The national pharmacy boards: how you can help them influence the
future
Pharmacists with experience of the health care political scene in England, Scotland and Wales discuss some of the issues that the members of the Royal Pharmaceutical Society's new national pharmacy boards will confront
Elections are shortly to take place to fill the 12 elected places on
each of the Royal Pharmaceutical Society’s three
new pharmacy boards for England, Scotland and Wales (see p498). The
closing date for nominations is Friday 3 November.
The new boards need members who can provide the leadership needed to
take the profession forward and influence government policy within the
specific circumstances of each country.
The boards in England and Wales will each have 11 elected pharmacists
and one elected pharmacy technician; in Scotland, where there are no
current plans for pharmacy technicians to be regulated by the Society,
the board will consist of 12 elected pharmacists.
The following summaries are intended to help pharmacists and pharmacy
technicians who are still wondering whether or not to seek election.
Issues to be considered by the English Pharmacy Board
The English Pharmacy Board will have no end of issues to get its
teeth into. Nearly everything in pharmacy practice is changing
at the moment.
Even the major regulatory changes will have practice implications
that need to be considered. In no particular order, here are some subjects
that new board members might want to discuss.
Mandatory CPD How should this be introduced? What structures will be
needed to support it? How can the board give guidance to members in England
about what might
be considered acceptable topics for CPD, particularly for pharmacists
who are not working in patient-facing roles or who are working outside
the core sectors?
New ways of working How can the board support the introduction
of new ways of working within different sectors of the profession? How
can experience
in one sector (such as hospital) be translated into other sectors? What
are the practice implications
in England of electronic prescriptions or automated dispensing?
Workforce What are the implications for the pharmacy workforce in England
of the many changes under way? In particular, what advice can be given
about extended hours services, workloads and flexible working conditions?
Pharmacy contract How would the board like to see the contract develop
in future? What support can be given to pharmacists working under the
contract?
One of the main issues that the board will have to face is the development
of a spirit of Englishness within pharmacy. The devolved nature of pharmacy
practice in Scotland and Wales has long been recognised. This is less
obvious in England, where there is still a tendency, in some circles,
to think of the NHS as a single body. In fact, it is a myriad of bodies
covering various areas, from county level up to the whole of England.
This needs to be specifically recognised.
Another aspect for the board will be the sharing of experiences across
different sectors of pharmacy. The reserved seats on the board will be
helpful in this respect. There is a need for fresh thinking, new ideas
and new perspectives. I hope that the newly elected members of the board
will bring these different views to share with their colleagues.
Pharmacists and technicians: if you want
to share your experiences and help your colleagues shape the practice
of pharmacy across England, now is the time. Please put your name forward
for election to the English Pharmacy Board. I cannot do it all by myself.
— Jonathan
Buisson (member of Council for the constituency of England, the Isle
of Man and the Channel Islands).
Opportunities in the new era for pharmacy in Scotland
The formation of the Scottish Pharmacy Board signals the beginning
of a new era in the history of the Society. The pharmacists elected to
the board will have a responsibility to provide strategic leadership
and deliver new policies for the profession in Scotland.
There will be many opportunities, some of which are based on the foundations
laid since devolution. Many Bills, White Papers and strategies have impacted
upon the profession and the delivery of care to the Scottish public,
particularly the Scottish Health Plan, “Our National Health: a
plan for action, a plan for change”, the Scottish Executive Health
Department’s pharmacy strategy, “The right medicine: a strategy
for pharmaceutical care in Scotland”, published in 2002, and most
recently the Scottish Executive’s “Delivering for health”,
published in November 2005.
Through implementation of “The right medicine”, pharmacists
have taken on new areas of service provision that have improved patient
care and radically altered the perception of pharmacists from being suppliers
of medicines to being clinicians and providers of a wide range of health
care. In addition, there
has been increased recognition of the expertise of pharmacists; an acknowledgement
that pharmacists can be used to improve the quality of care for the patient
and alleviate pressure on other health care professionals. “Delivering
for health” illustrates this and outlines new and better ways of
providing health care through community pharmacy as part of a planned
and integrated service. The document outlines the four core elements
of the new pharmaceutical care services contract, which it states will
promote the improvement and use of pharmacies as “walk-in healthy
living centres”.
Although there is much to welcome in current health policy and in the
recently implemented contract, it will be for the new board to ensure
that there continues to be the political will to fully exploit the opportunities
to enable pharmacists, wherever they practise, to be an integral part
of the multidisciplinary health team. In addition, there are still areas
where better use of the profession’s skills would make a difference
to the health and well-being of the people of Scotland.
There are opportunities to develop the role of pharmacists as public
health practitioners, providing smoking cessation services, sexual health
advice and an infrastructure that supports drug misusers and the wider
public health strategies. In addition, there is scope for pharmacists
to be more widely used as first line health care professionals. This
has been addressed to a certain extent through “The right medicine” and
now through the core components of the community pharmacy contract, but
there are areas where pharmacy can contribute even more, such as through
pharmacist prescribing and the delivery of
out-of-hours services. The chronic medication service will afford community
pharmacists the opportunity to play a key role in using their clinical
skills for the benefit of patients. However, this will only work effectively
if pharmacists have appropriate access to medical records. In addition
to this, there may be challenges ahead, for example in relation to exemptions
from NHS prescription charges, but it will be for the board members to
consider these issues and decide upon the course of action to take to
maximise the contribution pharmacists in all sectors of the profession
can make to improve the health of the people of Scotland.
— Lyndon
Braddick (the Society’s director for Scotland).
What is happening in Wales?
The Welsh Pharmacy Board will be established at a time when Wales is
undergoing great change. “Designed for life”, a 10-year
strategy for the NHS in Wales, was published 18 months ago and a number
of documents and initiatives have followed it.
Reorganisations have been suggested for secondary care (“Designed
to deliver” consultations) but in the case of West Wales these
plans have been shelved following public opposition. The decision was
made that community services would have to be in place before secondary
care can change. But where will the money for this come from? Other ways
of developing services in West Wales will have to be found. In this region,
challenges of geography, manpower and access are all issues.
The Welsh Assembly Government is developing a chronic conditions model
for Wales, the delivery of which will be a challenge for the next few
years. Pharmacy development has been identified as a key “Foundation
for change” in the improvement of services. It is anticipated that
this model will be launched in 2007 in the form of an action framework.
The focus for pharmacy moving forward will be to develop pharmaceutical
clinical networks to deliver effective medicines management across organisational
boundaries, enabling the shift of services from secondary to primary
care. This was one of the action points included in “Remedies for
success”.
The new board will have an essential role in ensuring that the profession’s
voice is heard in the development of services and that pharmacists are
supported in the delivery of their roles.
Information technology developments in Wales are separate from those
in England. In primary care Wales is adopting a phased approach to ensure
connectivity to the NHS network, electronic transmission of claims and
electronic transmission of prescription via a two-dimensional bar code.
This will lead to a full Welsh electronic prescription service, in line
and in collaboration with the national information management and technology
(IM&T) architecture of “Informing health care”. This
programme is developing a work stream looking at pharmacy and medicines
management, to address the use of medicines-related information flow
between primary and secondary care both on admission to hospital and
upon discharge. An essential role for the board will be to continue to
lobby for pharmacy and medicines aspects to be a priority in these IT
work streams.
In April 2007, prescription charges will be removed. We will await with
interest the impact of this on the way in which patients in Wales seek
treatment, in particular for self-limiting conditions and self care.
The board will need to watch carefully what happens.
May 2007 will see the Welsh Assembly Government elections. It may be
that no single party will win an outright majority and a coalition will
be formed. Certainly, we can expect new faces and a potentially different
approach to accommodate merged policy agendas, and also new powers granted
to the Assembly.
The Welsh Executive has been lobbying the political parties in Wales
for the inclusion of a number of issues in each party’s election
manifestos. The board may wish to follow this up and lobby prospective
AM candidates, using the Assembly elections in May 2007 as the first
opportunity for the board as an entity to engage in Welsh politics.
The Government of Wales Act will mean changes in the powers of the Assembly,
a distinction between the Assembly Government and the Assembly itself
and major change in procedures and processes. These changes will provide
an opportunity for more devolution than ever before, with Cardiff Bay
working closely with Westminster to pass Orders in Council, and the Assembly
granted powers
in the Orders in Council to proceed with drafting Assembly Measures.
All in all, pharmacy in Wales faces interesting times with much opportunity.
— Cath
O’Brien (the Society’s director for Wales). |
The
Pharmaceutical Journal