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Letters to the Editor
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Community pharmacy
Community pharmacists need access to patients' medical records
From Dr N. Kometa, MRPharmS
I read with interest the letters of Gordon
Appelbe and Stephen Potter (PJ, 27 January, p105) regarding to the case of Horton
vs Lloyds Pharmacy Ltd 2006. They made me think about some of the shortcomings of community
pharmacy practice.
When assessing a prescription, as stated in the Royal Pharmaceutical
Society Code of Ethics, most pharmacists will generally use their knowledge,
experience and reference sources, and then contact the prescriber if
there is any ambiguity with the prescription. However, community pharmacists
do not have the primary and essential piece of information they need
at hand to undertake a complete professional assessment of a prescription
presented for dispensing for that particular patient, namely, the patient’s
medical notes, which may include the consultation, diagnosis and medicine(s)
prescribed and the rationale behind it.
I assert that the professional assessment of a prescription will never
be complete for as long as community pharmacists do not have access to
patients’ medical records. Because no two consultations are the
same, neither is dispensing.
There are fundamental flaws, therefore, that underpin and permeate the
practice of community pharmacy. These flaws include the lack of access
to patient medical notes (as stated above), the lack of a requirement
to disclose the indication for prescribed medicines, and high-volume
dispensing with its resultant time pressure and minimal patient contact.
In practice, it is not always possible to contact a prescriber if needed,
as any community pharmacist will testify. Therefore, I ask pharmacy’s
representative bodies, including the Society, the National Pharmacy Association,
the Pharmaceutical Services Negotiating Committee and the Pharmacists
Defence Association, to recommend to the Department of Health and all
the health authorities and boards to arrange for community pharmacists
to have access to a patient’s medical notes when dispensing a prescription
for that patient.
Prescribers’ computer systems should also be redesigned or the
software modified to include a brief indication for the medicine.
There is no doubt that the implementation of electronic transfer of prescriptions
across the NHS has presented pharmacy representative bodies with an unprecedented
opportunity to put forward a strong case to enable pharmacists to have
access to patients’ medical records at the point of dispensing
so that they can provide the duty of care to each individual patient
as required of them by law.
Nsanyi Kometa
Birmingham
Subscribe to journals and keep up with informed patients
From Mr R. I. Dunkley, MRPharmS
Your article
about patients accessing the internet for health problems
and then going to their pharmacist or doctor with their results was thought-provoking
(PJ, 3 February, p143).
I applaud efforts by pharmacists to access the internet when helping
patients, but have they considered accessing the various online issues
of the major medical journals?
If they were to go to Medline, as I do, as a first stop, then there is
a good chance that the paper required is in one of these major journals.
However, when the link to the journal is followed, unless the enquirer
is a subscriber, all he or she will get is the abstract of the paper.
Papers can be ordered from the Royal Pharmaceutical Society’s library
at a cost. Thus I was spending a great deal of money to obtain papers
to help my patients. I then discovered that an online subscription to
the major medical journals would save much money. I currently subscribe
to the BMJ (£24), The Journal of the American Medical
Association (£50), Archives of General Psychiatry (£53), The
New England Journal of Medicine (£34), The American Journal
of Psychiatry (£54),
and The Lancet (£103). Yes, the figures appear huge, but if we
are going to provide an information service to our patients, then it
is worth it. We would get access to the complete content of the journals,
and we could download as many papers as we want.
Bob Dunkley
Community Pharmacist
Dewsbury,
West Yorkshire
Where is the funding for the PSNC's low-volume LPS?
From Mr D. R. Kent, MRPharmS
Your report of the “off-the-shelf” low-volume local pharmaceutical
service (PJ, 3 February, p124) cannot pass without comment. In the opinion
of those who have been striving to get fair play for low dispensing volume
pharmacies (LDVPs) this proposal is no more than window-dressing by the
Pharmaceutical Services Negotiating Committee, which is fully aware that
this proposal requires funding by primary care trusts — and therein
the problem lies.
PCTs have little or no cash even to continue many recent, and in some
cases long-standing, commissioned services from pharmacy contractors
and have firmly stated that support of LDVPs from their available funds
is not possible. What the PSNC has done is to seem to be acting — but
to ignore this blatantly obvious fact. It has been brought before the
committee time and again over the past two years that funding outside
the new community pharmacy framework will never be achieved; the committee
chooses to ignore this.
You may wish to ponder that no other primary health care negotiating
body has ever sought to disadvantage their weaker members.
These are my personal views and do not necessarily represent those of
any organisation with which I may be associated.
David Kent
London
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SUE SHARP, chief executive, Pharmaceutical Services
Negotiating Committee, responds:
Mr Kent is unduly pessimistic. One PCT
has already contacted
the PSNC to express interest in this proposed local pharmaceutical
service. |
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The
Pharmaceutical Journal