Evaluation of community pharmacy contract shows some progress but still
room for improvement
Substantial changes have occurred since the introduction of the community
pharmacy contract in England and Wales, with community pharmacists providing more services across the three tiers in the contract, data released at the British Pharmaceutical Conference reveal.
Craig Strong
Alison Blenkinsopp: issues in relation to integration with general
practice continue to be a barrier |
Alison Blenkinsopp, professor
of the practice of pharmacy at Keele University, presented findings from
the first major national evaluation of the new
contract since it was introduced in 2005 (PDF 500K).
Professor Blenkinsopp
told the conference that the first advanced service — medicines
use reviews and prescription interventions — is provided by 60
per cent of pharmacies. Almost three quarters of those not yet providing
MURs are independents, she said.
At least one enhanced service is being provided by 87 per cent of pharmacies
and over 40 per cent are providing more than three. Primary care organisations
reported that lack of available funds was the main barrier to commissioning
services.
Professor Blenkinsopp said that pharmacists value the increased patient
contact brought by the new contract, although they also reported a number
of negative aspects (see Panel below).
Workforce patterns and job satisfaction
Most pharmacists believe they are financially worse off under
the new community pharmacy contract in England and Wales than they
were under the previous arrangements, data from the evaluation
suggest.
Jackie Inch, research fellow, school of medicine, general practice
and primary care, University of Aberdeen, presented results from
an analysis of workforce patterns and job satisfaction among community
pharmacists, examining changes since the introduction of the contract.
A
survey of 543 pharmacists along with 219 telephone interviews revealed
that the new contract has had a negative effect on job
satisfaction and that respondents felt under pressure from the
daily demands of work.
In addition, many perceived there to be no financial reward from
the new contract — 57 per cent believe they are financially
worse off under the new arrangements and 45 per cent believe the
new contract is less fair than the previous one.
However, Ms Inch
pointed out that it may be too early to draw any hard conclusions
about the impact of the new contract and so it will be important
to track changes over time. |
And while most of those involved in the evaluation thought the contract
had the potential to increase integration into primary care, in practice
it has had little effect on inter-professional working between pharmacists
and GPs. Over 80 per cent of pharmacists said there had been no change
in their contact with GPs since the new contract.
The findings also show
that GPs perceive a gap between the areas they would like pharmacists
to concentrate on in the MUR service and what pharmacists are providing.
“Issues in relation to integration with general practice continue to be
a key barrier,” said Professor Blenkinsopp, “particularly
to achieving the potential of new services such as MURs and the Department
of Health’s objective of reducing demand on GPs and increasing
community pharmacy input in the care of long-term conditions. These need
to be addressed.”
The authors of the study, commissioned by the Pharmacy Practice Research
Trust to inform the continued development of the contract, make a number
of recommendations aimed at the Department of Health, primary care organisations,
GPs and community pharmacists as well as pharmacy organisations.
Among
these is a need for investment in local change management, more information
for patients about the new services, increased patient and public involvement,
the development of local pharmacy leadership, and a more proactive
approach by community pharmacists to meet with local GPs.
The researchers collected data from 1,081 community pharmacists, as
well as from patients, GPs, and the NHS (at primary care organisation
and
strategic health authority levels), focusing on 31 primary care organisations
in England and Wales. |
The
Pharmaceutical Journal
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