Primary Care Pharmacy June 2001 Vol 2 No 2 p28

Leading article

NHS health plans

The introduction of three separate health plans in England, Wales and Scotland has provided pharmacists with probably the biggest opportunity to develop their contribution to delivering safe and effective health care to patients, since the Nuffield Report was published in 1986. There are common components to all of the plans but, in this issue, we examine the differences between the plans and what they mean for pharmacists. All three plans recognise the skills that pharmacists have to offer. Although strategies might differ, each aims to redesign services around the patient and to improve the health of the population.

In the 1960s, adverse drug reaction reporting in hospitals gave rise to clinical pharmacy. Hospital pharmacists faced substantial challenges; they had to acquire the knowledge, skills and attitudes necessary for clinical practice. In 2001, those of us based in primary care are being faced with similar challenges. After the Nuffield Report was published, some innovative pharmacists did take up the challenge to leave their pharmacies to carry out other professional work. The health plans recognise the contribution that pharmacists can make within the primary health care team, and new opportunities have been created for them to do this. The profession cannot, without consequences, ignore these opportunities and must take up the challenge that hospital pharmacists faced during the 1970s and 80s.

I suspect we have a fairly narrow window of opportunity in which to deliver the objectives outlined in the health plans, wherever we live in the United Kingdom. If national contracts reward high quality services at the expense

of others, then pharmacy services will not be permitted to stand still. It is important that the innovators, who did much to pave the way for the expansion of the primary care role, find ways in which to support and encourage their less forward-thinking colleagues to grasp the challenge.

First PCP conference

It was good to see so many enthusiastic primary care-based pharmacists coming together for the first PCP conference held at the Royal Pharmaceutical Society at the end of May (see p49). An audience of about 100 people included community pharmacists (contractors and employees), prescribing advisers, community service pharmacists, practice pharmacists and representatives from the pharmaceutical industry and academia.

The speakers portrayed an exciting future, which will not only enhance the professional role for the pharmacist, but will improve integration into the multidisciplinary health care team. However, grasping these opportunities could require considerable changes in the way that community pharmacists practise. It is likely that more than one pharmacist will be required within each community pharmacy to develop the primary care role to its full potential, and changes in the way the dispensing process is managed could also be desirable. Partnership between the industry, community and practice-based colleagues, as well as with hospital colleagues, will be a necessary component for a successful outcome.

Sheena Macgregor
Editor