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White Paper event ranges far and wide

An interactive day explored how key proposals in the Pharmacy White Paper can be turned into local actions. Leila Taheri reports

by Leila Taheri

An interactive day explored how key proposals in the Pharmacy White Paper can be turned into local actions. Leila Taheri reports

 

The two new national clinical directors for pharmacy, Martin Stephens and Jonathan Mason, had their first official appointment since taking up their roles at the “Pharmacy White Paper: Leading local implementation” event held in Warwick on 20 November 2008.

Mr Stephens, national clinical director for hospital pharmacy, stressed that “good prescribing, antibiotic stewardship and communication between primary and secondary care are vital in making sure medicines are used well and safely”.

He gave an example of a patient started on a medicine in hospital but, because of poor communication, his GP had received no information about this and therefore the patient was not kept on the medicine. He explained that this commonly leads to the patient developing the same condition in community, which leads to further hospital admissions.

He suggested that one way of delivering White Paper aims is to make full use of consultant pharmacists. He said “they have a specific and vital role in championing medicines safety” and so are well placed to ensure medicines are used well and safely.

Mr Stephens also addressed the additional prescribing responsibilities of pharmacists and said he thought pharmacists “can be good role models for prescribing for junior doctors”.

He described his own priorities in his new role as listening, identifying and sharing good practice and supporting chief pharmacists and front line practice in delivering the changes necessary to make sure fewer patients are harmed, and that patients gain more benefits and have a better understanding of medicines.

Jonathan Mason, national clinical director with responsibility for primary care and community pharmacy, first focused on community pharmacy strengths. He said people value continuity of care and trust their pharmacists. Pharmacies are convenient — they have extended opening hours thus providing patients with a choice.

However, he supported comments by Mr Stephens that a lot more needs to be done on integration of services, particularly with respect to medicines.

He highlighted one of the White Paper’s aims of shifting community pharmacists’ role from dispensing to providing clinical services, but acknowledged that dispensing was still the “bread and butter” of community pharmacy.

Mr Mason encouraged more pharmacies to aim to become among the best by “being seen as a retailer of information and advice, a service provider, a provider of advice and support in helping people with medicines”.

Responding to the recent Which? report on pharmacy, he said: “Which? always do things like that … bang people over the head.” He suggested pharmacists need to “get out there” and tell people that they and their staff are skilled, trained, competent and indeed do provide a good service.

Disparity

Mr Mason acknowledged the disparity between organisations and their use of medicines use reviews and that some pharmacy managers promote MURs as target- and incentive-driven, irrespective of patient needs. He said that there is currently work under way on changing the way MURs are paid for and making them more health outcome related — the result of that consultation will be available soon.

In response to challenges from GPs in providing a vascular risk assessment service, Mr Mason said that pharmacists will need to be “skilled up” to be able to provide the service. He went further, saying that patients need choice and good access to services, and pharmacists will be key providers of this service.

Moving on to primary care trust commissioning, Mr Mason was confident that minor ailments will soon be a directed enhanced service, which means every PCT will have to commission a minor ailments scheme unless it can prove there is no need. He identified smoking cessation as another area where more commissioning of pharmacy services should occur because, at the moment, provision is “patchy”.

Elaborating on challenges for PCTs and community pharmacists, he remarked that “if they are not engaging, then with all the best will in the world the White Paper will not be implemented … if we don’t deliver, pharmacy is going to miss the boat”.

Keith Ridge: Now is the time for pharmacy leadership

Keith Ridge, chief pharmaceutical officer at the Department of Health, spoke on modernising pharmacy careers. He highlighted the many problems facing pharmacy and said there is scope to improve markedly how medicines are used in practice. As an example he quoted the well known fact that 50 per cent of patients do not take their medicines as intended.

In addition, up to 5 per cent of hospital admissions are due to adverse effects and while patients are in hospital errors surrounding the medicines they receive are all too common.

He mentioned results from the Picker Institute that 58 per cent of patients who are prescribed a medicine are not informed about the side effects by their GP. The rise of antimicrobial resistance was also identified as another area for improvement.

In light of all this, he remarked, “much of the pharmacy profession is aware of these problems but have done relatively little to improve the situation. Now is the time and opportunity for pharmacy leadership.”

Dr Ridge set out his vision for pharmacy as a science-based, clinical profession. He pointed out the White Paper aims of shifting the emphasis from dispensing and volume to clinical services outcomes and quality, and employing pharmacy skills more fully.

He went on to say that the Government has asked the Royal Pharmaceutical Society to identify unique competencies based on the knowledge, skills and values which should remain within the pharmacy profession as its transformation to a science-based, clinical profession accelerates.

 

The Pharmacy White Paper event was organised by the United Kingdom Clinical Pharmacy Association, the Guild of Healthcare Pharmacists, the Royal Pharmaceutical Society and the Department of Health with the Association of Teaching Hospital Pharmacists and took place in Warwick on 20 November 2008 

Citation: The Pharmaceutical Journal URI: 10040691

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