Changes to pharmacy role needed for medicines management
to succeed
Medicines management is an approach not an activity,
Musa Dhalla, chief executive of Pharmalife, told the conference. Medicines
management services for patients could be delivered anywhere and not just
by pharmacists.
“We need to break away from the premises-based contractor
as the core perception of community pharmacy. To offer medicines management
individual pharmacists, specialising in different disease areas, will
have individual contracts with health care purchasers. Patients will choose
between them.”
Numark Ltd is part of a new joint venture which
will allow its members to take part in medicines management programmes.
The scheme will focus on individual pharmacists rather than pharmacy premises
or contractors.
The other partners in the venture are Pharmalife
and Positive Solutions Ltd. Pharmalife has established an internet-based
medicines management resource centre under the direction of Douglas Simpson,
former editor of The Pharmaceutical Journal. The centre will contain
background information, documentation, trial results and best practice
guidance for pharmacists.
Trials of medicines management services would be
starting after the general election was over, Mr Dhalla said. The Government’s
25-site trial was well-structured and proscriptive. It would build on
the strengths of community pharmacy but pharmacy input into its development
was limited. The Pharmaceutical Services Negotiating Committee’s trial
would follow a classical pharmaceutical care model and was designed to
show that such services could be delivered through community pharmacies.
“Community pharmacists need to be involved in either
local or national trials of medicines management. They need to identify
and develop specialist skills and they need to accept that changes to
the way they work are needed,” Mr Dhalla said.
Around half of all the £6bn worth of medicines prescribed
on the National Health Service were not used properly, John D’Arcy, chief
executive of the National Pharmaceutical Association, said. Around £100m
worth was returned unused to community pharmacies annually. This was a
big problem and it was a shared problem for the Government, the pharmaceutical
industry, health care professions and patients. Medicines management was
an all-embracing approach to this problem and its implementation would
lead to community pharmacists being integrated into primary care.
The basis for medicines management was a repeat
dispensing service. In order for repeat dispensing to work there had to
be a robust information technology infrastructure. He warned the Government
against taking short-cuts in developing this.
David Wood, deputy managing director of Numark,
said that the role of community pharmacists had changed from that of compounders
to dispensers. It was changing again to being medicines managers and advice
givers.
“I do not think any of us will be sad to see the
end of the cut-and-snip, lick-and-stick, box-shifting era. It has been
the least professionally satisfying for pharmacists and we have been held
in low esteem by other health care professionals because of it.”
To help pharmacists Numark is to hold a series of
change management training evenings for its shareholders and their managers.
These will cover new working procedures and standard operating procedures,
time management, management effectiveness and leadership, and customer
service. There will also be guidance on applying for Investors in People
accreditation. Courses will cost £125 for five two-hour sessions.
Speaking at an Institute of Pharmacy Management
session, Professor Ian Jones, professor of pharmacy practice, University
of Portsmouth, highlighted a number of problems facing pharmacists taking
part in medicines management schemes. These had been uncovered in a small
trial conducted by the university.
The biggest problem was that of pharmacists’ time.
The trial had shown that the time commitment to medicines management,
including preparation for patient visits and follow up with GPs and patients,
had been underestimated. Major changes to the pharmacist’s role, particularly
in supervision, would be needed if medicines management was to have a
realistic chance of working, Professor Jones said. Patient registration
would also be needed so that pharmacists could develop complete medication
records that included non-prescription and complementary medicine usage.
The good news was that community pharmacists could
cope with the clinical aspects of medicines management and those taking
part saw a real improvement in job satisfaction.
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