| Community pharmacy is changing. With pharmacists’ clinical
advisory role coming to the fore, pharmacy premises in the community
are having
to change, too. This is demonstrated by the proliferation of consultation
areas in pharmacies throughout the UK.
Now community pharmacists in Scotland are being asked if their premises
are up to scratch. This week, the Scottish Executive published (in an
NHS circular) a checklist for pharmacists to use to assess their premises.
If premises meet the requirements, or if a development plan for improvement
is agreed with the NHS board, then pharmacists will receive a payment.
Bill Scott, chief pharmaceutical officer, Scottish Executive, explains: “The
overall objective is to ensure that community pharmacy premises are fit
for purpose and support the delivery of the new community pharmacy NHS
contract.”
The premises assessment is one part of the work covered by the “contract
preparation payments” (PJ, 9 June, p663). These are tasks that
have to be undertaken before the introduction of the acute medication
service and chronic medication service. They include clinical training
and IT improvements, as well as the premises work.
Both Mr Scott and Community Pharmacy Scotland point out that investment
has already been made in premises development. Alex MacKinnon, CPS head
of corporate affairs, says: “Within the strategic intent of ‘The
right medicine’ and the development of the pharmacy contract, it
was recognised that support should be provided to ensure that pharmacy
premises are fit for purpose. Funding has previously been made available
for provision of private advice areas, compliance with the Disability
Discrimination Act legislation and security aspects.” He adds that
if this premises assessment reveals particular problems, CPS will seek
to negotiate additional funding.
In addition to the checklist, detailed standards for premises are also
being published this week: although currently aspirational, they add
context to the checklist and provide a blueprint for developing a new
pharmacy. This document (“Scottish health planning note 36 — part
3, community pharmacy premises in Scotland”) may be obtained
from the Health Facilities Scotland website (www.hfs.scot.nhs.uk).
Mr
Scott comments: “It outlines guidance, drawing from best practice,
on the design of pharmacy premises. It is aspirational and is intended
to help community pharmacists when upgrading existing or planning new
premises. The document is dynamic and will evolve and change as the clinical
aspects of the contract develop over the next few years.” Checklist
The checklist gives seven core requirements for pharmacy premises.
They are: • Ensure equality of access for
all patients — the premises, and
the pharmacy’s services, must meet the requirements of the Disability
Discrimination Act 1995
• Have a waiting area with seating — it must be big enough for
a wheelchair user, or someone with a guide dog or pushchair to sit without
causing an obstruction
• Have a consultation area which is private and fit
for purpose — it
must be large enough to accommodate two people (standing or seated) and
be accessible for wheelchairs (if supervised consumption of methadone
is provided, then the area should be safe for clients and staff, and
be reasonably separated from other pharmacy users)
• Have a specific health promotion area to display health promotion and
education materials
• Have a professional image and be uncluttered, particularly in areas
where clinical activities are provided
• Have facilities to collect and store returned medicines
• Display a sign stating the services the pharmacy
offers, and further
signs around the pharmacy pointing out particular facilities
To be eligible for the premises contract preparation payment, the pharmacy
must meet at least four of the requirements and, for any deficient area,
have a development plan in place.
How Toll Pharmacy in Prestwick, Ayrshire, rose to the challenge
A consultation room |
Pharmacist Cathy Burns has transformed Toll Pharmacy
in Prestwick, Ayrshire, so it delivers much more than the core
requirements of
the new premises standards.
The pharmacy now has two consultation
rooms, a treatment room, two semi-private areas (one for quiet
words at the medicines counter and the other for supervision of
methadone
consumption) and a seated waiting area. It is bright and airy with
a modern, clinical feel.
“The pharmacy used to be long, dark and narrow, and customers in wheelchairs
had difficulty coming in. This clearly was not good enough so,
in February last year (2006), I approached the people who owned the flat next
door to find out if they would sell to me,” she explains.
“We
had some problems buying the flat and getting planning permission,
but eventually we were able to expand the pharmacy so it covers
a much wider area.”
The refurbishment was completed last month and the new space allows
Mrs Burns to offer supplementary prescribing, emergency hormonal
contraception and smoking cessation services from a consultation
room. She rents the other consultation room to a reflexologist
(at a rate of £25 for half a day), and is currently in discussion
with the local harm reduction team about using the treatment room
to treat things like injection site wounds.
Mrs Burns used Mark Forbes, of Retail Design Consultants, to plan
the new pharmacy based on a draft version of this week’s premises
standards. She also made use of her environmental engineer brother’s
skills to advise her on air conditioning, lighting and space.
Buying the flat cost £140,000, and the refit and building work
another £160,000, but Mrs Burns says the decision was not just
about a business investment: “I did it because it feels right.
I think pharmacy has a bright future in Scotland. Six years ago,
my oldest son was deciding which course to study at university and
I encouraged him to do medicine rather than pharmacy. Now my youngest
son is making his choice and I am encouraging him to study pharmacy.
That underlines the difference the new contract in Scotland is making
to community pharmacy.” |
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The
Pharmaceutical Journal