these changes, the PSNC has re-arranged its sub-committee
structure. Rather than appoint subcommittees and have those groups elect their
own chairmen, as in the past, chairmen are now elected directly by the PSNC
and then meet as a group with PSNC officers to appoint the subcommittee members.
The new subcommittees and their chairmen are:
Asked whether he intended to continue as a PSNC member, Mr Dove said that he
intended to seek renomination by the National Pharmaceutical Association if
he retained his seat on the NPA board. He added that he would be a candidate
in the forthcoming election for the Royal Pharmaceutical Society’s Council.
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Nominations and applications are being sought by the Government for membership
of the advisory committees established under the Medicines Act 1968 and two
review panels. The bodies involved are the Medicines Commission, the Committee
on Safety of Medicines, the Advisory Board on the Registration of Homoeopathic
Products, the British Pharmacopoeia Commission, the Independent Review Panel
on Advertising of Medicines and the Independent Review Panel on the Classification
of Borderline Medicines.
An information pack is available from
Judith Thompson
Room 16-137
Market Towers
1 Nine Elms Lane
London SW8 5NQ
Completed applications are required by March 16. Details can be found in the
“what’s new” section of the MCA website (www.open.gov.uk/mca/mcahome.htm).
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The Pharmaceutical Services Negotiating Committee has highlighted a number
of concerns it has about the Health And Social Care Bill, which received its
second reading in Parliament on January 11.
At a press briefing following the PSNC’s January meeting, its chairman (Mr Wally
Dove) said that the committee was particularly concerned about the effect of
the Bill’s provisions on existing pharmacy contractors and on current rules
on the granting of new pharmacy contracts.
There was concern that the provisions for the new local pharmaceutical services
(LPS) scheme did not include a requirement to consult local pharmaceutical committees
before they were implemented, Mr Dove said. If amendments to the Bill were not
made, the PSNC would seek to ensure that regulations to implement LPS schemes
included a consultation provision.
On the positive side, the committee was pleased that the Bill would enable the
provision of services across health authority boundaries. The provision of oxygen
services to patients who lived in a different health authority area to their
chosen pharmacy had always been problematic and minor relocations across borders
were not permitted at all, even when they entailed premises on opposite sides
of the road.
The PSNC was also keen to find out what the Bill’s proposals for accreditation
might mean. There was a provision for the accreditation of e-pharmacies, Mr
Dove said. He understood that this would not involve the Royal Pharmaceutical
Society.
Section 25 of the Bill provided for health authorities to prepare lists of pharmacists
suitable to be employed in the provision of pharmaceutical services. This raised
the question of how the Department of Health might co-ordinate a national database
- a matter which would be of particular concern to pharmacy multiples.
Other matters of concern were the proposed power of patients’ forums, which
were to replace community health councils, to enter and inspect contractors’
premises and the power of health authorities to suspend or remove professionals
from their practitioners’ lists.
Mr Dove said that it should be possible for single-handed contractors who were
suspended to continue their businesses under locum arrangements. It would not
be fair for people to lose their businesses during a period of suspension only
to be cleared of any wrongdoing after a full investigation. Other matters considered
at the January PSNC meeting are reported below.
Supervision
The committee approved a report by its supervision working party and passed
it to the National Pharmaceutical Association, Company Chemists Association
and Co-operative Technical Panel for comment. The report would be published
in February.
LPC constitution
A new model constitution for LPCs was approved which allowed the co-option of
pharmacists to fill committee vacancies for contractors where contractors were
unwilling to take places.
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Mr Alexander Matheson, FRPharmS, has been appointed Lord-Lieutenant for the
Western Isles. Mr Matheson has been a deputy lieutenant since 1993 and has been
Vice-Lord Lieutenant since 1994. He was made OBE in the Queen’s birthday honours
list in 1990.
Thirty years ago, Mr Matheson became the youngest provost of Stornoway town
council, aged 29 years. He was appointed to the Western Isles health board in
1973 and became its chairman in 1993, a post he still holds. Other chairmanships
held by Mr Matheson include Stornoway Pier and Harbour Commission and his family
business Roderick Smith Ltd.
In March, he is to become chairman of Highlands and Islands Airports Ltd.
Mr Matheson was awarded fellowship of the Society in 1993.
He has also been convener of the Western Isles council and a member of the Royal
Pharmaceutical Society’s Scottish Executive.
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If the Government is concerned about the protection of local communities and
addressing social exclusion it will need to consider carefully the effects of
its policies on local, independent community pharmacies, says a Guardian
feature
published on January 17.
Richard Lewis, a King’s Fund health policy institute visiting fellow, says that
the future is bleak for small independents. Proprietors, who are getting older,
are locked into their businesses and young pharmacists are unwilling to invest
in the current environment of fees and discount clawback which discriminate
against small operators.
The author says that there are signs that the pharmacy plan might make a difference.
However, he notes that plans for 500 one-stop primary care centres and the breaking
down of controls over new pharmacy contracts might increase competition and
push small independents over the edge.
“Many industries go through fundamental restructuring,” Mr Lewis writes. “Why
not let the market take its course? A key policy objective of the Government
and the Department of Health is better access to health services, particularly
for the disadvantaged.
“The worst case scenario would be an uncontrolled contraction of community pharmacies,
with disastrous consequences for patients. Even the large multiples are not
immune; Boots is closing dozens of smaller high street branches in favour of
new out-of-town sites. Loss of pharmacies would particularly hit elderly people
and those without cars. And the chemist shop may often be the linchpin in already
vulnerable local high street parades.”
An associated column included with the feature highlights the effect on small
pharmacies of the possible abolition of resale price maintenance.
It quotes a member of the Royal Pharmaceutical Society’s Council (Dr Gillian
Hawksworth): “If we lose RPM, we could lose community pharmacy altogether -
and it is actually the building block on which the success of Government plans
depends.”
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Boots the Chemists Ltd is to appoint a head of clinical governance to be responsible
for developing and implementing a clinical governance strategy for the company.
The post-holder will report to Boots’s assistant pharmacy superintendent (Mr
Steve Churton). The role will include reviewing existing pharmacy systems, designing
quality management systems and developing best practice for clinical governance.
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The Welsh Assembly has started six weeks of consultation on a proposal to
allow all nicotine replacement treatments to be prescribed on the National Health
Service by general medical practitioners. Currently, some, but not all, NRT
products are on the black list of products that may not be prescribed by GPs.
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