| Almost two-thirds of PCTs in England now have pharmacist members
of their professional executive committees (PJ, 28 May, p639)
and The
Journal knows of seven PECs that are chaired by pharmacists.
John Carr: PEC involvement increases understanding of how NHS works |
John
Carr is chairman of the PEC at East Staffordshire PCT. He took on the
role in December 2002 after being elected by the committee, of which
he has been a member since it was established in June of that year.
Mr Carr’s background is in community pharmacy and, until last summer,
he was employed by Boots The Chemists, where he latterly became involved
in working with primary care trusts. He now works as a practice pharmacist
and spends about two and a half days a week on his role as PEC chairman. “I
chair the monthly PEC meetings, but of course it is far more than being
just a meeting chair. I am responsible for ensuring that each of the
subgroups that report to the PEC are developing activities to meet the
PCT targets — both local and national standards of performance,” explains
Mr Carr. He adds that he also chairs the IT subgroup of the PCT and is
involved in the clinical governance and prescribing subgroups.
Mr Carr regularly participates in the weekly executive meetings and provides
clinical input. In addition, he meets monthly with the chief executive
and the chairman of the trust board. “These meetings are really
important in terms of making sure the three major arms of the PCT are
operating in a similar manner and driving towards the same key objectives,” explains
Mr Carr. He is automatically a member of the trust board and together
with the associate medical director and the public health director, provides
clinical representations to the board.
Another key part of his role is to go out into the community and meet
contractors, including pharmacists, GPs, dentists and optometrists. “The
purpose of these meetings is to listen to the issues and find out what
is going on out there, and to explain how the PCT works,” he says.
East Staffordshire PCT is currently working hard to develop relationships
with the local hospital and local council. “Public health is really
important to us and it is important to recognise that public health is
not just a health agenda, it is an environmental agenda as well.”
Primary care trust leadership structure
Primary care trusts are led by three key people: the chairman
of the professional executive committee, the chairman of the PCT
board and the chief executive. Their roles are as follows:
· The PEC focuses on the clinical and health agenda and evaluates
performance. It prioritises bids for future work and establishes
a local delivery plan
· The PCT board provides strategic oversight and verification
to the work of the PEC. Being largely made up of non-executive
directors, the board looks to the PEC to advise it on clinical
issues
· The management team, accountable to the chief executive, ensures
implementation of the decisions made by the executive committee
and the board, and looks after the day-to-day management of the
trust |
Developing the PEC
Brian Jolley, a community pharmacist, was appointed PEC chairman at
Waveney PCT in May. He has been a member of the PEC for two years and
is the
PCT’s lead on the new pharmacy contract as well as the clinical
governance lead for community pharmacy. “I am looking to develop
the PEC into an effective committee to advise the board on all clinical
issues within the PCT. What we are trying to do is to empower clinicians
so that we have a more effective PEC,” he explains.
Mr Jolley says that Waveney, like a lot of PCTs in the area, has financial
problems. He hopes to address this. “We are tending to look at
possible solutions, and the clinicians are going to be driving this so
that the base service is affected as little as possible but we get the
maximum savings,” he explains.
The PEC chairman is the link between the management side and the clinical
side of the PCT, explains Mr Jolley. “Decisions made at the PEC
are fed into the operations managers meetings. The PEC chairman is also
a member of the PCT board so I am expected to comment on various issues
that the PEC is involved in.” Mr Jolley believes that having a
pharmacist in this key role has improved communication between local
pharmacists and the PCT. Mr Jolley is chairman of the local pharmacy
development group, which meets twice monthly and is used as a discussion
forum between the PCT, local pharmaceutical committee and pharmacists. “I
can highlight issues that are important to pharmacy at high levels. I
think that has probably made people more aware that pharmacy is there
and it is able to offer services, particularly the enhanced services
in the new contract.”
Carol Charlton: better communication between pharmacists and GPs |
Carol Charlton is PEC chairman and pharmacy
representative at Darlington PCT. She was appointed in May this year
after serving on the committee
for about two years. Mrs Charlton has worked as a community pharmacist
for over 20 years and believes that it is important that she maintains
her “day job” so that she can see how decisions made at PCT
level and higher affect pharmacists. Like Mr Carr, she is also on the
prescribing and clinical governance subcommittees.
She perceives that her role as PEC chairman is to ensure professional
involvement in PCT decision-making and encourage clinicians to drive
forward agendas that will benefit patients. “I am trying to engage
with all professionals within the primary care setting, including pharmacists,
doctors, nurses, physiotherapists, dentists and optometrists,” she
explains.
Mrs Charlton says that Darlington has a large PEC which has representatives
from all professions. “It works very well. We have seminars at
the PCT, which allow professionals to talk with the PCT managers about
their professions and their capabilities.” Mrs Charlton believes
her involvement in the PEC has led to better communication and improved
relationships between GPs and pharmacists in the area. “Through
my work on the prescribing subgroup we now have improved telephone access
via which community pharmacists can contact GPs with prescribing queries,” she
says.
Her role has also enabled her to raise the profile of pharmacy and show
the PCT how pharmacists can be involved in improving public health. A
community pharmacy facilitator was appointed at the PCT about a year
ago, and the two pharmacists have set up a local pharmacy development
group, which has led to the initiation of a minor ailments scheme and
a co-ordinated schedule of public health promotion that all community
pharmacies within the PCT will follow for the next year. Becoming a member
Mr Carr says that, although pharmacists do not need to aim for the
position of PEC chairman, it is important that they are members of PECs. “By
being involved, pharmacists are likely to understand how the NHS works
and the opportunities that exist. They are also in a better position
to demonstrate how pharmacy can contribute to the overall working of
the PCT and the health of the public.” Mr Carr admits that, in
some respects, it is not as easy being PEC chairman. “I have
to take a balanced view. I have to represent nurses, GPs, physiotherapists,
etc, in just the same manner as I would pharmacists,” he says.
However, he believes that if people see pharmacists taking on the role
of PEC chairman then they recognise that pharmacists are willing to
contribute.
Many pharmacists have management experience that would be invaluable
for the role. “Pharmacists are often used to managing fairly large
businesses, and they gain a lot of skills and knowledge from working
in these larger organisations. It is often harder for clinicians to have
this experience because they have not had the opportunity to manage an
environment with a lot of people in it.”
Mr Jolley is optimistic about the future but says that more pharmacists
need to get involved. “Pharmacy has got a wonderful opportunity
to be integrated into the existing system. If we do not take this opportunity,
we are going to lose more and more services — the supply function
alone will not be enough to keep pharmacy going.” He adds that
more and more PECs are realising the value of having a pharmacist on
the committee.
Mrs Charlton concludes: “The board at Darlington PCT very much
welcomed the involvement of a pharmacist and is confident that the GPs
have seen the benefits in having me involved.”
Communication with primary care trusts will be key to the development
of the profession as the new contract is implemented. The message from
these lead clinicians is “get involved”. |
The
Pharmaceutical Journal