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Pavel Seplavy/iStock
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The Government’s White Paper “Pharmacy
in England — building on strengths, delivering the future”,
published last week (see news
p423), has caused an understandable stir
among the profession.
The
139-page document, dedicated almost entirely to pharmacy, sets out the
Government’s vision of future pharmacy services.
It has been broadly
welcomed by the profession as a show of faith from the Government.
However,
some concerns have been raised about aspects of the White Paper, including
how new services will be funded (see Panel below).
Words of caution
In contrast to the generally positive responses,
shadow health secretary Andrew Lansley says: “Three years
ago the Government made the very same promises as it’s making
today — that
pharmacists would start delivering more services like screening
and would be able to prescribe some drugs to patients.”
He
adds: “Labour has dithered and it hasn’t happened.
Now they’re trying to package the very same proposals as
a new announcement.”
Day Lewis chief executive Kirit Patel also sounds a note of caution: “An
increased focus on pharmacy’s potential and making community
pharmacy services more responsive to patients is welcome, but there
also must be the capacity and the resources to make this happen.
We will need further detail from the Government about where the money
is going to come from to fund these changes and to ensure that these
proposals are cost-effective, have proven health benefits, and make
the best and most appropriate use of the community pharmacy workforce.”
CCA and AIMp chief executive Rob Darracott says: “We believe
the fair funding approach is the right one, but it needs to be delivered
as well as designed, and work needs to be done as a matter of urgency
on the contract funding mechanism if it is to be fit for the purpose
of supporting the proposals contained in the White Paper.”
John D’Arcy, interim managing director of Numark, argues that
the options presented for reform of exemptions for 100-hour pharmacies
stop short of what is needed. “We welcome the fact that our
members’ views have been listened to in respect of 100-hour
pharmacies.
“However, the options for consideration don’t go
far enough. The 100-hour pharmacy exemption is frustrating the ability
of PCTs to plan local pharmacy services and is placing an unacceptable
strain on the global sum.” |
Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating
Committee, believes the White Paper is a positive development for community
pharmacy. “It builds on the NHS contractual framework, identifying
the barriers to developing our role and proposing practical and constructive
measures for tackling them. The White Paper includes many innovative
proposals and the PSNC will look forward to working with the Government,
NHS Employers and others to deliver the benefits we can bring to the
NHS as soon as possible,” she says. Increase pace of change
David Pruce, director of practice and quality improvement at the Royal
Pharmaceutical Society, says the Society is encouraged that the White
Paper recognises the importance of pharmacy’s role but adds that
the Society is calling for a greater sense of urgency from the Government.
In
addition to increasing the pace of change, the Society would like to
see more clarity on how the Government is going to fund the new
services. The Society is proposing a set of professional standards
to ensure a level of quality for the services suggested in the White
Paper.
The National Pharmacy Association describes the White Paper as “a
statement of faith in community pharmacy by Government”. However,
it warns that there remains a lot of detailed work to be done on the
contractual mechanisms that underpin NHS-funded pharmacy services in
order to get over the obstacles that are still in the way of an expanded
clinical role.
Colette McCreedy, NPA chief pharmacist, says: “The NPA has long
asked the Government to give community pharmacy a genuine chance to prove
itself in the fields of public health and long-term conditions. The White
Paper’s proposals for pharmacy-based vascular risk assessments
and for supporting patients with newly prescribed medicines for long-term
conditions show that they have listened.
“However, the precise nature
of the mechanism to bring about these changes is still to be determined.
These matters must be considered carefully, yet promptly, in order to
maintain momentum and to minimise uncertainty in the market place. In
particular, the commitment to review the 100-hour exemption, although
welcome, could lead to considerable disruption in the immediate term.”
The Company Chemists’ Association and Association of Independent
Multiple Pharmacies particularly welcomes the Government’s specific
commitment to work with the NHS and relevant partners to identify how
its world-class commissioning competencies should apply to the commissioning
of services from pharmacy.
The joint organisation is also pleased to see the recommendation that
commissioners should include community pharmacists in local planning
processes and link with pharmacy stakeholders to understand where community
pharmacy services can have the greatest impact in meeting the objectives
of practice-based commissioning.
Peter Gibson, head of public affairs at Alliance Boots, believes that
the White Paper has raised the bar for pharmacy. “The untapped
resource has been recognised and at last will be fully used. We especially
welcome the recognition that pharmacy’s active involvement and
planning at all the relevant stages of interaction with the patient is
needed and the plan to raise awareness and promote pharmacy’s role
will ensure success.” Focus on local needs
Kenny Black, managing director of Rowlands Pharmacy, says he is pleased
to see an emphasis on delivering services to those who will benefit
most, particularly in the area of medicines use reviews. “Focusing
on local needs and patient relevance has to be the priority to make
best use of our expertise and resources and to ensure the right people
are receiving the most appropriate and timely advice and treatment,” he
says.
The NHS Confederation, which represents 95 per cent of NHS organisations
and is the parent body to NHS Employers, says that the White Paper presents
a further opportunity to unlock the potential of community pharmacy.
“In
tackling this agenda, the challenge will be ensuring strong working relationships
between PCTs and pharmacists. Both parties will need to see themselves
as members of a network of local services geared towards improving health,” says
Jo Webber, the organisation’s deputy policy director.
The British Medical Association also backs pharmacists’ wider role: “We
agree there are many areas in which appropriately trained pharmacists
can take on extended roles in primary care and we would welcome this.
We believe the overall management of patients with long-term conditions
is best done within general practice but pharmacists have a role to play
in supporting patients in their use of medicines,” says Laurence
Buckman, chairman of the BMA’s GPs Committee. |
The
Pharmaceutical Journal