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Chee
Thak Koo
4th year MPharm student, University of Bath
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I don't think we should keep complaining that there are
insufficient pharmacists. Instead, I think we should think how to maximise
use of the professional knowledge of pharmacists in order to minimise
the negative effects of the lack of pharmacists.
Technicians should be trained to do more work to decrease pharmacists'
workload. Technicians can be trained to dispense accurately so that pharmacists
do not need to check dispensed items; decreased workload equals decreased
need.
I feel that the pharmacist's professional knowledge is more needed in
drug screening rather than dispensing and that pharmacists are needed
more in primary care. The reason for this is that prescribing is initiated
in primary care, not the community. Therefore, pharmacists should be on
the spot helping doctors to prevent mistake right from the start. Without
doubt pharmacists are needed in the community to monitor over-the-counter
medicines. However, I still think that primary care needs pharmacists
more than community pharmacy.
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Mark
Robinson MRPharmS
HealthGain Solutions Ltd, Newbury
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Have you ever looked in a dictionary for the definition
of a pixie. It refers to a fairy or elf. The definition of a fairy is
an imaginary creature, in the form of a diminutive human being, supposed
to meddle, for good or for ill with the affairs of men.
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David
Rowlands
prescribing support pharmacist, Morecambe Bay PCT
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I now have more frequent and meaningful interactive discussions
with doctors and other members of the primary health care team around
pharmaceutical and therapeutic issues in one day than I had in a whole
month or more when working in the community for a large multiple. Face-to-face
discussions with prescribers with whom you have a close working relationship
around, for example, recommendations from a medication review clinic,
are essential if your views are to be trusted and acted upon.
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Christina
Lowe
Morgannwg branch
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As a branch delegate to the British Pharmaceutical Conference
I read with interest the report of Bill Scott's challenging remarks. The
message I took away from the presentations by the Scottish, Welsh and
English chief pharmaceutical officers and the associated question time
was far more positive. They described the advances made by pharmacy in
the changing health services but challenged the profession to recognise
and take advantage of the opportunities presented.
Bill Scott identified a need to restructure to deliver better services
to patients through well sited pharmacist practices capable of providing
advice to GPs along with all the other services we aspire to. The integrated
presentations from the three officers were divided along service delivery
lines rather than according to political and geographical divisions. I
thought this unexpected format was an excellent idea, which I was pleased
to interpret as a call for the profession to unite for strength in engagement
with the different political agendas driving change in the home countries.
Many factors were covered by these presentations including the transfer
of expertise out of hospitals into primary care and the shortage of pharmacists
in the community and hospital sectors. It was suggested that it will not
be sufficient to correct the shortage through increasing numbers practising.
It will be necessary to redistribute services and improve facilities:
to achieve this there needs to be significant investment plus a radical
change to the contract / remuneration package. These were presented as
realistic objectives, not as barriers or mere dreams. The debate should
be expanded to consider these issues.
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Ginny
Pasley
prescribing adviser, Southampton
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Primary care pharmacy is an important, and now well established,
area of pharmacy practice. Primary care pharmacists are part of the big
picture and provide pharmaceutical care and facilitate the implementation
of clinical governance in the practice setting. They come from a variety
of backgrounds — hospital and community and all have important and
interconnecting roles in the provision of pharmaceutical and seamless
care. Many work part-time in one or more areas of pharmacy and the cross-fertilisation
of ideas and skills is of great benefit.
We should be very careful as a profession that this sort of discussion
does not lead to professional in-fighting benefiting no-one and potentially
undoing the hard work of the last five to 10 years. We must encourage
more dialogue between community pharmacists and primary care pharmacists
as we have a common aim of patient benefit (commercial aims apart).
Is there merit in drawing an analogy with the hospital situation? Practice-based
pharmacists are akin to ward pharmacists and community pharmacies are
akin to dispensary services providing information and advice to patients
at the point of supply and using their clinical skills along with this
to monitor prescriptions effectively, give health education advice, etc
The roles are not mutually exclusive and may differ depending on the individuals
and situation involved.
Primary care pharmacy has proved to be effective and necessary —
let's not throw the baby out with the bathwater.
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Charles
Butler
Pharmacist, Reading
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I also heard Bill Scott and the other chief pharmacists
speak at the BPC, each one speaking on a separate part of the larger agenda
for change which faces the profession. I took a number of messages from
Bill Scott's speech, three of the most important being:
1. Sustainable methods of structuring community pharmacy
services had to be found
2. Other health care professions could be well supported
by pharmacists using their knowledge and skills in the provision of improved
patient-centred services
3. New methods of working must not undermine accessibility
to the network of community pharmacies, or to the unique services they
can provide
What Bill Scott outlined was a pragmatic, sensible and
balanced approach to modernising one part of the NHS. Unfortunately, the
NHS is continually being interfered with and sometimes seems it appears
to overlook what the general public really want and expect to find.
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