A pill every day
Plans to switch simvastatin from a prescription only medicine to a pharmacy medicine have been rumoured for some months. Now that consultation on the switch has been announced, there is a strong likelihood that it will happen by next summer.
For the Government it is economically appealing. The recommended target
groups for the switched product fall outside the current national guidance
on treatment of heart disease (National Service Framework for Coronary
Heart Disease) so the financial burden will fall on individuals rather
than the health service. And for those targeted patients who can afford
the product long term, there is thought to be considerable benefit.
For pharmacists, switching a statin from POM to P is a whole new ball
game, although there are echoes of the switch for the H2-antagonist ranitidine.
The original licence for that was granted for short-term dyspepsia. Simvastatin,
on the other hand, would be the first switched product to carry a licence
for prevention of a chronic disease.
Many pharmacists will welcome the opportunity to use their skills to
the full, and see the proposed switch as a vote of confidence, but there
will be new responsibilities and new challenges. Is the recommended dose
high enough to protect against heart disease, will taking it keep patients
away from general practitioners and will pharmacists be confident about
supporting these patients and being alert when things may be going wrong?
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In the right corner
A change in the culture in the health service so that mistakes can be reported and colleagues can learn to avoid making similar errors, without blame being instantly apportioned, is one of the aims of the National Patient Safety Agency. The agency has just produced a seven-point guide to patient safety (p700) and the first of four articles about the agency and its plans to roll out a national reporting and learning system next year is published this week (p719).
However, in another corner of the Department of Health, the newly created Council
for the Regulation of Healthcare Professionals seems to be having different thoughts
(p700). The CRHP wants to impress on all health care professionals that they
are likely to be disciplined if they make errors — patient safety would
be compromised if individuals were not responsible for them. There must be some
happy medium to be struck: health care professionals must feel confident that
they will be supported if they report errors for the greater good, rather than
fear that they may face retribution, and so go to ground.
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