The Pharmaceutical Journal
Vol 269 No 7217 p444
28 September 2002

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British Pharmaceutical Conference 2002 summary

We must make use of all pharmacy staff

Pharmacy and the National Health Service have to make full use of all of their available staff, Health Minister David Lammy told the Conference. He announced that the Department of Health has published its long-awaited skill mix review for pharmacy (see p432). The discussion paper, entitled "Pharmacy workforce in the new NHS: making the best use of staff to delivery the NHS pharmacy programme", covers four main areas, the Minister said. These are continued expansion of new roles for pharmacists, parallel development of new roles for pharmacy technicians, training and the regulation of technicians, and the supply of medicines directly by technicians working under protocols but not under direct supervision.

"While we have no predetermined model for this, we owe it to patients and to staff to make the best use of all staff in the NHS," the Minister said. He noted that similar developments are going on with the regulation of support staff for other health professions and suggested that there might be common solutions to be found.

"I have heard what your President said about the Royal Pharmaceutical Society's role as a lobbyist and I hope that as a Health Minister I will be able to lobby for you and for all your colleagues in hospital and community pharmacy," Mr Lammy told the Conference. He acknowledged the work already being done by pharmacists throughout the NHS.

Ageing and new services

Turning to the Conference theme of ageing, Mr Lammy said that improving services for older people was a key goal of the investment that the Government is making.

"We must also help address the social deprivation and isolation experienced by too many older people in our society. As well as health, improvements in housing, transport and financial support are needed. The Government has taken steps to provide extra support and we are enjoying the economic stability that allows us to do this."

The Minister said that society needed to place a premium on independence. "We need a new vision for the welfare state. We need proactive services that promote opportunities for all, that lift up rather than hold back and which fit patients' needs rather than seeking to fit them to what is on offer."

Mr Lammy said that effective use of medicines was central to most patients' experiences of the NHS. "We want to see pharmacists play a full role in achieving this. We also want to see real progress." The Minister said that he was pleased to see that several parts of the pharmacy plan for England were now getting under way. These included local pharmaceutical services pilots, repeat dispensing schemes and medicines management projects led by the Pharmaceutical Services Negotiating Committee and the National Prescribing Centre.

"We invited bids for 30 repeat dispensing pathfinder sites. I am pleased to say that we have had expressions of interest from over 120 primary care trusts and that the sites will be announced shortly.

"In medicines management, the first and second wave of the national collaborative schemes are up and running and mean that two-and-a-half million people now have access to better medicines management. A further nine million people have the potential to benefit from these schemes.

"I am delighted to announce today a third wave of a further 40 medicines management sites. As a result of these over 100 PCTs, more than one-third of the total, will be running medicines management schemes. This is a step towards our goal of having such a scheme in each PCT area," the Minister said.

He added that he knew how frustrated some pharmacists were feeling about progress towards pharmacist prescribing. He had been told how frustrated they were to see nurse prescribing being expanded — with some of them providing the training for it — and wanted to be able to move ahead themselves. Following a consulation process over the summer, Mr Lammy said that an announcement about pharmacist prescribing could be expected shortly and he was confident that the first pharmacists prescribers would be seen in mid-2003.

"We must make better use of pharmacists' skills. All the pharmacists I have spoken to have made this point clearly."

New contract

The Minister said that he recognised the need to modernise the pay structure for community pharmacists. He was aware of their concerns about the volume related aspects of the current contract.

"The bulk of your NHS income comes through dispensing. It does not recognise the totality of the work you do. It does not reward the high standard of skills and professionalism that you have.

"We want to modernise the contract and to refocus it in a way that rewards those who make the best use of their skills and who provide easily accessible services that patients want."

He said that the Department of Health's discussions with the PSNC had proved positive and would continue. However, he acknowledged that other factors would influence the discussions. Principal among these were the Office of Fair Trading's report on control of entry and the report on the pricing of generics.

"The OFT operates independently of the Government to provide advice about the effects of current policy on consumers. My job as a Minister is to ensure that when its report is published I hear your views and take them into consideration in our response to the report."

On generics he said that he wanted to see pharmacists fairly rewarded and to take into account other factors, such as the OFT's recommendations.

"We need to work together so that we can take any decisions on the basis of the best available information."

Turning to hospital pharmacy, the Minister said that hospital pharmacists were in the vanguard of the profession in developing new clinical roles and he expected them to be the first pharmacy prescribers.

"The next wave of the hospital management framework is under development. This will include the recommendations of the recent Audit Commission report 'A spoonful of sugar'. It will have exciting challenges and opportunities for hospital pharmacists."

Mr Lammy said that he welcomed the moves the Royal Pharmaceutical Society was making to modernise itself. "The Society needs to make changes to get greater patient involvement — we require this of all health regulators."