Trust the trusts

If ever there was a chance for pharmacists to influence the delivery of health care at a local level it has arrived — in England at least. It comes with the announcement in the Queen’s speech delivered on Wednesday that an NHS Reform Bill will contain proposals to give control of more than 75 per cent of health spending within three years to doctors, nurses and other frontline health professionals working together in primary care trusts (p840).

A tiny number of pharmacists took an active role in primary care group boards. But there is a much better opportunity for them to become involved in primary care trusts.

Any pharmacist working in a health authority (particularly those who may be concerned about their future employment), in primary care pharmacy or in community pharmacy who has an interest in the way the health service is developing should move heaven and earth to join the board of one of the primary care trusts currently being constituted. Already there are a handful of pharmacists in these positions, but there could be many more.

Moreover, the very best of the fledgling PCTs will either already realise the benefits that a pharmacist board member could bring to the party or could be persuaded of those benefits. However, it is not the time to hang back and wait to be asked: interested pharmacists must make themselves known to the movers and shakers at the local PCG boards, from whose number the PCT boards are most likely to be drawn. Indeed, medicines management and better use of community pharmacists have been identified as key areas for development by PCG board members interviewed by Manchester researchers (p857).

With such a huge Government majority in the House of Commons and, compared with 1997, so much surplus in the Treasury coffers, commentators and opposition parties are of one voice. In this parliament, the Blair Government will have to deliver real improvements in public services. That will mean that waiting lists or waiting times will not be the issue. The issue will be whether or not patients actually experience improvements in services. For primary care, in particular, that will be translated into access to, as well as improvements in, services. If, by whatever means, patients are more likely to see their GP within 48 hours of making an appointment, and local pharmacists have contributed to that process by taking over some of the responsibility for medicines management, everyone will benefit.

Pharmacists need to ensure that if there is any chance of influencing the shape of services they are actively participating in the process — not merely wondering what may happen to them. Over the next four years, make sure the pharmacist voice is heard.

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