The Pharmaceutical Journal
Vol 269 No 7217 p456
28 September 2002

This article
Reprint
Photocopy

UniChem convention 2002 summary

Development of pharmacy services obstructed by DoH

Within the Department of Health is an institutional scepticism about community pharmacy and a solid barrier of obstruction to developing pharmacy services, according to Barry Andrews, chairman of the Pharmaceutical Services Negotiating Committee. Positive and encouraging words from ministers are not being translated into positive and encouraging actions from officials.

Mr Andrews told the UniChem convention that the Government estimated that repeat dispensing could save 2.7 million GP hours — a cost saving of more than £400m. The Department should work with the profession to develop a good repeat dispensing service, properly funded. The £50 per pharmacy per month that had been offered was unacceptable for any service and ludicrous when one considered the gains that could be delivered.

"What policy maker can possibly have even contemplated such a pitiful proposal? Only one who is so obsessed with minimising costs that he cannot accommodate the concept of fair reward and fair funding." By sharing a percentage of the savings achieved elsewhere within community pharmacy, the Government would produce disproportionately large returns.

Mr Andrews also pointed out that primary care centres or one-stop shops, perhaps meeting some perceived patient convenience on the occasion of a visit to the surgery, could damage fundamentally the network of pharmacies in the locality. "This is perverse. Far from building services around patients, which is the Government's stated objective, they would achieve precisely the opposite and build services around NHS centres."

Mr Andrews went on to explain that the basic service level suggested in the proposed two-tier pharmacy contract was very much a formalisation of the current service. "Many pharmacies will be fulfilling many of the criteria now. In my view, this basic level of service that will be demanded is not unreasonable in a fully funded service."

The second tier could include services such as:

• Regular reviews of patients' repeat medication

• appropriate consultation facilities (not necessarily private)

• premises that convey a professional appearance

• appropriate supplementary prescribing services

• verifiable audit and monitoring systems and ongoing quality reviews

• participation, which may be multidisciplinary, in audit and training, including clinical governance requirements for other services

Mr Andrews asked if these standards sounded intimidating. "How many pharmacies are doing some of these services right now? How many would like to, given the correct funding?"

The big question was whether the new roles would be nationally or locally negotiated. "Our view is that without new funding at national level, we cannot deliver the investment needed to offer the services."

If the services were beneficial to patients, or groups of patients across Britain, then the Government policy of reducing health inequalities strongly suggested that all patients should have access to them. Contracting for services year by year within a primary care trust, subject to the risk of changing priorities and budget pressures, was a poor basis for real, substantial progress.