News

• ABPI fails to stop Government from blocking pharmacy data purchases
• MCA not impartial on cannabis medicines, say Lords
• Council of Europe gives support for pharmaceutical care
• Care homes must seek pharmacists' advice
• BMA sets out pharmacist prescribing proposals
• Students get advice tips discount
• How can Government assist pharmacists?
• Wales sets out to implement the NHS plan
• East London pharmacists mark National Science Week
• EU to make it easier to work in other member states

News in brief

ABPI fails to stop Government from blocking pharmacy data purchases

Pharmacies will be prevented from selling anonymised prescribing data to the pharmaceutical industry, despite attempts by the Association of the British Pharmaceutical Industry to convince the Government to drop a Health and Social Care Bill clause which could stop this. Instead, the Government has amended the clause to make it clearer that its aim is to block such sales.

Clause 67 of the Bill sought to allow the Secretary of State to make regulations prohibiting the processing and disclosure of patient information for prescribed commercial purposes. Now, after the Bill's committee stage in the House of Lords on March 22, a Government amendment to the clause makes clear that the aim is to stop the use of data collected in the course of National Health Service work for marketing or promotional activities which might be against the economic interests of the NHS.

Concerns were also expressed by peers that the new power could prevent pharmacists using data from their patient medication records to improve the efficiency of their businesses.

Lord Hunt of King's Heath (Parliamentary Under-Secretary of State for Health) said that there was no intention to hinder pharmacists, or any other professional, implement steps to run safe and effective services and that the amendment should reassure them on that point. Powers taken under the clause could only be used to improve patient care or in the public interest.

Following the Bill's second reading in the House of Lords on February 26, the ABPI wrote to peers asking them to reject what it called a Government attempt to control vital information on medicines.

“This would give the Secretary of State sweeping powers to prohibit on a completely arbitrary basis data on medicines gathered for commercial purposes,” Dr Trevor Jones (director general, ABPI) said. “These purposes are not clearly defined and could mean anything. Such data collection is primarily funded by the pharmaceutical industry. If it is banned, it will affect not only the industry itself but also the valuable work of many other groups, including patient and research organisations that currently have free use of the data.”

During the committee stage, Lord Hunt explained that the power was being sought following the Government's failure to stop the sale of prescription data by legal action almost two years ago. At the first stage, the High Court ruled in favour of the Department of Health which argued that the sale of anonymised data breached patient confidentiality (PJ, June 5, 1999, p794). Subsequently, the Court of Appeal ruled that there was no breach of confidentiality because the privacy of patients was safeguarded by anonymisation of the data.

One of the judges said that if the Department continued to view data sales as operating against the public interest then it should seek new powers (PJ, January 1, 2000, p5).

MCA not impartial on cannabis medicines, say Lords

The Medicines Control Agency is failing to deal with cannabis-based medicines in the same impartial manner that it deals with other medicines, the House of Lords Select Committee on Science and Technology believes.

In a report published on March 21, the committee says that the MCA is delaying the introduction of cannabis-based medicines by calling for new toxicology data on cannabidiol (CBD), one of two active cannabinoids being currently used in clinical trials. The MCA wants new data because of concerns about CBD inhibiting spermatogenesis in animals. However, the committee notes that cannabis oil extracts have a long history of use in humans and were in the British Pharmacopoeia Codex until 1948.

CBD is present in a sublingual spray being used in clinical trials by GW Pharmaceuticals Ltd. This will soon enter phase III trials. The company told the committee that if it had to provide the additional data required by the MCA it could delay the production of a cannabis-based medicine by two to three years. The Canadian regulatory authorities, for example, had not asked for additional toxicology data.

The committee accuses the MCA of taking an overly cautious approach which is denying patients with severe conditions such as multiple sclerosis the right to make informed decisions about their treatment.

The MCA says that its overriding concern is protecting public health and that it will not allow its standards to be compromised. It has received new information on the long-term use of CBD and the MCA and the Committee on Safety of Medicines are now permitting the extension of trials of products containing CBD by one year.

The Lords' committee also expresses concern about the slow progress of two Medical Research Council funded proof of principle trials of cannabis extract in multiple sclerosis and postoperative pain. Both trials use protocols developed by the Royal Pharmaceutical Society. The multiple sclerosis trial has only just started recruitment and the full details of the other trial have not been finalised. The committee welcomes a change in attitude by the Home Office that, subject to approval of quality, safety and efficacy, cannabis could be rescheduled from Schedule 1 to Schedule 2 of the Misuse of Drugs Regulations 1985. The Home Office said that there was a much clearer distinction now in public debate between medical and recreational use of cannabis.

The Lords' committee believes that in the absence of a licensed cannabis-based medicine, genuine therapeutic users of cannabis who possess or grow their own should not be prosecuted. It argues that current therapeutic users are subject to postcode prosecution because of differing decisions by regional offices of the Crown Prosecution Service.

Council of Europe gives support for pharmaceutical care

The Council of Europe has passed a resolution backing pharmaceutical care as a key element in preventing problems with medicines.

The resolution calls on governments to recognise the front-line role of pharmacists and to create links between pharmacists, other health care professionals and health departments. Pharmaceutical care, it says, should include careful record keeping, monitoring of prescriptions, evaluating patients' overall medication and giving advice to patients and other health professionals.

Care homes must seek pharmacists' advice

Care homes for older people will in future be required to operate medicines policies drawn up with input from pharmacists, according to new national minimum standards under the Care Standards Act 2000. Homes will be required to comply with the standards as from April 1, 2002.

The standard on medication — one of 38 standards — states that homes must have policies and procedures for the receipt, recording, storage, handling, administration and disposal of medicines. The home manager must seek information and advice from a pharmacist regarding medicines policy within the home and medicines dispensed for individuals in the home.

Residents who so wish should be able to take responsibility for their own medication, within a risk assesment framework, the standard says. Those assessed as able to self-administer medication should be able to store their medicines in a lockable space.

Homes must keep records of all medicines received, administered and leaving the home or disposed of, to ensure that there is no mishandling. A record must be maintained of current medication for each resident, including those who are self-administering.

The standard says that, as well as meeting the requirements of the Medicines Act 1968 and the Misuse of Drugs Act 1971, medicines handling must comply with Royal Pharmaceutical Society guidelines.

“Care homes for older people: national minimum standards” (ISBN 0 11 322310 2) is available from the Stationery Office, price £11.25. It can also be accessed from the Department of Health website.

BMA sets out pharmacist prescribing proposals

Local medical committees are to be asked by the General Practitioners Committee to approve a policy that community pharmacists should be able to prescribe certain over-the-counter medicines on the National Health Service. The proposal is made in a British Medical Association discussion paper published on March 21 and which calls for a radical rethink on National Health Service arrangements for prescribing, principally in relation to the cost to patients.

A section dedicated to the role pharmacists can play calls for a restricted formulary of OTC medicines to be available to patients on the same terms as NHS prescriptions, ie, free of charge or at no higher price than an NHS prescription. The proposal also calls for OTC sales to be recorded in patients central electronic records and for patient registration with pharmacies. In the interest of fairness, the draft policy calls for NHS rules to be changed so that dispensing doctors can supply OTC medicines on the same terms as pharmacists.

The BMA says that the current system of prescription charges is riddled with anomalies. The discussion document suggests a range of options to reform the system. For example, allowing anyone requiring medication for longer than six months to qualify for charge exemption. Alternatively, no-one would be exempted from prescription charges on any grounds, but discounts would be available to people on low incomes or with chronic conditions.

The discussion document can be found here.

Students get advice tips discount

Members of the British Pharmaceutical Students Association will be able to purchase sets of the “Advice for patients” tips, published in The Pharmaceutical Journal, at a 25 per cent discount.

The BPSA has reached an agreement with Pharmacy Practice Consultants, which writes the advice tips. It will be promoting the sets to its members, making them more widely available to undergraduates and preregistration trainees.

How can Government assist pharmacists?

The Government needs to find ways to help community pharmacists so that they can implement the pharmacy plan, the All-Party Pharmacy Group says in a letter sent to Lord Hunt (Parliamentary Under-Secretary of State for Health).

The letter was sent on March 21 following the group's recent visit to the Boots the Chemists branch at High Street Kensington, London (PJ, March 10, p304). In it, Dr Howard Stoate (chairman, APPG) says that staff at the pharmacy, in common with pharmacy staff elsewhere, are keen to develop the services they offer to the public. However, the group is conscious that many community pharmacies do not have the resources available to invest in providing new services. On this basis, the Government needs to address four issues, it says:

How can community pharmacists be helped to provide quiet areas for patient counselling, medicines management and pharmacist prescribing?
What assistance can be given to enable single-handed community pharmacists to take on additional pharmacists to provide new services?
How might material encouragement be given to community pharmacists to undertake additional training?
How can the Government work with pharmacy organisations to tackle the current shortage of pharmacists?

The All-Party Pharmacy Group says that it is encouraged by the action taken so far by the Government, but it wants to see actual and potential barriers to the development of pharmacy services dealt with quickly and effectively.

Wales sets out to implement the NHS plan

Mrs Ann Lloyd (director of the National Health Service in Wales) has set out how the NHS plan will be implemented in Wales.

The process will be controlled by a 25-member steering group chaired by the Welsh Health Minister (Ms Jane Hutt). The director of NHS Wales will be assisted by an implementation group, which will include the chief medical and nursing officers for Wales. Nine task and finish groups will be established covering structures, public health review, service development, health challenges, patient focus and public engagement, joint working, workforce development, finance and assets, and performance management. The nine chairmen will be part of the implementation group. Each group will have its own multidisciplinary reference group on which ideas can be market tested. The task and finish groups are to produce their work schedules next month and to complete their short-term objectives by June.

Mr Colin Ranshaw (chairman of the Royal Pharmaceutical Society's Welsh Executive) told The Journal that he had written to Mrs Lloyd asking for the chief pharmaceutical adviser in Wales to be included in either the steering group or the implementation group. The Executive was actively pressing the case for the inclusion of pharmacists on the task and finish groups. He would be making a progress report to the Society's Council at its April meeting.

East London pharmacists mark National Science Week

Pharmacists in the Barking and Havering health authority area marked National Science Week (March 16 to 22) by launching a year-long campaign aimed at encouraging primary and secondary school pupils to become involved in science.

The “Scientist in the high street” campaign is the first project of its kind in the area and aims to show that science can be fun, interesting and a rewarding career.

Planned activities include:

pharmacists in Barking, Dagenham and Havering adopting students for a day to show the daily use of science in the high street
a specially produced “Ask your pharmacist” booklet commissioned by the health authority and produced by the National Pharmaceutical Association
window displays in participating pharmacies and the health authority's health information shop
school visits by pharmacists to talk about the importance of science

Mr Hemant Patel (secretary of the local pharmaceutical committee and a non-executive director of the health authority) said: “Science and maths are used more and more in every day life and many careers are science based. This is why it is extremely important for us to encourage children from an early age to become interested in these subjects.”

The health authority chairman (Ms Sue Young) added: “The National Health Service is full of scientists. The NHS could not operate if it was not for scientists and that is why the health authority supports this campaign and is so keen for young people to get involved in science.”

EU to make it easier to work in other member states

Pharmacists should find it easier to work in other European Union member states within a couple of years.

The EU has approved changes to existing directives encouraging the mutual recognition of qualifications for a limited number of professions, including pharmacists. The directives aim to promote the free movement of workers within the EU — one of the union's key Treaty of Rome commitments.

The amendments will oblige member states to take rapid decisions on requests for recognition of qualifications. They also underline the requirement for national authorities to take account of professional experience gained in different member states. They also insist that national governments promptly update lists of professional diplomas, certificates and titles that are automatically recognised by professional bodies across the EU.

Member states are required to implement the amendments in their national laws by January, 2003.

News in brief

Buprenorphine instalments

Subutex (buprenorphine) sublingual tablets will be prescribable in instalments on FP10HP(AD) or FP10MDA forms from April 1. The change only applies to England and such prescriptions cannot be dispensed in Wales. The Welsh Assembly is expected to introduce the change shortly. Buprenorphine can already be dispensed in instalments in Scotland.

Industry report published

The pharmaceutical industry and the Government have published the final report of the Pharmaceutical Industry Competitiveness Task Force saying that they are pleased with the results of a year of talks between Ministers and senior industry executives. Further talks are to be held in a Ministerial Industry Strategy Group.

Paediatric etanercept review

The National Institute for Clinical Excellence is to review the use of etanercept (Enbrel) in children as part of its ongoing review of the product's use in adults.

Plain English guide

The Plain English Campaign has published a free guide to writing medical information in plain English. It contains a glossary to help staff explain medical terms in everyday language. The guide is available from the PEC's website (www.plainenglish.co.uk/freepub).

More organ donors

Boots the Chemists Ltd says that around 120,000 holders of its Advantage loyalty card have registered to join the National Health Service organ donor scheme. Card holders can register by completing a form or through instore Advantage card kiosks.

Council expenses website

Mr Sultan Dajani, a member of the Royal Pharmaceutical Society's Council, has set up a website listing the expenses and allowances he received last year as a result of his Council activities. He received £28,637.31, comprising £12,398 in attendance allowances and £16,239.31 in reimbursed expenses.

Mr Dajani told The Journal that he had established the site in order to open up the Council's expenses system so that pharmacists could feel some ownership of it. He hoped that other members of Council would follow suit.