The Pharmaceutical Journal
Vol 269 No 7228 p859
14 December 2002

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College of Mental Health Pharmacists/Industrial Pharmacists Group summary

NSF for Mental Health is a "feel good" document

The National Service Framework for Mental Health (England & Wales) was described as a "feel good" document for the National Health Service by Steve Bazire, director of pharmacy services, Norfolk Mental Health Care NHS Trust. Whereas other NSFs include substantial advice on medicines, the NSF for mental health contains little and vague guidance on medicines and has no pharmaceutical advice. He said that pharmacy is mentioned in three of the document's 149 pages:

• Community pharmacies are described as places where people may first present with mental health problems

• A specialist pharmacist is mentioned as an example of improved bed management through better medication management

• Pharmacists are mentioned as one of the groups having a higher suicide rate

Mr Bazire explained that in Norfolk he is involved with a local implementation team, which includes provider trusts, social services, voluntary agencies, primary care trusts, housing agencies and users. Service mapping has been undertaken, priorities identified and a local implementation programme established. Issues raised by the NSF have been addressed, such as the prescribing of ineffective doses of antidepressants, poor recognition of symptoms by general practitioners and inadequate outcomes. The lack of information on drugs and the role of non-drug treatments has also been addressed and protocols for drug use have been agreed between primary and secondary care.

Since medication is a vital component of patient care and failure to resolve medication issues can render other aspects of care less effective, pharmacists have been shown to be valuable members of the assertive outreach teams established as a result of the NSF.

Mr Bazire said longer-term medication issues have been resolved by joint nurse and pharmacist visits. Patient group directions have been written and medication training of other team members by pharmacists is ongoing.

He explained that although a few primary care trusts are looking after mental health services, a number of new specialist mental health trusts have been formed. Some of these have chief pharmacists' posts but recruitment is a particular problem.