Hospital Pharmacist
Vol 10 No 2 p48
February 2003

Review of circulars and official publications
by Alex Bower, MRPharmS

The document, "A guide to National Health Service foundation hospitals", was issued by the Department of Health (DoH) in December 2002. Foundation hospitals will be part of the NHS, and will be subject to NHS systems of inspection, but will be controlled and run locally. This will be done through a process of social ownership, rather than central state ownership.

Foundation hospitals will be independent public interest organisations, modelled on co-operative societies and mutual organisations. Local people will elect representatives who will serve as a majority on the NHS foundation trust's board of governors. The first generation of these trusts will come from existing three-star NHS trusts.

Eligibility for membership of an NHS foundation trust will apply to members of the public who live in the local area or who have been patients at the trust in the previous three years. Employees of the trust are also eligible for membership (if they have a permanent contract or a fixed term contract that exceeds 12 months), as are representatives of partner organisations on the board of governors.

The document will be of particular interest to hospital pharmacists currently working in three-star trusts that may apply for NHS foundation hospital status.

The document can be accessed as a PDF file (205K).

"Diagnosis and treatment centres (DTCs)" was issued by the DoH on 27 December 2002.

The DTCs provide fast-track elective surgery (eg, for conditions such as hip and knee replacements, hernia repair, gall bladder and cataract removal) and/or diagnostic procedures (eg, endoscopy and ultrasound).

DTCs will not provide emergency care, but will facilitate patients in choosing the date and time of their admission, which will usually be within six weeks of referral.

A total of 10 DTCs are already open, a further 19 centres are planned to open by 2005, and another 12 recently announced that they would open during 2005.

A related document, "Growing capacity: independent sector diagnosis and treatment centres", was issued at the same time. This document outlines an opportunity for the independent sector to become involved in the provision of DTCs, particularly for cataract removal, orthopaedics, and day case work. The development of this new form of service provision can be expected to impact significantly on the work of hospital pharmacists. It is important that hospital pharmacy managers become involved at an early stage in the planning for DTCs.

Price regulation scheme

The document, "Pharmaceutical price regulation scheme (PPRS): sixth report to Parliament", was issued on 19 December 2002. The current agreement, which covers branded products, began on 1 October 1999. It will last for five years unless one of the parties calls for an earlier review. The PPRS covers 80 per cent of the medicines used within the NHS.

The report notes the positive contribution that the pharmaceutical industry makes to the UK economy. It states that the Government is determined to help the UK pharmaceutical industry maintain its competitive advantage during a period of industry consolidation and increasing globalisation.

The report, which is essentially a study into the extent of competition between branded medicines within the NHS, is made available to help the Government and the pharmaceutical industry consider future policy on the supply and distribution of medicines. The report will be of interest to those hospital pharmacists who wish to have a better understanding of the operation of the PPRS scheme. The report is available as a PDF file (65K).

The "Royal Pharmaceutical Society of Great Britain outline curriculum for training programmes to prepare pharmacist supplementary prescribers: November 2002" was issued on 13 December 2002. This document sets out the specification for programmes of study to prepare pharmacists to register as supplementary prescribers. The content includes:

• Consultation and decision making

• Influences on, and psychology of, prescribing

• Prescribing in a team context

• Update on relevant aspects of basic and applied therapeutics

• Principles and methods of monitoring

• Evidence-based practice and clinical governance in relation to supplementary prescribing

• Legal, political, professional and ethical aspects

• Prescribing in the public health context

The expectation is that the course will run over at least 25 days, a substantial proportion of which will be face-to-face contact time, delivered over a three to six month period.

Hospital pharmacists who have aspirations to be early supplementary prescribers can access the outline curriculum here

The "National Service Framework (NSF) for diabetes: Delivery strategy" was issued by the DoH in January. This notes that diabetes services are well positioned to take advantage of the proposed extension of prescribing rights to pharmacists. It notes that pharmacists are a regular point of contact for people with diabetes, and that they can play a central role in improving medicines management. Reference is made to the medicines management guidance that accompanied the NSF for older people. Guidance on medicines management in patients with chronic conditions, which include diabetes, is being developed, and will be available later this year.

The NSF for diabetes places emphasis on the role of primary care trusts in implementing the delivery programme. However, hospital pharmacists with an interest in diabetes management, or in recognising the overlaps that exist between the primary and secondary care sectors, may wish to access the document as a PDF file (175K).

  * PDF files on PJ Online require Acrobat Reader 4 or later.

Mr Bower is a consultant pharmacist