Primary and Community Care Pharmacy Network
Promoting pharmacy in a new NHS
Keith Ridge: a demand for strong leadership within pharmacy |
PCCPN membership
Pharmacists or pharmacy technicians supporting community health
services, including community hospitals, or a pharmacist involved
with the
regulation of health care who would like to join or find out
more about PCCPN, should contact David Green, PCCPN membership
secretary
(e-mail david.green@essexrivers.nhs.uk)
An application form is also available on the PCCPN website
www.pccpnetwork.org |
Keith Ridge, chief pharmaceutical officer, England, congratulated the
Primary and Community Care Pharmacy Network on its achievements over the
past 20 years. And, looking to the future, he said that patients will have
more influence over the commissioning and delivery of services. Managing
a health economy based on patient choice and diverse providers will demand
a new style of management and strong leadership within pharmacy. The skills
of community health services pharmacists will be needed, both in commissioning
and provision, to ensure quality and adherence to standards.
Theresa Rutter, joint director of community health services and London,
Eastern and South East specialist pharmacy services, described a toolkit
designed to help commissioners and providers of community health services
understand the need for pharmacy input, particularly in relation to clinical
governance. The toolkit includes a detailed proforma that prompts the user
on what needs to be in a service level agreement or contract to assure
a safe service. The toolkit also includes a description of the competencies
needed by pharmacy staff supporting community health services. The toolkit
will be available on the websites www.nelm.nhs.uk
and
www.pccpnetwork.org.
Heather Gray, of Primary Care Contracting, told the meeting that the community
pharmacy assurance framework could be a powerful tool to stimulate and
promote primary care trusts’ consideration of pharmacy’s involvement
in PCT strategy. She outlined what “went well” in the application
of the framework to date, which included better communications between
community pharmacy and PCTs, greater collaboration with others in the health
care team and a higher profile in relation to clinical governance.
Ongoing issues include the ability of PCTs to monitor compliance with regulations,
and obtaining the additional investment needed to realise fully the opportunities
and benefits provided in the contract. For example, now that every pharmacy
can potentially claim £10,000 per year for medicines use reviews,
it is critical that these represent value for money and are shown to improve
patient care. PCTs, practice-based commissioners and community pharmacists
will need to explore at a local level how this can be achieved. Similarly,
suitably anonymised information from pharmacy records of, for example,
clinically significant interventions, referrals and support for self care
also have the potential to raise the profile of pharmacy and provide a
better understanding of the potential contribution of pharmacy in practice-based
commissioning.
Nearly half of care homes still not meeting national standards
Evidence that care homes are still not placing enough importance on the
management of medicines is provided in the 2006 report “Handled with
care”, a follow up study to the 2004 report by the former National
Care Standards Commission. Brian Brown, South West regional lead pharmacist,
from the Commission for Social Care Inspection, told the meeting that nearly
half of care homes for older people and adults are not meeting national
minimum standards for medicines, ie, around 210,000 placements. The evidence
in “Handled with care” points to the need for homes to tackle
core management issues such as training of staff and monitoring of practice
and procedures. The allocation of training funds seems to be weighted in
favour of local authorities rather than private care homes. Under-provision
of training and failure to monitor current practice can lead to “short
cuts” that can be catastrophic for residents. Mr Brown drew an analogy
between the short cuts found in practice and the bad habits developed by
drivers who passed the driving test a long time ago. He pointed out that
the responsibility of PCTs within the annual health check extends to their
residents who are in care homes.
There was discussion about the perception in some care homes that monitored
dosage systems (MDSs) are mandatory. Mr Brown clarified that they are not
but that he is aware that provision of medicines in MDSs is sometimes driven
by the ability to produce a medicines administration record chart along
with the MDS.
New UK vaccinations
The childhood immunisation programme changed in September with the addition
of the pneumococcal conjugate vaccine, a change in the primary dosing schedule
for the meningococcal C vaccine and a booster dose of a combined haemophilus
influenzae type B and meningococcal C (Hib/MenC) vaccine at 12 months of
age.
Judith Moreton, programme manager, Department of Health, discussed the
reasoning behind the changes. The UK has been the “trailblazer” in
terms of implementing vaccination against meningitis C, she said. Ongoing
surveillance has shown that two doses of meningococcal C vaccine in the
primary course gives the same protection as three doses. The boosting dose
of Hib/MenC vaccine at 12 months of age gives further protection through
the early childhood years.
The new childhood immunisation programme now includes protection for the
most vulnerable age group (under two years of age) against invasive pneumococcal
disease. As well as protection from life threatening disease, children
will also benefit from increased protection from less serious but common
illnesses such as otitis media.
Ms Moreton reiterated the responsibility of all health professionals to
actively support the childhood programme which protects children, their
families and communities.
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The
Pharmaceutical Journal