The Pharmaceutical Journal Vol 267 No 7178 849-854
15 December 2001

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Letters to the Editor

Hospital pharmacy (2 letters)

What role in wasteful prescribing?

From Dr C. A. Conroy, MRPharms, and Ms R. M. Beckett, MRPharmS

With reference to the article on wasteful prescribing (PJ, 24 November, p741), we would like to outline the value of the hospital clinical pharmacist in reducing medicines wastage and avoidable ill health.

A current audit being conducted on a care of the elderly ward at our hospital has demonstrated that most patients aged over 75 years readmitted to hospital within a three-month period do not have their hospital-initiated changes implemented in primary care. This results in considerable financial and health-related costs.

When general practitioners in our local health authority were contacted regarding the discharge information they receive from hospital, more than 90 per cent considered discharge summaries to be inadequate. A similar number of GPs stated they would value additional prescribing support from pharmacists to highlight changes in a patient's medication profile on discharge.

As Professor McGavock suggested in your article, pharmacists should actively seek to develop constructive and supportive relationships with GPs via pharmacist-led prescribing support. The value of hospital pharmacists undertaking this responsibility will not only ensure the delivery of pharmaceutical care, but will also avoid drug-related hospital readmissions, which in themselves result in a significant financial burden to the National Health Service.

Clare Conroy
R&D Pharmacist

Rachel Beckett
Care of the Elderly Pharmacist, Bristol Royal Infirmary

Oncology pharmacy course already available

From Mr Z. A. Nurgat, MRPharmS

Denise Blake and colleagues (PJ, 1 December, p790) suggest that at "present there is no nationally recognised training scheme or mandatory qualifications for pharmacists working in oncology or haematology". The article further suggests that such a course be run by organisations such as the British Oncology Pharmacy Association.

There is an internationally recognised postgraduate course open to pharmacists working in the field of oncology, with a post-basic diploma in clinical pharmacy. The MSc course in clinical oncology, which is a multidisciplinary course both in its intake and its teaching is run by the division of cancer studies at the University of Birmingham school of medicine.

It is a two-year part-time course and covers all aspects of cancer from cellular and molecular basis of cancer to radiobiology. It is assessed by multiple-choice questions examinations at the end of the first year, 2,000- to 3,000-word essay and/or presentation for each of the six core and two optional modules and a 15,000 to 25,000-word dissertation. Candidates must obtain an average of 50 per cent in each of the modules in order to pass the course with the dissertation passed by the external examiner.

Although not formally recognised by the pharmaceutical regulatory body (neither is the diploma in clinical pharmacy) it is recognised as part of senior house officers' and registrars' part 1 of the Fellow of the Royal College of Radiologists examinations in medical oncology.

Yes, there is a need for a formal training scheme for pharmacists who choose to specialise. However, with so much emphasis on the multidisciplinary team approach such training should be based within such a framework and not run by interest groups such as the BOPA. Moreover, it will be competing with courses already available from institutions that enjoy international recognition.

Zubeir Nurgat
Pharmacy Department, Aberdeen Royal Infirmary

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