The Pharmaceutical Journal
Vol 269 No 7225 p742
23 November 2002

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Letters to the Editor

Community pharmacy

Engaging community pharmacy in NHS planning

From Mr A. B. McCoig, MRPharmS

Hemant Patel's (PDF 50K) thought provoking article (PJ, 16 November, p714) and Dr Jill Jesson's report on the UK Public Health Association's Forum (ibid, p725) serve to reinforce the current state of National Health Service planning culture.

The simple truth is that senior and lead NHS executives consistently fail to factor community pharmacy into any broad plans for the future of health services nationally. This in turn means that we are all faced with different and disparate debates and negotiations for the involvement and procurement of additional pharmaceutical services locally.

The latest attempt by the Department of Health to impose its wishes on local primary care trusts came in the form of the new three-year plan. Mr Patel is right to alert us all to the pitfalls in this and puts us on notice to act promptly to safeguard and promote our rightful engagement and interests. The publication of the three-year plan provides us yet again with opportunities to put pharmacy into the PCT frame when they consider how best to achieve the proposed targets laid out in the document. Our continued exclusion in name is lamentable and is not only disappointing but intellectually irresponsible from an NHS viewpoint.

Blindness towards the pharmacy constituency is an affliction peculiar to the DoH when considering how best to manage expanding capacity and access in the NHS. We also have an important role to play in public health; this is one of the most glaring areas of omission that occurs with monotonous regularity. Dr Jesson's criticism, however, of the lack of pharmacist presence at the most recent UKPHA conference is unworthy. Attendance at such an event lasting three days would cost the participant at least £1,500 in hotel bills, conference fees and locum cover.

As a result of the continuing exclusion of pharmacy involvement and representation from all major NHS planning teams, is it any wonder that pharmacists fail both to register a presence and to obtain funding for such gatherings? I belong to both the London Public Health Taskforce on Inequalities and the London Modernisation Board as a representative of almost 2,000 community pharmacists who deliver services in the capital. My inclusion on these bodies was not automatic; the London Pharmacy Forum had to make forceful representations through various routes and contacts to gain entry and claim a seat at these tables. There is no central funding for me to attend such gatherings; neither is there any mechanism to reimburse my expenses from the regional office.

PCTs are now charged with being "radical" in order to achieve targets and milestones set within the plan. In my view, based on information received from the various pan-London committees, there is no chance of ever achieving the targets set for employing more GPs and consultants in the three-year plan. The term "wishful thinking" springs to mind when one considers that the London region is currently trying to attract 71 doctors from Europe at a cost of £20-£30,000 per doctor in recruitment expenses alone. Armed with this information and given the position of GP retirements nationally, one would conclude that PCTs should be in some meaningful dialogue about health care provision with local pharmaceutical committee representatives around the country. Sadly, I doubt that many of us are engaged in such discussions.

However, let us be optimistic. We should allow some time for PCTs to digest the enormity of the challenge that has been set before we ask for an audience. PCTs have been sent Plan A. There is no Plan B except to note that local organisations will have to modify the original plan in order to meet their collective responsibilities. Pharmacy must be included in these arrangements to allow for the best chance of targets being achieved on a broad front.

Andrew McCoig
Chairman, London Pharmacy Forum
Secretary, Croydon Local Pharmaceutical Committee

PSNC advice on NHS three-year plans

From Mr M. J. King, MRPharmS

Although the latest announcement on planning services for the National Health Service (PJ, 16 November, p698) may have "passed The Journal by", it did not escape the notice of the Pharmaceutical Services Negotiating Committee.

The PSNC ran a series of seminars for local pharmaceutical committees from 4 to 18 October on developing additional pharmaceutical services at which we explained to the 120 delegates who attended the arrangements for the new three-year NHS planning cycle.

The seminar highlighted the opportunities and guided local pharmaceutical committees on how to become involved.

Furthermore the latest edition of the PSNC Community Pharmacy News, published in early November, featured an article on the new cycle.

A briefing paper for LPCs, expanding on the arrangements and providing action points for LPCs, was published by the PSNC on 15 November and is available on the PSNC website (www.psnc.org.uk).

Michael King
Head of Professional Development and Local Pharmaceutical Committee Services
Pharmaceutical Services Negotiating Committee

Endorsing prescriptions for dressings

From Ms C. A. Watson, MRPharmS

Clinical governance and continuing professional development are concepts that we should willingly embrace to enhance the image of our profession.

However, in return, I look forward to the day when a pharmacist will be trusted to endorse prescriptions for dressings with missing information without having to send them back to the prescriber for initialling.

Carol Watson
Derby

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