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Letters to the Editor
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Enhanced services
Reply from John
Finn, professional executive committee member at Devon Primary
Care Trust
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Four-week scheme
From Mrs A. J. Hayes, MRPharmS
Allow me to address all fellow pharmacists, whether in Devon or elsewhere
in the country, and tell them not to be coerced into chasing NHS targets.
I am referring in this instance to the new local enhanced service (LES)
for smoking cessation which has been recently circulated by Devon Primary
Care Trust.
Where our highly successful service previously allowed us to support
patients for up to 12 weeks, the new scheme only allows us to do so for
four weeks, contrary to National Institute for Health and Clinical Excellence
guidelines.
The new scheme also states quite clearly that once the primary care trust
target is reached, the contract will cease. Now I am not sure how many
pharmacists have read the new Code of Ethics.
Principle 2 states: “Exercise
your professional judgement in the best interests of patients and the
public” and goes on to say that “guidelines, targets … must
not be allowed to compromise your ability … on what is appropriate
for patients”.
Have any pharmacists who have signed up to the scheme considered what
they are going to do with their patients at the end of four weeks? Are
they just going to dump them and say “on your own now”? Are
pharmacists going to force successful quitters at the end of four weeks
to purchase their own nicotine replacement therapy?
There is no point
in sending patients to the GP, since they cannot be signed up to another
NHS quit smoking scheme within a six-month period. What about those
patients on a low income who cannot afford to buy the products?
This service has also been designed to allow pharmacists to fail. GPs
have been offered the same LES, however, with the help of their prescription
pads they will be able to continue offering NRT (and other products
such as Champix and Zyban) to their patients.
Pharmacies in East Devon
have
previously demonstrated a quit rate of 60 per cent and more (which
is greater than the national rate) and we are now set to look second
rate
when compared with the advantaged GPs. In time this will then provide
evidence for the PCT to discontinue the service in pharmacy altogether.
I urge those pharmacists considering providing the service to do
the training by all means but not see any patients until they have
arranged
continued support for them. Alison Hayes
Exmouth,
Devon
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JOHN FINN, professional executive committee member
at Devon Primary Care Trust, responds:
There has been some confusion
over the intended
outcomes of the recently introduced local enhanced service (LES) for
smoking cessation within Devon PCT. We welcome this opportunity to
clarify our position.
Devon PCT is keen to support the roll-out of an LES for this service
that improves access and availability to all patients. Bearing in
mind that such an LES had
been offered to all GPs during 2006–07, the PCT made a decision to offer
this same contract to both GPs and community pharmacists in 2007–08 at
the same level of funding to ensure equitable access to providers.
The present scheme does acknowledge that some patients may require up to 12
weeks of nicotine replacement therapy to quit successfully (in accordance with
National
Institute for Health and Clinical Excellence guidance) within available resources.
Despite
these best laid plans Devon PCT has welcomed feedback from pharmacy contractors
detailing their concerns about the practicality of patients getting
further supplies
of NRT after the initial four weeks.
As a result of this, the service is
to be reviewed. |
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The
Pharmaceutical Journal