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Notwithstanding Ann Robinson's recent gibes about
Wales and her inhabitants, pharmacy in Wales is neither weakest link nor
should be confined to Room 101. The Welsh Executive, now 25 years old,
has always been in the forefront of thinking, as Colin Ranshaw explained:
“In a rare example of a health care profession actually getting ahead
of the game, the Royal Pharmaceutical Society of Great Britain set out
its vision of the future back in 1995, in a strategy called 'Pharmacy
in a new age'. I was delighted to reread it and realise just how up to
date and relevant it still is.”
There were particular challenges for the profession
in Wales which drove the health agenda, he said. Underpinning all NHS
initiatives were two statistics: first “the famous 'iceberg' of illness
of which the GP just sees the tip which would overwhelm the NHS if were
not for the support of professionals such as pharmacists”. This was especially
important in the most deprived communities in Wales. Second was the fact
that £1 in £8 spent by the NHS went on medicines that had to be used properly.
Devolution had given the health service in Wales
the opportunity really to meet the needs of Wales, Mr Ranshaw added. The
implementation of the primary care strategy, which was expected to be
published in the next few months, would be hard but it would also be a
way to liberate the potential of community pharmacy. “That is when the
long hard slog will really begin and when cultures have to change,” Mr
Ranshaw said.
He also emphasised that, then, pharmacists would
be able to realise their professional aspirations “and deliver for Wales
a proper return on its investment in pharmacy and prescribed medication”.
The report of the Task and Finish Group on Prescribing
was also welcomed by Mr Renshaw, particularly the specific recommendations
on repeat dispensing by pharmacists, and the supplementary prescribing
rights for pharmacists and nurses and other initiatives in other parts
of the health service. “All this adds up to a coherent whole in which
each profession is free to do what it does best, and the puzzling hurdles
which prevent patients getting their medicines easily and safely are swept
away,” he declared.
But, Mr Ranshaw cautioned, to achieve all this community
pharmacy needed to work much more closely with GPs and nurses, and also
with social services (many of whose clients had pharmaceutical care needs
that were not being appropriately met at present).
There were also commercial imperatives to be considered.
The NHS, argued Mr Ranshaw “gets its community pharmacy on the cheap”
because so much of the costs were borne by the contractor. “Moving towards
a system which rewards professionalism therefore remains a major objective.”
On the policy level, “Improving health in Wales”
outlined a vision of the NHS with its partners in which pharmacists clearly
had much to contribute. This had been nicely complemented by the prescribing
Task and Finish Group's report, Mr Ranshaw pointed out and “'Access and
excellence' also plays to our strengths”. The primary care strategy would
be the final element and would both remove barriers and provide incentives
for change.
The pharmacy profession throughout Wales longed
to contribute to the new health service that was now emerging. “Since
1995 we have sought a position in which we can contribute that for which
we have trained and which the public want from us. It is now much nearer.
There are a lot of committed pharmacists out there who have contributed
an awful lot. I would like to pay tribute to those who have worked so
hard.”
Mr Ranshaw added: “We welcome the way the service
in Wales is developing and strongly believe that working with all different
professionals in the health service, we can help the NHS, with its partners,
take that leap forward which it so clearly needs.”
Pivotal role in health care delivery
In reply, Jane Hutt thanked Mr Renshaw for his comprehensive
overview of the issues as they affected the profession in Wales and his
aspirations for the future of the profession. “Inspired by what you say
I would also like to support his comment on the pharmacist's pivotal role
in the delivery of health care in Wales.”
Ms Hutt went on: “I would like to acknowledge the
enormous contribution that the Welsh Executive has made, not only to the
pharmaceutical profession in Wales, but also for their contribution in
supporting the work of the National Assembly.” She highlighted the role
played by the Executive in the development of the Assembly's sexual health
strategy, support for the emergency contraception campaign and involvement
in the mental health strategy. She hoped that they would move forward
together to the benefit of patient care.
Ms Hutt outlined some of the achievements of the
Welsh Executive in increasing the profile of the profession in Wales by
intensive networking with health professional and political representatives.
The Welsh Executive was also applauded for its informal meetings involving
all sectors of the profession across Wales so that the reply to major
initiatives came in a unified voice. She also pointed out how well the
profession performed when it was subjected to an Audit Committee report,
and that she had heard positive feedback about the performance of those
who had appeared before the committee.
Ms Hutt commented on the introduction of prescription
exempt charges for people under the age of 25 in Wales. She said: “The
important message here is that, when we see something needs doing in Wales
and it falls within the scope of the powers of the Assembly, then we will
do it. While we will always have regard for developments across the border,
we set our own agenda.”
She also spoke about the Task and Finish Group on
Prescribing and commented on how the report recognised the valuable but
under-utilised skills of pharmacists. “I am keen to redress this, so that
we can ensure that patients gain maximum benefit from their medication.
We will use [local pharmaceutical services] pilots to explore innovative
ways of delivering pharmaceutical care and remove existing service and
professional boundaries and encourage joints working across the sectors.”
Ms Hutt also spoke about the contribution the Welsh
Centre for Postgraduate Pharmaceutical Education had made to the development
of a continuing professional development toolkit for pharmacists. And
she also welcomed the Society's initiatives to establish a workforce advisory
group.
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