The Pharmaceutical Journal
Vol 268 No 7194 p520
20 April 2002

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Good news, we hope

Proposals for pharmacists to become supplementary prescribers were released for consultation earlier this week by the Department of Health and the Medicines Control Agency (p521). What a supplementary prescriber will be able to do will be dictated by a clinical management plan drawn up in conjunction with the independent prescriber (ie, a doctor) and the patient as well as the supplementary prescriber. Most supplementary prescribing, therefore, is likely to revolve round the management of chronic conditions where repeat prescribing is a feature.

If supplementary prescribing by pharmacists becomes a reality it will be good news for patients and doctors as well as pharmacists. But although there seems little in the consultation document that suggests that pharmacists will not be quickly competent to perform this new role, there will be logistical difficulties to overcome. The good news for patients is that handing the responsibility for prescribing to health professionals who have real depth of knowledge of drugs and their interactions can only bring health benefits. For doctors, the burden of signing repeat prescriptions will be taken away, and, if they are honest, they will accept that a proper review of their patients' drug therapy by pharmacists should give the prescribed medication the best chance of working. For pharmacists, a recognition of their skills and knowledge should bring greater job satisfaction.

The question remains: where and how is it all going to be done? Nurses, who are also covered by the consultation document, have a head start. They already have space in doctors' practices and access to patients' notes. Pharmacists, who have much greater knowledge of medicines than either doctors or nurses, are handicapped on a number of fronts. Until the electronic prescription record becomes a reality, other more cumbersome ways will need to be found for them to access patients' notes. They will also need to provide an area within their premises for patients to be able to consult them privately and support staff to dispense their prescriptions.

In time, patients will become aware that the main benefit of pharmacist prescribing is an improvement in their health, but in the short term they are likely to see it as a way of reducing the burden on GPs and of increasing convenience for themselves. But if this convenience is marred by poor pharmacy facilities and lack of privacy, patients are not likely to want to know.

With the Chancellor of the Exchequer promising the National Health Service an extra 43 per cent of funding over five years, the Government has finally run out of excuses: find pharmacy the money and the profession will deliver the goods — more efficiently and more cost-effectively than doctors.