| Once legislative changes announced in 2005 come into effect, pharmacists
will be able to prescribe any licensed medicine for any condition — with
the exception of Controlled Drugs — and to benefit from the relaxation
of strict supervision requirements. And with a new pharmacy contract
being introduced in England and Wales and the start of electronic transmission
of prescriptions, 2005 has seen many of the important developments proposed
for community pharmacy over the past few years come to fruition.
The launch of “Choosing
health through pharmacy” in the spring
showed some of the services the Government envisaged pharmacists taking
on, by identifying public health targets that pharmacists can have an
impact on, such as smoking, obesity and sexual health, and describing
how pharmacists could become health champions over the next decade (PJ,
9 April, p409).
Changes were not confined to community pharmacy, however. Through the
year hospital pharmacists saw their pay restructured as part of the Agenda
for Change programme. By July, 70 per cent of NHS employees had been
matched to their appropriate AfC payband, although progress with switching
to the new scheme was less dramatic — less than half of all staff
had actually been switched to the new pay system by then and evidence
emerged that NHS trusts were abusing the job evaluation process because
they could not afford to implement AfC in full (PJ, 27 August, p245 and
8 October, p429).
Contracts
The new community pharmacy
contract for England and Wales came into
effect in April, albeit with a six-month transition period, meaning that
full
implementation and monitoring by primary care trusts only began in
October. The contract enabled contractors to be paid to provide advanced
and enhanced services to patients — a move which saw pharmacists’ income
tied to high-quality services rather than dispensing large volumes
of prescriptions.
From its foundations in essential services, the contract began to expand
as the first enhanced service specifications were announced in September
(PJ, 10 September, p299).
Plans for a new community
pharmacy contract in Scotland continued to
progress in 2005. The Scottish Executive explained in November how the
contract would be introduced through a phased implementation, from April
2006, over the course of a year (PJ, 3 December, p677). And
this week saw the announcement of the first of the four core service
specifications
to be agreed by the Scottish Executive Health Department and the Scottish
Pharmaceutical General Council.
In advance of the new contract funding arrangements, GlaxoSmithKline
revised its discount terms, ceasing to offer discounts on products with
no price competition, a move that was mirrored by IVAX and which raised
concern from contractors throughout the UK as well as from the Pharmaceutical
Services Negotiating Committee and the National Pharmaceutical Association
(which saw change itself this year, becoming the National Pharmacy Association
in June) (PJ, 19 February, p197 and 2 April, p381).
Changes to contracts for the supply of oxygen to patients at home also
threw up difficulties for contractors, who had to conduct audits of their
cylinders ahead of the planned introduction of monthly rental charges
on cylinders (PJ, 19 February, p197). New regional contracts for the
supply of home oxygen were awarded to Air Products, Allied Oxycare/Medigas,
BOC and Linde. The new arrangements — which both the PSNC and NPA
warned could compromise patient care — were due to come into effect
in October, but a legal challenge by an unsuccessful bidder meant that
they will be delayed until February 2006.
Regulations
Ripples from the Shipman
Inquiry also continued to stir pharmacy during
2005. Although in February the Royal Pharmaceutical Society’s
Statutory Committee found that the pharmacist involved in the Shipman
case had no case to answer, in March the DoH announced a review of
all UK health regulators, including the Society (PJ, 19 March,
p323). Initially dismayed at not being asked to join the review’s advisory
committee, the Society welcomed its subsequent invitation to be included.
In August, the Home Office began to consult on how the prescribing
and auditing of CDs needed to be changed in response to recommendations
of
the Shipman Inquiry. The Government also proposed requiring pharmacies
in England to make regular declarations about CDs and allowing pharmacists
to amend prescriptions for CDs where there is a technical error but the
intention of the prescriber is clear (PJ, 16 July, p71 and 6
August, p155). The Society warned, however, that patients’ clinical needs
might be ignored as health care professionals try to avoid the use of
CDs in order to reduce the potential harm from misuse.
Tighter regulation of the promotion of new drugs was also called for
this year — by a report from the House of Commons Health Select
Committee on the influence of the pharmaceutical industry. The committee
also argued that an urgent review was needed of the Medicines and Healthcare
products Regulatory Agency, which, it said, lacked the discipline and
leadership needed to protect patients’ health needs (PJ,
9 April, p410).
Politics
Following the general election in May, in which junior health minister
Melanie Johnson lost her seat, a new team was appointed to the Department
of Health. Former Secretary of State for Trade and Industry, Patricia
Hewitt, took over as Secretary of State for Health from John Reid,
who became defence secretary.
Jane Kennedy, the newly appointed minister of state for quality and
patient safety, was given the pharmacy portfolio, which had previously
been assigned
to Rosie Winterton.
In the Society’s Council election in April, 13 of the 17 pharmacists
elected to the Council were supporters of the Save Our Society campaign — no
candidate who declared open support for the SOS
campaign failed to be elected and only one unreserved place and the three
regional
representative places went to non-SOS
supporters.
In May, Stephen Denyer, head of the school of pharmacy at Cardiff University,
was appointed as the academic member of the Council and the number of
lay members of the Council was increased from three to 10.
At the first meeting of the Society’s new Council, in June, Hemant
Patel was elected President of the Society, Gerald Alexander was elected
Vice-President and John Jolley was re-elected Treasurer.
The Society saw other changes in 2005. In August it accepted its Devolution
Review Group’s proposal to establish separate boards to provide
strategic leadership and support for pharmacy practice development relevant
to each home country (PJ, 6 August, p155). And in January, Linda Hopkinson,
Alan Hunt, Clair Moore and Lesley Morgan became the first four technicians
to be registered with the Society — by the end of the year over
2,300 had done so.
Even after a year full of important developments, the continued expansion
of pharmacists’ roles in patient care and changes to supervision
requirements will mean that there are plenty of changes to pharmacy practice
lying ahead in 2006. |
The
Pharmaceutical Journal