Pharmacists’ role in PBC is often peripheral
Pharmacists offer proven value for money in medicines management but their role in practice-based commissioning (PBC) is often peripheral, David Jenner, NHS Alliance official and GP, told the AAH
Pharmaceuticals convention in Cape Town, South Africa, last week.
“Practice-based commissioning is about implementing Government
policies [in England] through primary care trusts — it is all about
18 weeks and saving money,” he said, referring to the Government
target of 18 weeks or less from GP referral of a patient to hospital
treatment.
“At
the moment, pharmacists don’t have registered lists, you don’t
normally have access to the notes, you don’t directly refer to
hospital often, and you prescribe little. So in terms of money you are
not big players.” This is why, he believes, the Government has
come to GPs first.
Dr Jenner said most GPs realise that pharmacists have
a proven track record with medicines management issues, such as concordance,
compliance, controlling prescribing budgets, prescribing advice and avoiding
waste. However, he said that GPs were sceptical about pharmacists’ abilities
to deal with complex problems.
“When you start looking at long-term
conditions, as you go in you get more and more consultations not about
the index condition but about intervening conditions too — the
co-morbidities. … These are very murky waters.”
Michelle Webster, national PBC programme lead at the Improvement
Foundation,
led a commissioning workshop during the convention. She told participants
that GPs still had not got to grips with PBC and that there are still
opportunities within PBC for pharmacists who persevere and are proactive.
“I
can’t stress enough that good commissioning and redesigning services
are about relationships. It is about relationship management and it’s
about understanding who the key players are,” she said.
“You need to know what their mindset is, you need to know what
difficulties they’re facing at the moment, and then decide how
you can help them.”
Pharmacy has come a long way
Speaking at the AAH Pharmaceuticals convention,
Colette McCreedy, chief pharmacist and director of pharmacy practice
at the National
Pharmacy Association, called attention to the amount of work
that had gone into “re-engineering” the profession.
She
said: “If you look at the development of pharmacy practice
in Europe, the UK is really [at the] leading edge in pharmacy
development. If you talk to a colleague from any of the other
EU countries about point-of-care testing in pharmacies, prescribing
pharmacists, P medicines that are antibiotics, their mouths drop
open. They cannot believe how much progress we’ve made.”
“I think we need to pat ourselves on the back that we have come forward.
But, we have asked for this and now we need to deliver.”
She also pointed out: “The business case has to stack up. I
think that the negotiations around remuneration are going to be vitally
important — because we are businesses as well as clinicians.
And I don’t think we should make any apology for that.”
Mrs McCreedy said that she was “rather concerned and slightly
disappointed” to see the Royal College of General Practitioners’ comments
on the recent White Paper around the need to consider pharmacy’s
commercial incentives.
“I’ve not met any GP who will
do anything for nothing,” she said. “The business and
clinical side of pharmacy is what makes us unique. And that’s
what makes us a different choice.” |
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