Unwanted medicines
Prescription forms
E-pharmacy
Mood disorders
The Society
The Journal

Send your letters to letters@pharmj.org.uk

Prescription forms

Perplexed by design

From Mr T. Mahmood, MRPharmS

I am perplexed as to why the National Health Service prints 15 boxes on (some) batches of the National Health Service FP10MDA prescription form? I have on occasions come across 15 days' supply being ordered by prescribers as result of this form and this has resulted in extra work for the pharmacist, the patient and the prescriber in order to obtain another prescription promptly.

The blue FP10MDA normally has 14 boxes allowing records to be made for a maximum of 14 days' prescribing. What is the logic of having 15 boxes on these forms?

Tariq Mahmood
Romford, Essex

Mrs JUDY CARTER, of the pharmacy and prescriptions branch of the Department of Health, replies:

New prescription forms were introduced in April, 1998, and the FP10MDA was inadvertently printed with 15 lines. However the notes on the form, which represent GPs' terms of service, made clear that the total quantity prescribed must not exceed the amount sufficient for 14 days' consecutive treatment. The form was reprinted in August, 1999, with 14 lines.

Mr Mahmood's difficulty arises because prescribers are using out-of-date forms despite being advised to change to a newer version on more than one occasion by the Department of Health. If anyone has a persistent problem with these old forms, thay should contact Ms Chris Clark at the Department of Health (tel 020 7210 5514; e-mail Chris.Clark@doh.gsi.gov.uk).

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E-pharmacy

Reinventing the wheel?

From Mr R. Richardson, MRPharmS

May I pass comment on the National Pharmaceutical Association reinventing the wheel again and misdirecting its members. The NPA deal allows e-pharmacy sites (PJ, February 3, p143), but its comments have to be seriously challenged before pharmacists go charging down a blind alley through misinformation and spending hard earned cash for little or no gain.

If £2m was spent on development by two professionals, where is the value and who paid? Hopefully not NPA members. There are many companies, including ourselves, which can provide many levels of e-commerce whether it be secure or retail. There will be one in, or near, each high street. It is even possible to buy programs to build one's own e-commerce site for vastly less than quoted and one has one's own editorial content. There are sites such as ours that offer free listing and which have regular hits already. A site has to be looked at to be successful. It is not whether one has the most expensive or beautiful site; it is how many times it is used. The watchword with regard to the internet should in reality be “pharmacist beware: this pond is full of affluent advertising people ready to take your money”. How much advertising can one get for £100 a month locally? After all, is a pharmacy not a local service for most of the time? Does “Mr Jones” with the bad legs and five items per month have an internet connection with a scanner? If so, is he likely to want to “e-commerce” his five items from a pharmacy miles away? I thought the NPA was there to protect its members.

Roland Richardson
Webmaster, Pharmacy.uk.co

Mr JOHN D'ARCY (chief executive, National Pharmaceutical Association) replies:

The NPA is there to protect its members. And this is precisely why we have launched the AskYourPharmacist.co.uk initiative. Notwithstanding the concerns Mr Richardson has about the uptake of e-pharmacy, it is clearly the intention of the Government to encourage it as stated in the pharmacy plan for England. It is also clear that a number of large pharmacy players have geared themselves up to capitalise upon any e-pharmacy opportunities. It is essential therefore that the NPA levels the playing field by developing a cost-effective solution for those members — particularly the smaller ones — who wish to pursue e-commerce proactively or to defend their existing business against any competition.

The site AskYourPharmacist.co.uk provides NPA members with tailored websites at minimal cost. Pharmacists may choose from a free-of-charge, static website (including locational details, opening hours and a list of services provided) to a low-cost, fully transactional e-commerce site. Our solution builds upon the highly successful AskYourPharmacist website, which achieves 55,000 page impressions each month. The solution adopts a “clicks and mortar” approach as opposed to a warehouse model thereby ensuring that consumers are driven toward their local pharmacy. In this way consumers benefit from the combination of traditional trusted local pharmacy services and the convenience of internet shopping.

We would agree that it is possible to establish a low-cost web presence. But it is our view that consumers in the future will favour sites that are regularly updated. Regular updating is a feature of our initiative. The AskYourPharmacist environment will feature consumer news and information posted regularly by experts at the NPA and will provide the platform by which consumers can access information and services available from individual pharmacies including a link to any pharmacy website. In this way members can link either to a site they have built themselves or take advantage of the AskYourPharmacist web building service.

In launching this initiative, the National Pharmaceutical Association is neither reinventing the wheel nor misdirecting its members. Rather we are offering members a range of affordable internet solutions and allowing them not only to realise any e-pharmacy opportunities, but also effectively to defend their businesses against growing competition from large online operators.

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Mood disorders

Depression website

From Dr C. Stillman-Lowe, MRPharmS

I am delighted to see the extended coverage being given in the PJ to mood disorders and the drug treatments for these conditions. In the article on implications for primary care (PJ, February 24, p259), the authors refer to the 1992–96 Defeat Depression Campaign.

Your readers may be interested to know that the Depression Alliance runs annual media campaigns about this illness and provides support for sufferers all year round. Its website can be found at www.depressionalliance.org. The section on treatment covers both antidepressant medication and the range of “talking treatments” available.

Catherine Stillman-Lowe
Reading, Berkshire

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The Society

Bright future for science

From Professor W. Dawson, FRPharmS

Arvind Jayan suggests that there is a lack of commitment towards science in the Royal Pharmaceutical Society (PJ, February 10, p186). I must beg to differ. In the past five years we have seen a dramatic rise in the quality and volume of pharmaceutical science communicated at the British Pharmaceutical Conference, culminating in BPC 2000 with a programme recognised by all who attended as outstanding. Indeed, many have commented favourably on the programme when compared with that of the recent American Association of Pharmaceutical Scientists meeting in Indianapolis.

This has not happened by chance: the Pharmaceutical Sciences Group made a commitment in 1995 to achieve this goal and also to build bridges towards the UK Association of Pharmaceutical Scientists. As a result, the Academy of Pharmaceutical Scientists was formed from the merger of the two organisations in January, 2000, with a membership of pharmaceutical scientists who were both pharmacists and non-pharmacists, industrial and academic members. The Council has been totally supportive throughout this process. It is worth reflecting that the Association of the British Pharmaceutical Industry has been fully briefed throughout this process by myself (I am a member of its R&D committee) and Michael Murray (a staff member who sits on the Society's Industrial Pharmacists Group).

In addition to the Conference, the Society has a major initiative — the Scientist in the High Street initiative — which is attempting to bring current science from academia and industry into the practice world of the profession with some success. Indeed, the Minister for Science, Lord Sainsbury, was our guest at the Society's Science Reception on Monday, March 5, when a fact sheet on genomics prepared by the Science Committee of the Society was launched as well as a report on “UK drug delivery research — the way forward” which has been facilitated by the Society's chief scientist [see p324].

Mr Jayan mentioned the Industrial Pharmacist in his letter so it would be wrong for me not to comment on the issue. The Indistrial Pharmacist is an excellent publication which clearly meets the needs of a world-wide audience. As a member of the Society's Resource Management Committee which recommended the financial cuts in the budget to maintain our fiscal prudence, I do understand that top-down decisions on resources are never popular. As an industrialist, I am well aware that we have all managed in such an environment. In this case, we did not succeed in conveying the message that we were after constraint not discontinuation. However, I do believe that all concerned have learnt that communication is all and I understand that the phoenix is arising from the ashes, which is a credit to the Industrial Pharmacists Group committee and its members.

The Council and staff at Lambeth are attempting to implement the new ways of working described in the Banks report. These are sensible and far-reaching and embody transparency and openness, but they do require change, and we as a profession do not easily accommodate such change. There is a requirement for delegated responsibilities to allow the many strands of professional business to proceed smoothly but our ability to reach consensus and accept that we have all moved a little to achieve it is still a struggle. I believe we have moved a long way in the past few years, both for science and for the profession as a whole and I hope and expect that the upwards trend will continue. Certainly science has a key role to play in all our futures and the Society is doing its best, with the Academy of Pharmaceutical Sciences, to maintain itself at the leading edge. The future is bright, not black.

W. Dawson
Member of Council, Royal Pharmaceutical Society

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The Journal

United front

From Mr A. D. Allen, FRPharmS

Can I support my colleague David Coleman (PJ, March 3, p283) regarding the rationale and purpose of the special general meeting recently called by Ashwin Tanna and his 80 colleagues. Let me say from the outset that I was not a member of any of the interview panels that met to assess and appoint the editor of The Pharmaceutical Journal but was apprised of the situation at the beginning and end of the process. The overall process was explained to the Council at its meeting in February and I for one was satisfied that the appointment was properly made.

For the past few months I have been working tirelessly with all the directors to finalise a budget for 2001 which we hope will achieve a surplus of approximately £220,000 despite the many financial pressures on the Royal Pharmaceutical Society's funds. This process has been painful for all parties concerned but I am determined that the Society's funds will show a surplus in future years. We have further work to be done in order for this situation to be achieved but I am confident that with the profession pulling together this can be done. Despite all this hard work, there have been letters from within the Society's Council and from the membership criticising the Council for their every action.

The Society is facing extreme financial pressures in order that it can carry out the most challenging agenda faced by our profession for many years. We need the support of the membership at this extremely challenging time. Instead we are facing an SGM with a motion of no confidence. I hasten to add that this meeting will cost the Society at least £20,000. Surely this is not the way for a profession to go forward, we should be discussing the challenges facing us rather than navel-gazing about the appointment of a non-pharmacist to the role of PJ editor.

I am amazed by the comments and letters that arise, whenever a senior post at Lambeth becomes vacant, over the issue that the appointee must always be a pharmacist. Surely we want the best person for the vacancy, one who brings vision and clarity to the job rather than the fact they must be a pharmacist.

We must as a profession realise that there is a world outside pharmacy where there are many capable individuals from different backgrounds who can enrich our profession by their knowledge and ability.

We must be able to tap into this labour market and use it to the advantage of our profession. It has been said that standing still is not an option and at this point in pharmacy's development we must take the opportunities presented to us in the NHS plan. To do so, we must have the support of the vast majority of our members.

I would like to throw open a challenge to your readers (including the movers of the SGM). I am prepared to speak to any of them in any forum to discuss frankly and openly any issues over this appointment process but, please, let us not go through the agony of an SGM which will be destructive, unproductive and extremely expensive. We all need to show a united front at this challenging time.

On a personal note, I am always prepared to accept criticism provided it is accurate and balanced, but of late the Council has been attacked by it own members with a series of rumours, gossip and genuine misunderstanding. The third issue, I am prepared to accept, happens when we are trying desperately to move to a more transparent process but the first two issues should be treated with the contempt they deserve.

David Allen
Treasurer, Royal Pharmaceutical Society

Editor's appointment

From Mr H. Patel, FRPharmS

Ann Lewis's letter about the appointment of the editor of The Pharmaceutical Journal (PJ, March 3, p284) misrepresents my position. It has also to be said that at best the appointment process for the editor of The Journal was “clouded”.

Miss Lewis admits that no vote was taken so, at best the decision is nem con (with no one dissenting), which is different from voting unanimously (all present showing agreement). In fact, before and during the process of interviewing I raised the following as concerns:

1. the presence of a non-pharmacist on the list of interviewees when the Council had not discussed this at any stage of the process
   
   
2. the absence of “knowledge of the field” on the selection criteria (a reason for the above view)
   
   
3. lack of a remit for the panel from the Council

In fact, it was me who insisted that the panel did not have a remit to make an appointment and that the matter should be taken to the Council for decision.

There were unsatisfactory aspects of the interview process, which I intend to take up with the Council in due course.

Points to note are:

• The brainstorming group, according to its written report, did not even consider the appointment of a non-pharmacist and the Council did not consider this in October, 2000, when it considered the group's report.
  
  
• This group was not reconvened to re-examine the recommendation of the recruitment agency nor were all the Officers involved.
  
  
• Non-pharmacists appeared on the list of interviewees without the knowledge or consent of the Council. I see this as a strong tendency to bypass the Council, tolerated, if not encouraged, by lack of action by the Council.
  
  
• The field, because of the specialist role, was narrow but the list of applicants was not short.
  
  
• Miss Lewis says she agreed to the appointment of a non-pharmacist on the basis that the final decision would be for the Council. This was not a choice offered to the Council at its meeting in February. The choice was to ratify or not to ratify the appointment of a recommended candidate. The identity of the candidate was revealed later. In the circumstances Miss Lewis describes, I feel the correct way to give the Council choice would have been first to ask for a discussion and vote on whether to employ a non-pharmacist and then, depending on the outcome, make a suitable recommendation of the best person from the appropriate category. This would have necessitated both options covered by a suitable recommendation from the interview panel but this was not the case. However, it would have been preferable to involve, at least, the Officers after taking advice from a recruitment agency. Another recruitment agency might have had a different view.

As the process is “clouded”, there is now a need to review the process to introduce clarity and accountability. Looking ahead, I feel that the Council must take charge and review the process of appointing senior staff so that it is fair, transparent and robust enough to undergo any scrutiny — just like the process used in the consideration of legal and ethical infringements by the Council. I repeat the points I made in my letter to The Journal (PJ, February 24, p251): I have never voted for a non-pharmacist as the editor of The Pharmaceutical Journal in any forum.

For me this letter ends the discussion and I will be putting energy into getting the Council to agree a review of the senior appointments at the Society and other more interesting projects.

Hemant Patel
Brentwood, Essex

Statement from the Royal Pharmaceutical Society We were members of the panel that met on January 22 to interview shortlisted candidates for the post of editor of The Pharmaceutical Journal and make a recommendation for appointment to the Council. The panel comprised the undersigned and Mr Hemant Patel (Immediate Past President of the Society). We the undersigned should like it to be known that it is the view of us all that the panel took a unanimous decision as to which candidate would be the best editor for The Journal.

Having discussed and made its decision, the panel was asked more than once to confirm that this was indeed the decision of us all. On the day, no panel member expressed dissent from that decision.

Christine Glover
President

Marshall Davies
Vice-President

Ann Lewis
Secretary and Registrar
Royal Pharmaceutical Society

Alison Blenkinsopp
Professor of Pharmacy Practice
Keele University

Alun Jones
Chief Executive
Institute of Physics

Independent, objective, analytical

From Dr T. D. Duffy, MRPharmS

I was delighted to read of your appointment as editor of The Pharmaceutical Journal. Your background in health and medical publications supplemented by a record of achievement with the Independent, the Times and the Observer seems to be ideal. One would expect such an appointment to enhance the status of the Royal Pharmaceutical Society; things do seem to be moving in the right direction.

It is important for the future that the profession is able to see its role within the complex mix of professions and organisations which now affect the pharmaceutical world. Your experience will surely help to paint the bigger picture. Sadly, however, your appointment is becoming a cause célèbre for the wrong reasons. How ludicrous that there should be a call for a special general meeting because you are not a pharmacist.
The Journal needs its voice to be independent, objective and analytical. It is a pity that the appointment of a highly suitable candidate is spoiled by the petty politics, small-mindedness and skulduggery which too often besmirches the Council's activities and surely adversely affects the way that pharmacy is perceived.

Surely a profession that is able to secure the services of members of other professions increases not only its skills base, but also its vision. Few pharmacists, if any, can contribute what you will bring.

T. D. Duffy
Senior Partner, Lowden International Pharmaceutical Quality Consultants

No harassment

From Mr C. Payne, MRPharmS

I fail to understand all the fuss regarding the appointment of a non-pharmacist as editor of the PJ and I have no doubt that you will do an excellent job and provide a much needed “breath of fresh air”. Mr Tanna states that “the Council had not taken into account the concerns of the membership when it had made its decision to appoint [you]” (PJ, February 24, p239). When has the Council ever taken into account the concerns of the membership regarding anything?

So let us allow you to get on and do your job without harassment. Perhaps we may one day even have a non-pharmacist president!

Conrad Payne
Haddenham, Cambridgeshire

Break with tradition

From Mr A. G. M. Madge, FRPharmS

The Royal Pharmaceutical Society has broken with tradition in not having a pharmacist as editor of The Pharmaceutical Journal. Is it a change in direction? Whereas our Journal has been a world leader in pharmaceutical matters, is it now the policy to be a world leader among allied science and professional bodies, while still extolling pharmacy? The change has not been enthusiastically welcomed and the old saying recalled of the “proof of the pudding . . .”. However, the die has been cast and good wishes are given to you with your impeccable record. There is another point that only a pharmacist can think as a pharmacist. Much responsibility must also rest on the shoulders of the deputy editor, Andrew Haynes, in seeing our PJ into the new era.

Mervyn Madge
Plymouth, Devon

Horses for courses

From Mr T. Dean

Congratulations on your appointment as editor of The Pharmaceutical Journal. Taking up this challenge was never going to be easy for anyone, particularly following in the footsteps of a long-serving and respected editor such as Douglas Simpson. It is unfortunate that some members of the Royal Pharmaceutical Society seem intent on making your job even harder.

The primary concern of any publishing house should be to appoint the best editor they can find. In the case of The Pharmaceutical Journal if this person happens also to have qualified in pharmacy many years ago all well and good. But editing is a career choice and a profession in its own right and this should be respected. After all no one would expect the Society to appoint a pharmacist to run its legal or financial services.

The most important thing for any editor of The Pharmaceutical Journal is that he or she has access to and the support of pharmacists in general and the staff of the Society in particular. I hope for your sake and that of The Journal that when the storm blows over this will be the case.

Tim Dean
Editor, Prescriber

Pleasure at appointment

From Mr D. R. Petty, MRPharmS, and others

We would like to express our pleasure at your appointment to the post of editor of The Pharmaceutical Journal. Your readers might like to know that we had the opportunity to work with you in establishing the Primary Care Pharmacists' Association while you were working with Medicom UK Ltd. Your foresight in appreciating the need for the association came through strongly and we believe this venture, which you supported, has already proved to be of benefit to many pharmacists throughout the United Kingdom.

However The Pharmaceutical Journal develops in the future, we fully expect that it will continue to be enjoyed by its readers and that you will make an important contribution to that development.

Duncan Petty
Sue Carter
Janet Krska
Primary Care Pharmacists' Association

Most fortunate

From Mr J. Wilson, MRPharmS

Whatever must you think of us? We have been most fortunate in securing the services of a successful and much respected professional medical writer as the new editor of The Pharmaceutical Journal and all we can do is whinge because you are not a pharmacist. Worse, some of our number want to investigate the circumstances of your appointment. What a welcome, and what appalling bad manners! May I suggest to all my colleagues that, now that you are in post, you are left to edit our Journal in peace.

John Wilson
Arnold, Nottinghamshire

Changes to the editor's job description

From Mr D. I. M. Simpson, FRPharmS

There is much I could say about the letter from the Secretary and Registrar (Miss Ann Lewis) that you published last week (p284), but I will confine myself to commenting on the part that discloses information about me.

Miss Lewis says that the overall duties of the editor have been broadened to include not only communication with the membership but also communication with the wider world. She says that I had agreed that change.

In fact, what I agreed to, at Miss Lewis's suggestion, was inclusion, as one of the main purposes of the editor's job, the words “to play a key role in communicating the work of the Society to the membership and to the wider readership.” I did not need any persuading to include these words because they set out what has since 1841 been the role of the editor of The Journal. The Journal has always been the principal communication link between the Society and its members and as such it has always communicated the work of the Society to the membership. At the same time, the PJ has always been read by others and so it has always had a role in communicating the work of the Society to non-members. So, in reality there was no change in role for me to agree to and no broadening of the role of the editor.

Perhaps by changing the word “readership” to “world” Miss Lewis gives a clue as to what this whole exercise is about. Could it be that the PJ is to become a weapon in the Society's public relations armamentarium? I hope that is not the case, because it would destroy the credibility and integrity of the publication, and without either of those attributes the publication is valueless.

I would not want readers of Ms Lewis's letter to believe that I had agreed the wording of the job description for the new editor. I was not consulted about it. My discussions with her were solely concerned with updating my job description while I was still in post as editor. In the event, there are substantial differences between the job description that I agreed with Miss Lewis and the job description supplied to candidates for the post. I would not have agreed to most of the changes, which seem to me to give too dominant a role to the new editorial advisory board, the form of which is dictated by the Council. The membership of the board will, we now learn (last week's PJ, p284), be subject to ratification by the Council, which means that the Council will be in a position to control the board's membership.

I will mention one addition that is of particular concern to me. In the version of the job description that I saw was the following duty: “To represent the Society at appropriate external meetings in order to communicate the work of the Society to the membership and healthcare professionals.”

In my view, that is a job for Council members and members of the Society's administrative and public relations staff. It should not be the job of the editor of The Pharmaceutical Journal. It is one thing communicating the work of the Society through the pages of The Journal and quite another to become an advocate of those policies on behalf of the Society.

In the light of all this, I am very concerned about the future independence of The Journal from the Society's administrative and political processes.

Douglas Simpson
Beckenham Kent

Miss ANN LEWIS (Secretary and Registrar, Royal Pharmaceutical Society) replies:

The editor's job description does indeed refer to the “wider readership”. This term was used to indicate those outside our pharmacy world, including researchers from a wide range of disciplines, politicians and civil servants. Surely we want to communicate to this “wider world” of readers.

On the second point, the Society's senior staff attend external meetings where they communicate the work of the Society. In the case of the editor, this would be the work of The Journal. This reflects the seniority of their posts and in no way affects the freedom of the editor of The Pharmaceutical Journal or its independence within the Society.

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