Wake-up call
This week's Journal could make for rather disheartening reading — particularly for community pharmacists. The two items that triggered this view are Broad
spectrum (p218) and the third Original
paper in our series on
commissioning services (p224), both contributed by the Workforce Academy at the University of Manchester's school of pharmacy and pharmaceutical sciences.
Broad spectrum focuses on the current demands made on community pharmacists:
workload is increasing relentlessly while remuneration is dropping and
there are difficulties for pharmacists in trying to take on new roles
while continuing to cope with their existing responsibilities. There
is a Letter this week, as well, from a pharmacist complaining about the
pressure he is under to do more and more medicine use reviews — not
because of clinical need but out of financial necessity (p219).
The Original paper examines the commissioning of enhanced services from
community pharmacists under the new contract in England. The bald truth,
from this research, is that there is hardly any commissioning going on.
Services that are in existence tend to have been launched before the
introduction of the new contract (in April 2005); moreover, the signs
for the future are not promising.
The Journal’s suspicion is that all this is an accurate reflection
of what is happening in many parts of England and there are only pockets
of innovative pharmacy practice.
Will things get better? It could be argued that the new contract needs
more time to bed down, that once practice-based commissioning starts
in earnest, the opportunities for pharmacists will start to emerge and,
significantly, that when all the new NHS IT systems are in place there
will be nothing to hold pharmacy back. So say the optimists.
The pessimists, on the other hand, can be heard laughing at their naivety.
Practice-based commissioning will primarily benefit GPs, they scoff,
and, as for the completion of the NHS IT system, pigs might fly.
Somewhere between these two views reality lies. Without doubt there are
opportunities for pharmacists, but how can they be grasped?
Primary care trusts should be forced to ring-fence money for enhanced
pharmacy services. The Pharmaceutical Services Negotiating Committee
should put much more pressure on the Department of Health. The All-Party
Pharmacy Group inquiry must play a part in raising more awareness of
the profession’s potential contribution. The national bodies should
start co-ordinating the lobbying of MPs — as they did successfully
over the control of entry consultation. Otherwise this may not be a wake-up
call so much as the first faint sounds of the last post.
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