The Pharmaceutical Journal
Vol 269 No 7217 p456
28 September 2002

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UniChem convention 2002 summary

Government wants hands-on approach to patient care

The pharmacy strategy documents in place for England and Scotland put major emphasis on medicines management, John D'Arcy, chief executive of the National Pharmaceutical Association, told the UniChem convention.

"The message is clear," he said. "Respective Governments want pharmacists to adopt a hands-on approach to patient care and expect measurable clinical outcomes from pharmacist intervention. It is equally clear that Governments are less than convinced about the intrinsic value of a straightforward supply role."

However, Mr D'Arcy added that the profession had to ask where the costed business plan associated with implementing the strategy documents was. "The programme conveys a huge mixed message. On the one hand is an apparent keenness to bring community pharmacy closer to the heart of primary care. But on the other, the Department of Health is waging a war of financial attrition against pharmacists," he said.

Mr D'Arcy pointed out that the "Pharmacy in the future" document made it clear that new roles might not be the exclusive domain of community pharmacy. "It suggests that consumers will want to rely on e-pharmacy, it talks about putting pharmacies into one-stop primary care centres and proposes local pharmaceutical services being run by pharmacists in competition with pharmacy owners."

Mr D'Arcy warned that the pharmacy network and thus the value of a pharmacy service located within local communities could be lost if the current arrangements were changed. "Can we afford to retain both the pharmacy network with all its benefits — in particular ready patient access — alongside the raft of alternatives envisaged by the Government," he asked.

However, pharmacists need to be flexible. They need to focus on the opportunities and threats inherent in the pharmacy strategies and adapt professional practices accordingly.

Mr D'Arcy went on to describe the importance of the supply element of pharmaceutical services. "It is easy to be dismissive of the supply element as a mechanistic process," he said, "but the principal reason for its importance is that it brings patients into contact with pharmacists and thus provides the opportunity for face-to-face contact between health professional and patient."

However, he added that concentrating solely on a supply role was over-focusing on the wrong part of the process. He pointed out that there was evidence of attempts to marginalise the supply role undertaken by pharmacists. "We have walk-in centres, with nurses supplying patients their medicines and we are likely to see proposals for out-of-hours arrangements where patients are provided with full courses of treatments." He added that the pharmaceutical industry also appeared keen to involve itself in direct supply to patients.

Mr D'Arcy said that pharmacists had to rethink the ways in which they worked if they were to take on new roles successfully. "As a minimum, we must do more to delegate the mechanical aspects of the dispensing function to appropriately trained staff."

He told the conference that it was essential that pharmacists impressed upon local health commissioners the value of including community pharmacy in their localised health planning. "Do not assume they know who you are or what you do," he said.

He also warned that medicines management was not the exclusive domain of the pharmacist and that the Government would not hesitate to hand over responsibility to someone else if pharmacists did not prove willing and capable of doing the job.