Hospital Pharmacist
Vol 10 No 9 p375
October 2003

Review of circulars and official publications
by Alex Bower, MRPharmS

The Department of Health has issued “Making partnership work for patients, carers and service users” here. This is a consultation document on a proposed strategic partnership agreement between the Department of Health, the National Health Service (NHS) and the voluntary and community sector (VCS). The consultation period closes on 20 November 2003. The aim is to promote the role of the VCS in health and health related matters. The Government’s intentions to develop a patient-centred service with patient choice as the driving force is made clear. The aim is to “treat patients as partners”. The document outlines a wish for a deeper and more meaningful engagement and understanding between the NHS and VCS by, for example, developing local strategic partnerships and making VCS part of mainstream service provision. The VCS supports service users and carers, acts as advocates and lobbyists, provides a range of health and support services and is a conduit for information, particularly on health promotion. Local community groups with an interest or role in health and/or social care are a vital source of expertise in specialist areas such as sickle cell anaemia, mental health and learning disabilities. They also contribute significantly to mainstream health service delivery and, as an example, are the main funders and providers of palliative care. The document indicates that the government has provided funding to the VCS for some specific initiatives. By April 2004, primary care trusts and NHS trusts in England must sign up to a ‘local compact’ or be actively developing one with the VCS. Hospital pharmacy has not had an extensive track record of working in close relationship with the VCS although there will no doubt be pockets of exemplar practice. This is, however, a key current driving force in the NHS. Hospital pharmacists may wish to consider areas where greater involvement would be appropriate in the development of strategic intentions, the introduction of new services or the provision of existing services. Making contact with the NHS trust person responsible for liaison with the VCS could be a useful starting point. Engagement with the VCS could become a key priority and the profession would benefit from a document that makes clear the potential links for pharmacy and outlines some examples of good practice.

“Fair for all personal to you. Choice, responsiveness and equity in the NHS and social care” was issued dated autumn 2003 as a consultation document. It is available here. Ignoring the fact that the omission of a comma or conjunction in the first part of the title means that it does not make grammatical sense, it is an important document which continues the theme of patient involvement established by the previously reviewed document on the VCS. Responses are sought by 11 November 2003. The document notes that “real choice includes decisions about ‘where’ and ‘when’ care is received as well as ‘what’ services and ‘how’ someone wishes to be treated or manage their condition”. It is noted that a choice of hospital is already being implemented for patients waiting over six months for elective surgery and this will be offered at general practitioner (GP) referral from December 2005. The document aims to stimulate debate on choice, responsiveness and equity by asking: “What changes would have the most impact on improving the experience of health and social care for patients, users and carers?” The consultation focuses on eight themes of maternity care, children’s health, primary care, emergency care, planned care, mental health, people with continuing, long-term conditions and older people. This is a rare opportunity for hospital pharmacists to comment on how the patient choice initiative might relate to the pharmacy profession. The networking system within hospital pharmacy has, however, been impaired following the last reorganisation. This means that there is no ready mechanism to develop strategic input on key documents in a co-ordinated manner, particularly across primary and secondary care. In the absence of a small task group at national level, a response at health authority economy level might be possible in the timescale if active collaborative arrangements already exist.

Scotland is in front again. “Connection of community pharmacists to NHSnet” was issued as HDL(2003)35 by the Scottish Executive. This outlines an aim to connect all pharmacy contractors to the NHSnet within 18 months of an October 2003 start date. The connection is seen as essential for the development and subsequent roll out of initiatives such as electronic prescribing, repeat prescribing/dispensing and direct supply of medicines. Funding will be provided for connection and rental charges and for new and upgraded equipment where these have gone through an appropriate approval process. Although this initiative relates to the connection of pharmacy contractors in primary care, it will have implications for the way hospital pharmacy services are provided in the future. It should, for example, facilitate communications between the two sectors and lead to improvements in the way that information is communicated about patient medication on discharge or admission. Hospital pharmacist colleagues in Scotland will no doubt be considering the opportunities presented by this significant development and others will eagerly await the outcomes since this is a development that should extend to other countries in due course.

The results of the “2002-03 survey of violence, accidents and harassment in the NHS” were published recently by the Department of Health. The estimated number of incidents per 1,000 staff a month for acute trusts were six for violence, 17 for accidents and five for harassment. Hospital pharmacy managers might wish to use this as an opportunity to ensure that their internal systems for reporting such incidents are adequate and to monitor the performance of the hospital pharmacy. Obtaining information on rates for the hospital pharmacy service will hopefully show the profession in a favourable light but could highlight if any change in approach was needed.

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

Mr Bower is a consultant pharmacist