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Letters to the Editor
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Community pharmacy
Concerns about loss of personal control
From Mrs V. Taylor, MRPharmS
On 11 December 2004 the Department of Health published the document “Making
the best use of the pharmacy workforce” and released it for consultation
(PJ, 18/25 December 2004, p873). The document, which proposed radical
changes to personal control in a community pharmacy, seems to have prompted
little response from the membership. The closing date for comments is
now past. I would like to set out some of my personal concerns.
I believe that careful consideration needs to be taken before changing
regulations which have served the public well for many years.
Community pharmacists, at present, are available throughout their working
day, without appointment, to give advice to members of the public. This
is an important part of their role and enables patients to have unprecedented
access to a health care professional. This role fits well with the strong
desire of the Government to promote self care. Indeed the role as custodian
of medicines has been performed so excellently that there is now a lack
of recognition of this vital function of community pharmacists.
Pharmacists also provide a safe supply service of dispensed medicines
that enables the patient to receive the correct medicines, labeled correctly
in a timely manner following the directions of an accredited prescriber.
The final accountability for supply of the appropriate medicines lies
with the pharmacist, and as the expert in medicines the advice provided
to patients is invaluable.
The consultation document recommends that the pharmacy workforce needs
to operate more flexibly. Although changes are taking place within community
pharmacy, a needs assessment should be undertaken to ascertain the degree
of flexibility required in order to meet these changes and only then
should regulatory changes be considered. This assessment needs to be
made in the light of the expected availability of funding to pay for
delivery of these new roles.
When this work is completed the need for radical change, which is likely
to compromise both patient safety and patient access to a community pharmacist
on the high street, may not be found to be so imperative.
Vanessa Taylor
Council Election Candidate
Eastbourne, East Sussex
Let us not underprice our services
From Mr P. J. Reeder, MRPharmS
The Royal Pharmaceutical Society’s Code of Ethics requires that “at
all times pharmacists must act in the interest of patients and other
members of the public and seek to provide the best possible health care
for the community in partnership with other professions”. Few could
argue with that aim.
If it is to be made acceptable for pharmacists to be away from their
premises there is a dilemma.
One of the important features of the service we provide is the ease of
access to our skills. Patients can just walk in and ask to speak to us
and, if they wish, they can do so anonymously. My patients and customers
tell me that they value that facility highly.
If the pharmacist is absent from the pharmacy for long periods then the
uniqueness of our service is compromised and I am certain that the health
care we provide will deteriorate. Will the activities undertaken by the
pharmacist during absence from the premises be of sufficient health care
benefit to compensate for this reduced access. I am not convinced that
it will.
A less rigid regime permitting some absence may well have some merit.
This must be thought through carefully to ensure that we continue to
provide prompt and easy access by patients to our skills. We must take
care not to get drawn into providing other services which would be more
appropriately delivered by doctors or nurses.
The cynical view might be that the Government does not really mind who
delivers services as long as the cost is reduced. The cost of medicines
use reviews will be about £60 per hour. Doctors’ consulting
times will commonly be charged at twice that rate.
Let us ensure that, as a profession, we continue to put patients first,
maintaining easy access, and that we do not underprice our services.
Phil Reeder
Lincoln
Society should address flaws in pharmacists’ business skills
From Mr J. S. Khela, MRPharmS
Pharmacists are classically considered as inimitable professionals who
amalgamate practice with business skills. Business leadership is ever
more important today, especially for the independent contractor. But
how does leadership in pharmacies compare with other businesses? How
many independents have key visions for their businesses, and if they
do, how many employees are aware of them? How many employees are still
awaiting appraisals and reviews? Indeed the issues underlying relate
to time and cost. As a number of pharmacies fail to recognise this concept
so their profits suffer.
Skill mix is an issue in light of the new contract. But such delegation
of skills cannot increase our business acumen as we take on more clinical
roles. One opening for pharmacy is the Royal Pharmaceutical Society’s
proposals to
reassess the definition of supervision and personal control
(PJ, March 19, p341). However, studies have shown that people feel better
and suffer less stress when they are in personal control.1 Does this
mean that business leadership needs to be outsourced?
The bottom line is that we cannot be both respectable health professionals
and outstanding business leaders under the same hat. As more clinical
specialties are introduced we should lever our management abilities.
Bona fide success of pharmacy will only be achieved if we have a balance
of individuals prepared to work on the job (as leaders) and in the job
(as professionals). Workforce may be available as more schools of pharmacies
start to open.
There is a need to execute the introduction of business study modules
(even as an option) in the undergraduate degree. Such resources to support
a multidisciplinary approach, which will create the bigger picture to
build awareness and confidence to network beyond a pharmacy scope, are
needed. We also need unidisciplinary courses where we have real-life
examples of pharmacy and where participants are introduced to skills
required for networking with colleagues who can be helpful in their careers
and who can act as mentors. Perhaps a cost-effective way of introducing
business leadership may be by assigning these tasks to preregistration
trainees. Could this be an incentive to counteract the deficient number
of preregistration placements currently available?
The Society had little or no input in the negotiation of practice guidance
for the new contract. The past does not equal the future; it needs to
act now and demonstrate its worth by paying attention to the flaws of
our business skills.
Jaggy Khela
Council Election Candidate
Eastleigh, Hampshire
Reference
1. Harrison A. How can pharmacists become effective managers? Hospital
Pharmacist 2005;11:325–6 |
The
Pharmaceutical Journal