LINDSAY MCCLURE, head of information services at
the Pharmaceutical Services Negotiating Committee, responds:
The article
must be seen in
the context of the series
of articles which were commissioned by the
Society to help stimulate debate within the profession in advance
of the consultation on “Pharmacy 2020”. The reader has misinterpreted
the quoted sentences that deal with two separate issues.
There is nothing new about the concept of “hub and spoke” dispensing,
where dispensing takes place in a centralised dispensary (hub), for the “spoke” pharmacists
to hand to the patient with appropriate counselling. The regulations currently
require such assembly of medicines to be undertaken within the same ownership
group and offer various benefits.
For example, many pharmacies now provide medicines
in monitored dosage systems and, although expensive, there are systems now
available which support automated dispensing of MDS. Using centralised assembly
of MDS
could alleviate many of the concerns being expressed to the PSNC about pharmacist
and technician workloads. These benefits are currently available to multiple
pharmacies but not single, independent pharmacists with one pharmacy.
I
suggested in the article that items delivered to a pharmacy from its wholesaler
might, if regulatory barriers were overcome, be packed in appropriate containers,
ready-labelled for patients — this is not such a huge advance from the
development of manufacturer’s patient packs.
My reference to remote supervision referred to this being controversial.
Let me repeat what I said: “Future regulatory change to enable remote supervision
could also potentially lead to the development of controversial new uses for
automation, such as unmanned dispensing kiosks to support patient access to medicines
out of hours.” Remote supervision is now technologically possible with
only the regulations blocking this practice.
The PSNC responded in 2004 to the Government’s consultation on skill mix
and, as part of its response relating to pharmacist supervision stated: “The
PSNC accepts that technology may allow this function to be provided remotely
and would even allow patients and customers to use remote links to seek advice
from a pharmacist. We advocate great caution in progress along these
lines.
Members of the public would, we believe, find remote consultation
less satisfactory than
face-to-face discussion and this could reduce the benefits in delivery
of health services we are seeking to provide under the new contract”. My article,
drawing attention to the potential for technology to move in these controversial
directions, was wholly aligned to the PSNC position.
It is also worth noting that the Society’s published policy on this issue
is not set against remote supervision, but instead lists a number of safeguards,
for example, “only pharmacists should be able to supervise remotely”,
and “pharmacists must have access to all relevant information that they
would have if present in the pharmacy, eg, PMR, etc, and must have enough information
to make an appropriate assessment” (PDF 80K).
As highlighted in my article, technology offers the profession benefits
but also many threats. It is important that these challenges are recognised
to
ensure
patient safety and to prevent the public’s confidence in the profession
being compromised. |
The
Pharmaceutical Journal