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Letters to the Editor
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Apothecaries
Pharmaceutical care versus medicines management
From Mr P. Jones, MRPharmS
I was interested to read the Article by Darrin Baines and Catherine
Hale entitled “New apothecaries: how pharmacists can protect their
independence in the NHS” (PJ, 6 November, pp684–5).
The use of the word “apothecary” is interesting and perhaps
with a touch of déjà vu. It is recorded that in the period
during which the Great Plague afflicted London, the apothecary at St
Bartholomew’s Hospital was a cross between a modern-day clinical
pharmacist and a house officer. With developments in pharmacist prescribing,
perhaps this is another case of history repeating itself?
It should be noted, however, that the word “apothecary” derives
from the Latin apothecarius (storekeeper) and the Greek apotheke (meaning
storehouse). Perhaps this is a reminder that pharmacists should not forget
their skills, expertise and knowledge of pharmaceutics. No matter how
good the clinical advice pharmacists may give in relation to drug therapy,
it will be of limited use if there is not a suitable medicine available
for the drug to be administered to individual patients in a form that
is safe, convenient and effective.
The authors, however, raise some other pertinent issues, namely the nature
of the profession and the manner in which it is practised in the UK.
We should be reminded that pharmacy is a worthy profession in its own
right and pharmacists do not practise solely to support medical practitioners.
Why for example have we had pharmacy facilitators who support GPs and
their prescribing? Why have we not had pharmacy facilitators who have
supported pharmacy and assisted fellow pharmacists, especially community
pharmacists, who have wished to expand and develop their range of professional
services, but have felt the need for professional support through the
period of change?
The authors also refer to the practice of pharmacy through “medicines
management” and “pharmaceutical care”. There appear
to be many in the profession who consider the terms synonymous. I would
contend, however, that they are not and that this is one of the major
differences in the way pharmacy practice is developing north and south
of the border. Whereas in England the profession appears to be developing
along the lines of “medicines management”, Scotland is following
a more holistic route. “The right medicine”, the Scottish
strategy on pharmaceutical care, relates to a wider canvas and builds
on existing good practice in Scotland. Key elements of the strategy are
to enable pharmacists, both in the primary and secondary care sectors,
to provide a service that is professionally based and professionally
driven, to meet the needs of the population. Pharmacists are key stakeholders
in relation to patients and medicines, but they are not the only stakeholders.
They have acknowledged the need to work in a wider professional environment
with other health care professionals to enable effective outcomes to
be obtained for patients who are using medicines.
I am pleased to see these issues, and others, raised by Baines and Hale,
and I hope their article will stimulate further discussion on the nature
and future of the profession within Great Britain.
Peter Jones
Edinburgh
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Pharmaceutical Journal