The Pharmaceutical Journal
Vol 270 No 7255 p880
28 June 2003

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National Pharmaceutical Association (www.npa.co.uk)

Centralised purchasing jeopardises Welsh health planning, says NPA

The National Pharmaceutical Association has issued a warning that centralising medicine buying by the National Health Service in Wales will put health planning at risk.

Responding to a report by the auditor general for Wales, which said centralising medicines buying for primary care could save £50m a year (PJ, 29 March, p430), the NPA management board said that any moves that adversely affect pharmacy income and the profession's ability to invest in and fund services will frustrate pharmacy planning and thus overall health planning.

The report claimed that the money could be saved by centralising drug purchasing at hospital prices. It also said that pharmacists made profits to which they were not entitled by beating the discount clawback.

At their June meeting, members of the NPA board warned that the pharmacy network would not be financially viable if all discounts were recovered by the NHS.

Other matters considered at the meeting are reported below.

Omeprazole Concerns were expressed over the proposed POM-to-P reclassification of omeprazole (PJ, 24 May, p709). These included the drug's slow onset of action, which board members believed made it inappropriate for the immediate relief of reflux-like symptoms. It was more suitable for the relief of frequent heartburn. Also, omeprazole was not supported by any nationally recognised guidelines as a first-line single agent for the treatment of dyspepsia. Pharmacists could find themselves advising GPs to use H₂ antagonists and antacids as first-line treatments for a condition for which a non-prescription proton pump inhibitor was a first-line non-prescription treatment. Board members accepted that PPIs were an exciting new group of medicines for pharmacy supply, but believed that other PPIs, such as lansoprazole, were to be more suitable, with a better safety profile.

Nurse prescribing There was broad support for plans to extend the nurse prescribers' formulary to cover areas such as pain relief in midwifery and for patients with suspected myocardial infarction, and the treatment of emergencies, such as acute asthma attacks and hypoglycaemia. A proposal to permit extended formulary nurse prescribers to prescribe specific medicines for unlicensed indications in palliative care was supported, so long as the nurses are made aware of the implications for professional liability.

CD regulations The board approved Home Office proposals to allow computer generated prescriptions for Schedule 2 and 3 Controlled Drugs and for computer registers for Schedule 2 CDs.

Care homes The NPA is to develop closer links with the National Care Standards Commission to determine the resources members need to providing services to care homes.