Primary Care Pharmacy March 2001 Vol 2 No 1 p25-26

News / Daily News

Realising shared aims in patient care

Primary care group boards accused of self interest

Primary care group boards dominated by doctors have been accused of self-interest when deciding where PCG funds should be allocated.

While debating a motion that neither the Department of Health nor health authorities are making any attempt to ensure that PCGs are even-handed in the disbursement of primary care funds at the 2001 conference of local pharmaceutical committee representatives on March 12, a number of participants outlined the refusal of their PCGs to support the development of pharmacy to the benefit of patients.

Mr David Kent (secretary, Camden and Islington LPC) said that the funds given to PCGs were intended for all primary care services. But many PCG boards equated primary care services with family doctor services. He said that the normal response to any application for funds to pay for new pharmacy services was to say that all available funding had already been allocated elsewhere. Because of this, his LPC had submitted a bid for funding for 2001-02 at the end of last year. Even so, the application had later been rejected on the ground that all the PCG funding had been committed elsewhere.

From Brent and Harrow, Mrs Marion Garner-Patel said that her LPC had been told that there was no PCG money for pharmacy. “They do not even consider us to be part of the health team,” she said.

Mr Raj Hindocha from Leicestershire believes that the problem derives from the structure of PCG boards. He says that, being dominated by doctors and nurses, they naturally prioritise funds for their own services. “Why do we have to market our services when they can allocate funds where it suits them?”

Dr Hopkin Maddock (Cornwall and Isles of Scilly) said that he had been told by his PCG chief executive that there was little hope of any money for pharmacy because there were five dispensing doctors on the PCG board. However, he takes the view that the recently published plan for the development of pharmacy in the National Health Service “Pharmacy in the future” is manna from heaven. He says that the plan can be used to draw up a detailed strategy for presentation to health authorities. PCGs are health authority subcommittees, so the solution to the problem is to convince the health authority to persuade its PCGs to accept LPC strategies.

From West Hertfordshire, Mr Graham Phillips agrees that it is possible to make progress if the right approach is adopted. He says that if pharmacists meet to discuss their plans with doctors, recruit the support of nurses and appeal to lay members of PCG boards matters can be moved forward.

His view, in a modified form, is supported by Ms Margaret Hook (Avon). She says that although pharmacy is very low in the pecking order, the answer lies in collaboration with those who influence PCG boards. To make them think that what you want is their idea is the way to make progress.

Rationing is necessary, BMA says

Health care professionals and the public will have to accept that treatments considered to be of limited clinical effectiveness will not be funded if a National Health Service that is accessible and free to all is to continue.

This is the conclusion of a report published by the British Medical Association health policy and economic research unit. The report was commissioned to answer four main questions:

• What health care does the public expect, want or need?

• What resources are required to provide this?

• Can these resources reasonably be expected to be provided under present or alternative funding arrangements?

• What mechanisms can be used to bridge any “affordability gap” that may emerge?

Despite an increase in Government funding for health care during the past two years, patient demands and needs are still not being adequately met from within the current NHS system, the report says.

The report, which took a year to produce, was put together by a steering group consisting of doctors, nurses, patient representatives, NHS managers, other health care professionals and representatives of the private health care sector. It says that, inevitably, demand will reach a point where the cost of treatment starts to outweigh the benefit to patients. It might not be apropriate for public funding to pay for trivial or self-limiting illnesses, and diseases associated with lifestyle or social problems.

The steering group found that the public generally supported the concept of free health care, with equal access and the same standards of care for everyone. In addition, they were prepared to pay more tax, provided real improvements could be guaranteed. The steering group looked at alternative ways of funding treatment but concluded that these could be costly to administer and would not provide the equal access that the public desired.

Rationing in health care was seen to be the only way forward. An informed public should to be involved in the decision-making process and, with the Government, should decide how much tax they are prepared to contribute, as this will dictate the services that can be delivered, the report concludes.

The full report can be found here

CPP launches prescribing faculty

The College of Pharmacy Practice announced in London in March that it was launching a Faculty of Prescribing and Medicines Management. The launch brought together a number of different professional groups in support of the initiative, which will foster the knowledge base, tools and skills required for practitioners in the health service.

Professor Bryan Veitch (chairman of the Board of Governors, CPP) explained that patients, the profession, the public and the makers of policy would benefit from the existence of the Faculty. The launch platform was shared by Dr Jim Smith (chief pharmacist for England), as well as representatives of the Pharmaceutical Advisory Group, the Scottish Prescribing Advisers Association, the Primary Care Pharmacists Association, the Primary and Community Care Pharmacy Network and the National Prescribing Centre.

The delivery of medicines management services, local pharmacy services, and pharmacist prescribing will be seen in the next three years, and the profession can ensure that delivery with the help of the Faculty. “I strongly support the initiative,” Dr Smith said.

Although the groups involved at the launch were closely associated with primary care, the Faculty would embrace the needs and interests of other pharmacists with an interest in medicines management and pharmaceutical care.

Any UK-registered pharmacist is eligible to be an associate of the Faculty, provided they can demonstrate an interest in the relevant specialty. Progression to full (practitioner) member will require completion of the College portfolio, consistent with criteria specified by the Faculty Board. The Faculty will recruit the initial wave of members by June, 2001. Nominations for the Faculty Board will be put forward at the end of that month, with voting taking place in July. An action plan and recommendations for competencies will be circulated to members in September. The College hopes to have 200 members in the Faculty within the first year. There is to be a supplementary annual subscription of £10 for Faculty membership, over and above the normal College fee of £47.

The aim was to launch another faculty later this year and then possibly two more in 2001.

Chief pharmacist to speak at PCP conference

The new chief pharmacist for England Dr (Jim Smith) is to give the keynote address at the PCP conference, which is being held at the Royal Pharmaceutical Society on May 24, 2001.

The Prescribing Support Pharmacists Group (PSPG) has been officially dissolved by its members. In a statement issued on February 26, the reason given was difficulties with time commitments and funding. Members will have had their fees returned but should contact Sue Knox at Rxadvice@aol.com if they have not received them.