More haste, more speed
The Government
White Paper setting out plans to extend the healthcare
services available through community pharmacies in England (p423)
has been generally welcomed by pharmacy bodies, by other health professions,
by the pharmaceutical industry and by the media. And The
Journal welcomes it, too.
But, although we applaud the direction
of travel, we are concerned about the speed of progress.
The long-awaited document includes an action plan setting out 56 actions.
But few of these will lead to any enhancement of community pharmacy’s
contribution to the delivery of patient care in the short term. Many
of the planned actions are merely “to consider”, “to
discuss” or “to examine”, or in some cases to convene
a group to consider, etc, or to ask others to do so — or even to
ask others to convene a group to do so.
Other actions include “to commission research”, “to
identify a work programme”, “to undertake further work”, “to
further review”, “to come forward with options”, “to
invite proposals” and “to seek further views”. Slightly
more practical sounding actions are “to plan” (or at least “to
begin planning”), “to develop”,”to devise” and “to
identify and agree mechanisms”.
The action plan gives a timetable for most of these intended activities
but, in many cases, the endpoint is merely the production of more proposals
or the initiation of another consultation. Not one timetable actually
ends with the implementation of a new pharmacy service. How much longer
do we have to wait for some real action? The profession needs to press
the Government to find ways of speeding up the process.
One key action in allowing community pharmacists to provide a stronger
contribution to healthcare is to give them access to information from
patients’ medical records so that their interventions can be as
safe and effective as possible. At the very least, pharmacists must be
able to see the electronic summary care records (SCRs) that are to be
produced for every patient in England by the NHS Care Record Service.
But
this essential requirement gets a surprisingly brief mention in the White
Paper, and its relevant “action” is merely to “undertake
further work … to consider the benefits, governance and practical
arrangements of community pharmacists having access to the SCR” — in
other words, more talk but again no timetabled implementation.
The main stumbling block in regard to accessing patient records appears
to be the issue of patient confidentiality. Paragraph 6.44 of the White
Paper seems to suggest that community pharmacists’ high street
setting might somehow compromise confidentiality.
But why? Like other
NHS employees and contractors, community pharmacists are obliged to
maintain confidentiality, and we are not aware of any evidence that they
are less
likely to do so than other healthcare professionals. This issue needs
to be nailed now, so that community pharmacy does not miss the boat
when the national SCR database is launched in 2010. Back to Top
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The
Pharmaceutical Journal