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Regulations not published
The National Health Service (Pharmaceutical
Services) Regulations 2005, SI 2005 No 641 were laid before Parliament
on 10 March and
came into force on 1 April. However, they had not been published
by HM Stationery Office when The Journal went to press. Urgent
Parliamentary business arising from the Government’s plans
to introduce legislation relating to the holding of terrorist suspects
without trial meant that the regulations were not laid before Parliament
on the date that had been planned and previously printed copies
bore an incorrect date. |
Welsh differences
The Welsh Assembly is expected to adopt a modified
version of the NHS (Pharmaceutical Services) Regulations 1992.
Notable differences
between the Welsh and English regulations will be that there will
be no changes to the provisions for controls on new contracts nor
to the agreement on how contracts are awarded in rural areas. In
addition, the Welsh regulations will not include rules on fitness
to practice.
Guidance on the new Welsh regulations Contractual and opening hours in Wales PDF (80K)
Community Pharmacy Wales: Letter PDF (150K)
Pharmacy contractor opening hours notification form PDF (90K) |
Readers of the NHS (Pharmaceutical Services) Regulations 2005, which
introduce the long-awaited new pharmacy contract for England, will be
forgiven if they think that they have imagined all the discussions about
freeing up pharmacists’ time for new contract services by relaxing
supervision requirements.
But there is a good reason for the new terms of service continuing the
old requirement that NHS prescriptions must be dispensed “by or
under the direct supervision of a pharmacist”. The pharmacy skill-mix
consultation only closed three weeks ago and no decisions have been made
about what, if any, changes should be made to the way pharmacists and
their staff work.
Apart from this, there are many new features to be found in the detail
of the regulations — including the new control of entry rules and
exemptions — most of which are likely to be welcomed by pharmacists.
Two significant differences between the new and the old regulations relate
to dispensing in rural areas and fitness to practise.
So far as fitness to practise is concerned, the new regulations mean
that pharmacists who have been convicted of criminal offences or who
have been struck off the professional register can be prevented from
holding NHS contracts even after they have been rehabilitated or restored
to the register. Pharmacists who have been convicted of murder or who
have served a sentence of at least six months for any offence will never
be allowed to be contractors. Decisions in other circumstances will be
made by primary care trusts on a case-by-case basis.
Steve Lutener, head of regulation for the Pharmaceutical Services Negotiating
Committee, said: “These fitness to practise matters affect only
contractors at this stage. Later, we may well see further regulations
introducing powers relating to employee pharmacists.”
In relation to dispensing in rural areas, the new regulations implement
an agreement reached between the PSNC and the General Practitioners Committee
some time ago. In essence, existing contractors have given up an absolute
right to additional contracts in rural areas in return for which doctors
have accepted that they cannot apply for dispensing contracts if their
surgeries are within 1.6km of a pharmacy. Pharmacies will also be allowed
to seek contracts in areas of sparse population without having to show
that their existence will not prejudice medical services. But such pharmacies
will have to compete for dispensing business with dispensing doctors.
Another change that will be welcomed by pharmacists is the introduction
of a right to refuse to dispense prescriptions in certain circumstances.
Previously, pharmacies were under an obligation to dispense all prescriptions
promptly. Now, dispensing and supply can be refused if the pharmacist
believes that they are not genuine orders for the person named on the
prescription form. Supply can also be refused if the pharmacist believes
the prescriber has made a clinical error or that the prescription is
clinically inappropriate. Prescriptions can also be refused if the patient
or anyone with them behaves, or threatens to behave violently or commits
or threatens to commit any criminal offence.
Mr Lutener is pleased that the regulations permit pharmacists to withhold
services when threatened with violence or subjected to criminal behaviour.
He said: “This underlines the commitment by ministers of a zero
tolerance policy towards violence against those working within the NHS.”
A feature in the new regulations that might not be universally welcomed
is a requirement to promote a service that might, at the time, only be
available from a competitor.
This applies to the planned introduction of electronic transmission of
prescriptions (ETP). Any contractor who is asked must explain the ETP
service to the patient, regardless of whether or not it is available
at that pharmacy. Furthermore, the patient must be told of at least two
pharmacies in the area where the ETP service is available, unless the
pharmacist has no idea where they are.
Direct health promotion is another new service that pharmacy contractors
are required to provide. The new regulations continue the old requirement
that contractors take part in up to six primary care trust run campaigns,
but introduce a new requirement for action aimed at individual patients.
As a result, anyone who presents a prescription for dispensing and who
has diabetes, is at risk of coronary heart disease (especially if they
have high blood pressure), smokes or is overweight has to be given advice
on the health issues they face.
The new regulations also allow pharmacies to decide their own opening
hours, provided that they open for at least 40 hours per week. This increase
from 30 hours is accompanied by the removal of a requirement for the
hours to be worked during the 9am to 5.30pm period on Monday to Saturday.
Mr Lutener said: “We know that some pharmacies will use the opportunity
provided to amend their hours so as to more closely reflect surgery hours,
now that many surgeries no longer open on Saturdays or out of normal
business hours.”
On the regulations as a whole, he added: “Ever since contractors
voted for the new pharmacy contractual framework, we have been eagerly
awaiting implementation of the new regulations. The new framework recognises
the much greater contribution to health care that community pharmacists
can make and as well as dispensing, it now includes support for self
care, signposting, promotion of healthy lifestyles and so on.
“PSNC published a book on the new contract for community pharmacy
in which the service specifications were set out. These, by and large,
have been
reflected in the Regulations themselves, so there is very little in the
terms of service that was unexpected.” |
The
Pharmaceutical Journal