BPC 2001 summary

Pharmacy cannot afford any path other than putting patients’ interests first

The overriding duty of the Royal Pharmaceutical Society has to be, and has to be seen to be, to the public interest, Marshall Davies, the Society’s President, told the audience at the opening session of the Conference. Pharmacy could not afford to go down any other path.

“Uniquely, our Society has a role as both regulator and professional leadership and development body. But this does not mean that the Society can or should support sectoral pharmacy interests or particular interests or agendas. Of course, we have a Charter duty to ‘promote the interests of the members in their exercise of the profession of pharmacy’. But, in this modern age, professions are rightly and increasingly being asked to justify the faith society places in them. For the Society, the only legitimate interest to pursue on its members’ behalf is the public interest.

“The new Council for the Regulation of Health Care Professionals will be there to reinforce that message and ensure that professions fulfil their obligations to the public interest. Make no mistake, there is an explicit message from Government: if professions themselves do not deliver robust, transparent mechanisms for assuring competence and conduct, then other ways will be imposed,” the President warned.

Patients versus public

In taking up new roles in medicines management or pharmaceutical care, pharmacists will face a particular issue of conflict that they will have to address. This is the conflict between what is best for an individual patient and what is best, clinically and financially, for the population as a whole.

“As professionals, pharmacists have an ethical responsibility to be open and transparent about patients’ interests and options,” the President said. “We must communicate our concerns when we have an evidence-based reason to believe that someone is receiving care that is likely to cause significant harm or lost potential benefit. This may involve questioning local or, on occasion, national policies.”

Partnerships and professionalism

Care has to be about partnerships, with the patient at the centre. The Society has committed major investment to work in this area, including gathering evidence to support best practice.

“We as pharmacists are now being expected, both in the community and in hospitals, to become more central to the work of the National Health Service. Just as we can facilitate self-care skills in patients, we can help colleagues to use medicines to best effect and to reduce waste.”

Mr Davies said that the Society had embarked on a process of reshaping itself to meet the new demands of modern health care and to move towards a patient-centred NHS. However, he cautioned that political rhetoric should not be allowed to obscure the fundamental worth of professionalism.

“Professionalism is people-centred. And, if the people responsible for delivering the service are not valued, then the highest of standards cannot be achieved.” The Secretary of State for Health, Alan Milburn, had acknowledged this in a speech last year.

“If the Government is serious about shifting the balance of power in the NHS in favour of patients, then we must remember that the professionals who serve them also have need that must be met.

“For health professionals working within the NHS, authoritarian management is no substitute for confidence-building and motivation. In the same way, a blame culture is no substitute for one that genuinely fosters learning.”

Global pharmacy

Mr Davies said that the theme of the conference was global pharmacy. In an era of globalisation, decisions and actions taken on one side of the world affect lives on the other side of the world. The terrible events in America the previous week brought this home tragically and shockingly. Displaced persons looking to enter the country across the English Channel were another reminder.

“The current debate about the HIV pandemic is a case in point. This is the sort of public health debate in which I believe our profession’s voice needs to be heard clearly,” the President said.

An ageing population

The population of Britain is getting older. Young people see illness as a temporary state and they will access advice and treatment from any convenient source, including telephone helplines, computer systems or health care professionals.

For older people, the position is often different. Living well is about living with long-term conditions and incorporating care and treatment into a normal life. For these people continuity of care is crucial.

NHS in transition

A carefully managed transition period will be needed to move from the services currently provided through community pharmacies to those envisaged by the various plans for the NHS in England, Scotland and Wales. New services will be more targeted than at present. More pharmacists will be working in primary care and more pharmacies will be co-located within primary care centres.

“If that is in the public interest, then it has to be in our profession’s interest as well,” the President said. What would not be in the public interest would be any reduction in the pharmacy network or the ability of pharmacists to support self-care outside of primary care environments.

Concluding, the President said that pharmacists needed four things to succeed:

1. a modern regulatory framework
2. support for continuing professional development
3. robust professional and political partnerships
4. enough financial security to allow continuous service improvement

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