News summary

Sue Sharpe, currently director of professional standards at the Royal Pharmaceutical Society, and Barry Andrews, retail director, Alliance Unichem Plc, have been appointed chief executive and non-executive chairman, respectively, of the Pharmaceutical Services Negotiating Committee...[more]

Flaws in the black triangle scheme, used by the Medicines Control Agency to highlight new medicines which are being closely monitored for adverse effects, mean that doctors and pharmacists do not always know which medicines they should be reporting side effects for, according to the Consumers Association...[more]

Glen Miller, MRPharmS, has been voted on to the executive committee of Eastern Hull Primary Care Trust to represent pharmacists in the locality...[more]

Fire badly damaged a pharmacy in Bradford during rioting in the city last Sunday night, April 15...[more]

Pharmacists in hospitals and the community are praised in a new report from the Department of Health for introducing good practice to reduce medication errors...[more]

Pharmacy students at the British Pharmaceutical Students' Association conference, held in Portsmouth last week, have expressed concern over the unsupervised consumption of methadone by addicts...[more]

The Office of Fair Trading recommences its attempt to overturn resale price maintenance (RPM) on medicines at the Restrictive Practices Court (RPC) in London on April 25...[more]

PSNC announces new leadership

Sue Sharpe, currently director of professional standards at the Royal Pharmaceutical Society, and Barry Andrews, retail director, Alliance Unichem Plc, have been appointed chief executive and non-executive chairman, respectively, of the Pharmaceutical Services Negotiating Committee.

Mrs Sharpe is expected to take up her new post during July or August and Mr Andrews will take over the PSNC chair from Wally Dove at the PSNC's July meeting.

The appointments were announced on April 17 following the PSNC's April meeting.

Mrs Sharpe said: “Community pharmacy has enormous opportunities to develop and grow and to enhance the range of services provided through the National Health Service to the public. There is a great deal to do if we are to capitalise on these opportunities and deal effectively with the challenges that undoubtedly lie ahead.”

She added that the greatest challenge was to get community pharmacists to feel positive and enthused. It was important to work with local pharmaceutical committees to help them make the best of local negotiations, but a lot of the groundwork would be done nationally.

Other matters raised at the PSNC meeting are reported below.

Remuneration No response had been received from the Department of Health to the PSNC's claim for a significant, but unrevealed, percentage increase to the global sum. Mr Dove said that he hoped to settle remuneration swiftly so as to be able to concentrate on the new pharmacy contract. Moves on that were expected towards October, with likely implementation in 2003.

NSF for the elderly The national service framework for older people, which included a separate booklet on matters related to medicines (PJ, March 31, p415), opened up many opportunities for community pharmacists to enhance their primary care role. Guidance was to be prepared for LPCs to help them take advantage of the NSF.

Pharmacy prescribing This was higher on the government's agenda than had been thought six months ago. Disillusionment following the round table meetings on the future of pharmacy in 1998 had been replaced by optimism after comments made by Lord Hunt, Parliamentary Under-Secretary of State for Health, and the Department of Health's chief pharmacist for England, Dr Jim Smith. The PSNC would seek views from all national pharmacy organisations before taking the matter forward with the Department.

Prescription charges The Department and the Welsh assembly were aware that apportioning prescription costs between England and Wales could be difficult if large numbers of prescriptions crossed the border to take advantage of cheaper Welsh prescription charges. A Departmental group was considering the issue.

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Black triangle scheme flawed, says the Consumers Association

Flaws in the black triangle scheme, used by the Medicines Control Agency to highlight new medicines which are being closely monitored for adverse effects, mean that doctors and pharmacists do not always know which medicines they should be reporting side effects for, according to the Consumers Association.

The CA concern, reported in the April issue of its publication Drug and Therapeutics Bulletin, is based on an analysis of summaries of product characteristics (SPCs) given in eMC, the electronic medicines compendium (www.emc.vhn.net).

Pharmaceutical companies are not legally obliged to publish SPCs on eMC, nor to include black triangles in their literature, although the MCA asks that they do so in order that the products can be closely monitored for two years. The Committee on Safety of Medicines then decides whether or not the black triangle can be removed in the light of reports received.

DTB says that 54 out of 159 branded products in the black triangle scheme on March 2, 2001, were not listed on eMC and 29 of those listed were not identified as black triangle medicines. Printed SPCs were then requested for these products. Forty-four out of 163 received from companies did not include black triangles.

The Consumers Association also looked at advice given in the SPCs on use of the medicines in liver disease. It concluded that most SPCs offered vague and unhelpful advice and gave little indication of what information should be given to patients.

DTB concludes that the black triangle scheme is not sufficiently robust and that this could put patients at unnecessary risk.

It says that if the scheme is to be effective its different components need to be robust in themselves and integrated with each other. “SPCs should be available, usable and reliable and those for black triangle drugs should be clearly identifiable.”

The DTB report is the second in a series of three articles planned by the Consumers Association on side effects. The first, in the April issue of Health Which?, called for patients to be allowed to report side effects to the MCA themselves (PJ, April 14, p493). The third, to be published in Health Which? in June, is to report concerns over the amount of information patients are given about potentially serious side effects.

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Pharmacist voted on to PCT executive

Glen Miller, MRPharmS, has been voted on to the executive committee of Eastern Hull Primary Care Trust to represent pharmacists in the locality. The PCT gained trust status on April 1.

Mr Miller told The Journal on April 17 that Eastern Hull had specifically sought to have a pharmacist on its executive and that this was the fruition of good relations between local pharmacists and general practitioners developed over the past two years. Mr Miller had been one of two applicants for the post and had been appointed after a vote among local community pharmacists.

“I believe that I can bring the trust an understanding of the costs of medicines and of management,” Mr Miller said. The PCT aims to spend its £91m budget efficiently while meeting Government targets. So far the executive has held two meetings.

His work for the executive is expected to take three-and-a-half days a month, once fully established, for which there will be a payment of £6,500 a year, plus a locum fee allowance. Mr Miller is manager of Lloyds Pharmacy's branch at North Point shopping centre, Bransholme, Hull. He is also a member of the local pharmaceutical committee and of Hull's pharmacy development group.

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Bradford pharmacy burnt out in riot

Fire badly damaged a pharmacy in Bradford during rioting in the city last Sunday night, April 15. The pharmacy at 82–84 Horton Grange Road was acquired by Lloyds Pharmacy Ltd from Per-Medic Ltd last month.

A spokesman for Lloyds said that extensive damage had been caused to the inside of the pharmacy, with stock and fittings charred and the pharmacy computer melted by the heat. Lloyds is offering an alternative service from a nearby branch and intends to have a prescription service running from the pharmacy in a few days. The pharmacy will be fully refurbished.

West Yorkshire Police said that damage to the pharmacy was one of a number of separate incidents that occurred after fighting broke out outside a public house. Other premises and a large number of cars were damaged at the same time.

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Pharmacists praised in safety report

Pharmacists in hospitals and the community are praised in a new report from the Department of Health for introducing good practice to reduce medication errors. The report “Building a safer National Health Service for patients” says that a National Patient Safety Agency is to be created.

The report says that systems need to be put in place to ensure that lessons learnt from adverse events in one locality are learnt across the NHS as a whole. The new agency will establish a standardised reporting system, initially on paper but later electronically, for adverse events and near misses.

The report sets targets of reducing the number of serious errors in the use of prescribed drugs by 40 per cent by 2005 and to reduce to zero the number of patients dying or being paralysed by maladministered spinal injections by the end of 2001 (see p528).

In a section on medication errors [page 50], the report says errors rarely happen because of one failure only and it would be a mistake to assume all medication errors were prescribing errors. Mistaken identification due to almost identical packaging is highlighted as an avoidable cause of error.

Good practices described by the report as under way or planned include the work by hospital pharmacists on medication history taking when patients are admitted; monitoring of hospital drug charts by pharmacists and technicians; a statement by the Guild of Healthcare Pharmacists on strong potassium chloride injections; introducing repeat dispensing in community pharmacies and medicines management programmes in primary care; and work by the Medicines Control Agency on the labelling of medicines.

The National Patient Safety Agency is to be established by July, 2001, with reporting phased in from December, 2001.

Copies of the report are available from the Department of Health's website (www.doh.gov.uk/buildsafenhs).

See also Comment

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Students call for supervision of methadone consumption

Pharmacy students at the British Pharmaceutical Students' Association conference, held in Portsmouth last week, have expressed concern over the unsupervised consumption of methadone by addicts.

Mike Embrey (Nottingham) proposed that all methadone supplied by pharmacists should be taken under supervision. Unsupervised consumption meant that methadone could be sold on to other addicts, he said.

“Pharmacists are put in a difficult position when addicts complain that their bottle of methadone has broken.” Supervised consumption would eliminate these problems.

Zubin Austin, lecturer in evidence based medicine, University of Toronto, said that patients in Canada were rarely allowed to take their methadone away from the pharmacy. This was not without problems as addicts living in rural communities had to travel large distances to collect their daily supply.

Speaking against the motion, Matt Howard (Portsmouth) said that the proposal did not take in to account real situations. He argued that some addicts could be trusted to take their methadone unsupervised. He also commented that problems with supply during holidays and for those living in rural areas were not being taken in to account.

However, other conference participants believed that supervising the consumption of all methadone dispensed by pharmacists was a good idea and the motion was carried.

A report of other debates and events at the BPSA conference will appear in next week's Journal.

See also Article (PDF file, 120K)

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RPM case recommences on April 25

The Office of Fair Trading recommences its attempt to overturn resale price maintenance (RPM) on medicines at the Restrictive Practices Court (RPC) in London on April 25.

The new panel hearing the case — Mr Justice Buckley, Professor Sajal Lahiri (Professor of Economics, Essex university) and Carol Ferguson (an economist) — will begin hearing evidence from the point at which the case was suspended last year. They have been studying the original evidence since March 19.

The case was suspended after the Proprietary Association of Great Britain and the Proprietary Articles Trade Association applied for one of the original panel members, Dr Penelope Rowlatt, to be removed after it was discovered that she had enquired about a job at Frontier Economics. The company had provided advice and evidence to the OFT for the case. Dr Rowlatt made her job enquiry after she had begun hearing evidence. One of the company's directors has been a witness in the case.

The RPC rejected the application for Dr Rowlatt's removal from its panel. The Court of Appeal subsequently ordered that the entire RPC panel should be dismissed (PJ, November 25, 2000, p774).

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