The Pharmaceutical Journal
Vol 279 No 7475 p459
27 October 2007

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Pharmacy contribution to “care closer to home” agenda highlighted

Some of the ways in which services provided by pharmacists might contribute to the Government’s “care closer to home” agenda are set out in a report released earlier this week by the Department of Health.

The report — written by clinicians involved in the six specialty subgroups of the “care closer to home” pilot — describes how care has been shifted to community settings in the areas of orthopaedic surgery, urology, general surgery, ear, nose and throat, gynaecology and dermatology.

According to the report, the two areas where pharmacy has the most to contribute are dermatology and gynaecology. The dermatology subgroup includes Rod Tucker, a pharmacist who works as part of a multidisciplinary community dermatology service that is one of the pilot sites (PJ, 21 October 2006, p471).

The subgroup writes that community pharmacists could play a potentially valuable role in providing advice about appropriate skin care, particularly since most pharmacies now have a private consultation area. It suggests that the increasing number of topical preparations available without prescription might allow pharmacists to treat a wider range of conditions.

However, it warns that the pharmacist’s role should not be confused with that of a diagnostician and patients should be referred to their GP if doubts exist.

The subgroup also concedes that there is limited evidence of the effectiveness of pharmacists with special interests (PhwSIs) in dermatology but says that what evidence does exist suggests that both community pharmacists and PhwSIs are capable of successfully providing adequate treatment and advice.

“Providing that PhwSIs are suitably accredited there is no reason why their role should not be developed further as part of an accessible, integrated dermatology service,” it concludes.

The gynaecology subgroup, which does not include a pharmacist representative, simply says that there is clear scope for pharmacists and PhwSIs in providing care closer to home alongside, or in some cases within, an integrated gynaecology service. It recommends that this should be further evaluated.

In the report’s foreword, health minister Ben Bradshaw says that the Government wants people to use the report to catalyse local changes.