News summary

A special interest group (SIG) has been set up to help develop the contribution of pharmacy to public health...[more]

National Health Service trusts should carry out better checks on locum practitioners before they are employed, says the Commission for Health Improvement...[more]

Specially trained nurses in England and Scotland are to be allowed to prescribe on the National Health Service all non-black-listed pharmacy and general sale list medicines, along with an increased range of prescription medicines...[more]

The National Institute for Clinical Excellence is having little effect on the postcode lottery by which the treatment people receive from the National Health Service depends on where they live, according to the Liberal Democrats...[more]

Pharmacists can expect to be given two months' notice of the planned discontinuation of medicines under guidelines agreed between the Department of Health and the Association of the British Pharmaceutical Industry...[more]

GW Pharmaceuticals, which is testing cannabis-based medicines, is now moving to phase III clinical trials of a sub-lingual spray containing cannabis derivatives to alleviate severe pain and spasticity caused by multiple sclerosis and spinal cord injury...[more]

A medicines safety campaign endorsed by the Royal Pharmaceutical Society has won backing from 67 members of Parliament who have called for Government support for such projects...[more]

New arrangements are to be made for the repeat prescribing of gluten-free foods for people with coeliac disease...[more]


News in brief

New AAH course AAH Pharmaceuticals has launched a five-module distance-learning programme for Vantage medicines counter assistants. The five text-based modules cover nutrition, skin conditions, summer health, diabetes and gastro-intestinal disorders.

AIDS agreement GlaxoSmithKline is to supply Combivir (zidovudine and lanivudine) to Burundi at $2 per patient per day (a 90 per cent discount on the average world price), enabling the country to quadruple the number of AIDS patients treated over the next year. Burundi is the seventh African country to reach such a deal.

Clinical trials A European Directive on clinical trials came into force on May 1. The directive sets down rules for the conduct of clinical trials which must now be translated into domestic legislation....[more]

New group to help develop pharmacy's contribution to public health

A special interest group (SIG) has been set up to help develop the contribution of pharmacy to public health.

The UK Public Health Association pharmacy SIG aims to advise the UKPHA on the development of public health policy affecting pharmacy. Other aims are to promote links between pharmacy and the wider National Health Service, social services, local authority services and the voluntary sector, and to raise awareness among the public about the advice and resources available in pharmacies.

At a recent meeting to launch the group, Dr Jim Smith, the Department of Health's chief pharmacist, said that he was delighted to be able to support the launch of the pharmacy SIG. The links between pharmacy and the UKPHA would be important over the next few years as the pharmacy plan was implemented, he added.

Geof Rayner, chair of the UKPHA, said: “We need to be loudmouthed about the emerging role of pharmacy — not only among pharmacists but also among other people too.”

Patients wanted to see pharmacists playing an expanded role, said Yve Buckland, chair, Health Development Agency and Pharmacy Healthcare Scheme. “Pharmacists are a real resource that we need to understand how to use,” she said. “I think we have a role, both in terms of the HDA and the PHS, in helping to make pharmacists' advice as accepted as possible in terms of the evidence base, encouraging standards and professional development.”

The advantage of pharmacies was that they were “totally accessible”, said Andy Murdoch, director of pharmacy at Lloyds-Pharmacy. Anybody could walk off the street and the pharmacist should be able to provide them with health information. Pharmacists would become not only health providers but also health evaluators. However, there were concerns over time pressures and prescription volumes. It was important to get the right skill mix and to delegate roles to staff so that pharmacists could be released to take on the extra roles.

Pharmacists interested in joining the pharmacy SIG need to be members of the UKPHA. Details from the Pharmacy Healthcare Scheme (tel 020 782 3213).

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Better checks on locums needed

National Health Service trusts should carry out better checks on locum practitioners before they are employed, says the Commission for Health Improvement.

Its conclusion comes after an investigation into the practices of four trusts which employed a locum histopathologist linked with high error rates, but is just as applicable to pharmacists.

“The lessons we have drawn from this report can be used for the employment of all clinical and medical staff,” a CHI spokesman told The Journal. “We found that trusts did not carry out any real checks. We suggest basic checks on somebody's employment history and qualifications. It's a very simple message.”

In particular, the CHI report, which is principally about locum doctors, says that there is inadequate checking of references, full interviews are not carried out and there is little performance monitoring.

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More nurses to prescribe more

Specially trained nurses in England and Scotland are to be allowed to prescribe on the National Health Service all non-black-listed pharmacy and general sale list medicines, along with an increased range of prescription medicines.

The first nurses to take the new prescribing powers are expected to complete training in the spring of 2002, with a total of 10,000 nurses in England to be trained by 2004. Consultation on a range of prescription medicines linked to specific medical conditions that nurses will be allowed to prescribe is expected later this year.

Nurses are being given these extended prescribing rights following consultation on the move towards the end of last year (PJ, November 4, 2000, p673). The Government said that the majority of 900 responses to the consultation were in favour of the change.

No announcement has been made regarding the situation in Wales. A spokeswoman for the National Assembly for Wales said that a extending prescribing powers for nurses was to be considered by a steering committee later this month.

Steps to allow supplementary prescribing by nurses are to be taken after the Health and Social Care Bill is enacted. Prescribing by pharmacists is also expected to be allowed.

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NICE achieves little, say Lib Dems

The National Institute for Clinical Excellence is having little effect on the postcode lottery by which the treatment people receive from the National Health Service depends on where they live, according to the Liberal Democrats.

Commenting on a survey of health authorities, Sandra Gidley, MRPharmS, the party's health spokeswoman, said: “It seems that NICE approval is not worth the paper it is written on. And at £1m a shot it is very expensive advice.”

The survey found that one in five health authorities in England was not prepared to fund treatment with at least one medicine which had NICE approval. Furthermore, many were paying for treatment of multiple sclerosis with interferon beta and for trastuzumab treatment of breast cancer, neither of which had NICE approval.

Mrs Gidley added: “Ministers are hiding behind NICE to avoid making controversial decisions on expensive treatments. Local health authorities are ignoring NICE and publishing their own guidance.”

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Two months' warning for discontinued medicines

Pharmacists can expect to be given two months' notice of the planned discontinuation of medicines under guidelines agreed between the Department of Health and the Association of the British Pharmaceutical Industry.

The guidelines, which are not binding, say that companies intending to discontinue any products should seek a meeting with the Department at least 12 months before the planned date if there is no existing therapeutic alternative. The guidelines add that unlicensed uses should be borne in mind. Formal notification of discontinuation should be given at least three months, and preferably six months, before supply by the manufacturer is expected to cease. At this stage, the Department will assume that the information can be shared with the National Health Service, patient groups, other companies and the medical Royal colleges unless companies clearly indicate to the contrary.

Professional bodies and the pharmaceutical and medical press are to be notified of the planned withdrawal by means of a press release two months before supplies cease.

Under the guidelines, the last people to be told officially about a planned withdrawal will be pharmaceutical wholesalers. This is to prevent them from deleting items from their inventories before supply by manufacturers ceases.

The ABPI director-general, Dr Trevor Jones, said: “Co-operation between the government and the pharmaceutical industry is absolutely essential if the NHS is to provide the service that patients expect and if the industry is to operate to everyone's benefit. This is a good example of what can be done. If a medicine is discontinued, it is important that the health of the patient is not compromised and I am confident that these new measures will ensure that this remains the case.”

The full guidelines can be found on the internet.

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Phase III clinical trials about to start for cannabis-based medicine

GW Pharmaceuticals, which is testing cannabis-based medicines, is now moving to phase III clinical trials of a sub-lingual spray containing cannabis derivatives to alleviate severe pain and spasticity caused by multiple sclerosis and spinal cord injury.

If the trials produce positive results, GW hopes to apply to the Medicines Control Agency for a marketing authorisation next year.

The company says that results to date appear to show significant reduction in pain, muscle spasm and bladder dysfunction as well as improved neurological function. In addition, patients are able to self-titrate the dosage so as to provide the suitable level of medical benefit without incurring unwelcome side effects.

Dr Geoffrey Guy, GW's chairman, said: “Data from our four phase II studies in approximately 70 subjects are positive and encouraging. Patients are clearly gaining benefit. These results provide enough confidence for us to increase the number of trial centres and the number of patients taking part. We are seeing a significant improvement in quality of life for sufferers of a range of medical conditions and look forward to extending the trials programme.”

Patients who want to be considered for participation in the company's trials can contact the company's patient contact supervisor, Helen Adams, on 0800 0527100.

Details of GW Pharmaceuticals and its trials programme can be found on the internet at www.gwpharm.com.

Phase III trials are the final stage in obtaining data on large numbers of patients to establish efficacy and to justify a marketing authorisation. Phase II trials involve smaller numbers of patients, while phase I trials establish a safe dose range in healthy volunteers.

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MPs support Society medicines campaign

A medicines safety campaign endorsed by the Royal Pharmaceutical Society has won backing from 67 members of Parliament who have called for Government support for such projects.

An early-day motion about the Society's “Be clear about your medicines campaign” (PJ, January 27, p101) notes that only one in four people aged over 65-years asks pharmacists for advice on medicines.

The campaign, supported by the Doctor Patient Partnership and Age Concern, as well as the Society, was launched by Parliamentary Under-Secretary of State for Health Lord Hunt.

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New plan for gluten-free prescribing

New arrangements are to be made for the repeat prescribing of gluten-free foods for people with coeliac disease.

Government proposals for reducing general practitioners' paperwork include removing the need for them to issue such repeat prescriptions by December. No indication of the nature of the new arrangements has been given. The proposals also include advice to people to consider seeking health advice from pharmacists or from NHS Direct, rather than troubling a doctor.

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