Let's share the cake
Now that the new financial year has started, we should be entitled to hope that the NHS will be able to shake off its troubles, and the cash crisis will be seen to be a problem of the last quarter of 2005/06. But nothing could be further from reality.
If we can anticipate what the leitmotif for 2006/07 might be, it is the
sound of people complaining about cash shortages. There is a real danger
for pharmacists that their expectations for the new contract — now
a year old — will never be met.
Primary care trusts in England are not only dealing with shortfalls caused
by their obligations to pay for the two-year-old GP contract and to keep
acute trusts in business; they are also facing upheaval and uncertainty
as some are merged and others disappear all in the next six months. Matters
may be slightly easier in Wales and Scotland, where pharmacy seems to
have a higher profile in the health family, but it is not going to be
easy for anyone.
By chance, in this issue we carry a number of items about instances where
lack of resources has been found to be a limiting factor in the development
of pharmacy services. This week’s Broad
spectrum (p414) examines
the progress of medicines use reviews. According to the latest figures
less than 3 per cent of the 200 reviews that were expected to be undertaken
by each pharmacy by April 2006 are being carried out. The problem seems
to be, one way or another, lack of resources. This may be mitigated by
the revised GP
contract (p408), which carries guidance for the first
time on how to perform medicines reviews. Opportunities for pharmacists
to advise GPs may follow. However, not until there is a financial incentive
for GPs to respond to a pharmacist’s recommendations will there
be any real impact on pharmacy.
Since there will be little support for pharmacy from central government,
the only thing pharmacists can do is talk to GPs, to PCTs and to health
boards, and do everything in their power to influence the commissioners
of care and hope that they will appreciate the value of sharing what
cake there is.
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Lessons from Northwick Park
The good news, earlier this week, that five of the clinical trial volunteers who had ended up in intensive care at Northwick Park Hospital less than a month ago have now been discharged, was followed up by a press
conference held by the Medicines and Healthcare products Regulatory
Agency (p408). The agency
said its interim findings were that usual custom and practice had been followed
in the trial — although protocols are likely to be revised in the light
of the incident. Two issues are worthy of comment. The first is that the activity
of biological molecules is not well understood: these medicines are powerful
and participants in preliminary human trials will always face risks. The second
is that the MHRA can be swift-footed when required.
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The
Pharmaceutical Journal