|
No Smoking Day campaign
This year’s No Smoking Day theme urges smokers to “wake
up” to the health effects, the cost and the mess caused by
smoking.
Further details about No Smoking Day and a
link to the Royal Pharmaceutical Society’s information
centre reference list on the pharmacist’s role in these
services can be accessed here 
|
Society media campaign
The Royal Pharmaceutical Society is co-ordinating a media campaign
through its branch public relations officers to coincide with
No Smoking Day. The campaign aims to spread the message that people
who want to stop smoking can get help from their local pharmacist. |
Scottish initiatives
Liz Grant, public health pharmacist at Greater
Glasgow NHS board, says that since the establishment of the “Starting Fresh” stop-smoking
project in Glasgow in June 2003, 4,845 customers have achieved
a four-week quit rate. The project is currently run by 162 out
of 219 pharmacies in Glasgow. Pharmacy fees are covered by a
discount from Pfizer for the supply of Nicorette products, and
the cost
of the NRT is met by the primary care division of the board.
Mrs Grant says it is too early to anticipate how the new community
pharmacy contract for Scotland might affect such schemes since
it is not effective until 2006.
All community pharmacists in Scotland will shortly receive a
pack containing support materials for No Smoking Day, funded
by the Scottish
Executive and NHS Health. |
Welsh initiatives
Peter Haydn Jones, chief executive of Community Pharmacy Wales,
says that in Wales discussions are under way about a series of
directed
enhanced services, of which smoking cessation services would
be one. These services would still fall under the tier of enhanced
services, but would be directed by the Welsh Assembly Government
and it would be mandatory for local health boards to commission
them. Other services that may fall into this group include
substance
misuse and minor ailment schemes. Mr Haydn Jones says that
this will be assessed by the Project Implementation Board, following
recommendations by the strategic policy sub-group of the board.
He also says that it is possible that smoking cessation services
may eventually become an advanced service, although the whole
process
is in the early stages of development. |
This year’s No Smoking Day is Wednesday 9 March and is, as usual,
supported by a national campaign (see Panel).
No Smoking Day is a registered charity that highlights the help available
to smokers across the UK who want to give up, including national help
lines, local stop-smoking services, drop in centres, GPs and pharmacists.
The contribution that community pharmacists can make to establishing
and running stop-smoking services has been well documented (PJ, 6 March
2004, p275) and many pharmacists have worked hard to secure funding for
their projects.
However, the question remains as to how current services will be affected
by the new community pharmacy contract. Although pharmacists are still
waiting for details regarding enhanced services, it is possible that
current services will be shaken up by redistribution of primary care
funding.
Alastair Buxton, head of NHS services at the Pharmaceutical Services
Negotiating Committee, says that pharmacists in England should be aware
that the priorities of their primary care trusts and may change depending
on the outcome of pharmaceutical needs assessments. However, he says
it is unlikely that stop-smoking services will be adversely affected
by this.
“Many PCTs are still struggling to meet stop-smoking targets,” he
explains, “and many PCTs have found that including community pharmacists
in these services has achieved and often surpassed their requirements.”
Mr Buxton says that if a locally commissioned service is already up and
running and is helping a PCT to achieve its targets then it would not
be compulsory for the new national service specifications to be adopted.
Andrew McCoig, a community pharmacist from Croydon has been involved
with stop-smoking services in his area for the past three years. He also
sits on the steering group of his PCT and has helped more than 500 customers
stop smoking.
Mr McCoig acknowledges that there is concern about what will happen to
some current pharmacy-led services that will fall under the category
of enhanced services in the new contract, such as diagnostic testing. “These
services will be subject to massive change at the whim of financial directors,” he
says.
However, Mr McCoig adds that stop-smoking services are one the few services
that he does not have concerns about. “There is no danger whatsoever
that this service will be curtailed or withdrawn while it remains a Government
target,” he says. “I have visited three or four other PCTs
to discuss this issue and the overwhelming feeling is that this service
is here for good.”
Riaz Esmail, a community pharmacist in Harrow, Middlesex, has been involved
with the stop-smoking service in his PCT since he helped design it three
years ago. About 50 pharmacies are involved in the scheme and since it
was established about 4,000 customers have used the service.
Mr Esmail says he sees the new community pharmacy contract as an opportunity
to expand this service. Customers currently have a 15-minute appointment
with their pharmacist every week for five weeks, and nicotine replacement
therapy (NRT) is supplied under a patient group direction. Customers
are then referred to their GP to get further supplies on an FP10. “We
would now like to expand this service so that customers can be seen by
the pharmacist for 13 weeks,” Mr Esmail says. “This would
mean that the entire stop-smoking service in Harrow would be run by community
pharmacists, unless the patient chooses to see their GP instead.”
Mr Esmail says that discussions are currently under way with his PCT
about obtaining funding to expand the service. One of the main obstacles
he expects to encounter is that the supply of NRT through pharmacies
is more expensive than on an FP10 because the sum reimbursed to the pharmacist
includes VAT. He says that discussions are currently under way with PCT
tax advisers and Customs and Excise about how this problem might be overcome.
“I see the new pharmacy contract as an opportunity to take this
service to its logical conclusion,” he says. “Essentially
the drive for enhanced services must come from the PCT, but it is not
on their
agenda right now. I think it will generally be supported but it is still
early days since PCTs are still grasping the concepts of the new contract.”
|
The
Pharmaceutical Journal