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Have Scottish and English pharmacy practice grown apart?

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I have had the unique experience of working in pharmacy on both sides of the border, firstly as a pre-registration pharmacist in England before commencing my career as a pharmacist back in my homeland. And, without any doubt, the profession in Scotland and England are not mirror images of each other. I'm focusing on both countries specifically because I've only ever worked in both countries. And therefore on this occassion, I can only really specifically comment on the profession in both countries, because I have never worked within pharmacy in Wales or Northern Ireland.

In a recent blog, I explored the prospect of Scottish independence and what it may mean for the future of pharmacy north of the border. But did you know that the National Health Service in Scotland is already independent of its counterpart in England (and Wales and Northern Ireland also)? Thanks to devolution, health policy is managed by the Scottish Parliament.

Despite pharmacy in Scotland taking it's own direction, many of the laws that affect pharmacy practice still apply on both sides of the border. But one of the first major differences between the countries is the way the NHS in run. The Scottish Government have brought much of the service in line with the public sector and pushed out the private sector in the provision of services whilst this year's reforms in England have seen the health service operate in, arguably, the opposite direction.

As far as pharmacy is concerned, the provision of a minor ailments scheme certainly has had it's major differences in both countries. The service does not have universal provision in England, therefore patients suffer from a "postcode lottery", disadvantaging patients with the greatest needs who may not necessarily have immediate access to such a vital service.

In Scotland, the minor ailments scheme has been a proven success (I highlighted this in a previous blog post) in every corner of the country. The devolution of responsibility to pharmacists, empowering them to prescribe appropriate treatments for patients with minor ailments, has given a confidence boost to the profession. The service also provides value for money for the taxpayer in the tune of approximately a cost of nearly £20 million per annum in 2012-13. I am totally astonished that the Department of Health haven't taken full note of the success of the service in Scotland and rolled out a minor ailments service to serve all of England's population.

But there's a lot we within pharmacy in Scotland can learn from England. Much has been made of the New Medicine Service which launched in late 2011 in England. Costing over £50 million per annum, this is a service which has supported pharmacists, supporting their patients who commence pharmacological therapy to tackle specifically targeted conditions such as chronic obstructive pulmonary disease (COPD) and high blood pressure. It's aim is to increase patient compliance with newly prescribed medicines, reduce hospital admissions and reduce medicine waste. A majority of pharmacies in England take part in the service and the fact that this service has been continuously extended from it's trial run shows that the money has been well spent and enabled pharmacists to provide strong standards of care and support. This is something we in Scotland should be keeping a close eye on, because patients north of the border can benefit from dedicated support from their pharmacist.

It is yet to be seen to what extent pharmacy will change in Scotland following the published Wilson Review. Following on from the review, the 'Prescription for Excellence' document, published by the Scottish Government, could well result in the pharmacy changing very radically in Scotland, hence more evidence emerging of the very different direction the profession may well be taking.

The pharmacy profession within Scotland and England can learn from each other when it comes to evolving their services and style of healthcare delivery. They may be distincitve from one another. But no matter what the future holds, the profession in both countries do still hold a lot in common. 

Please click on the following link for more on 'Prescription for Excellence' - http://www.scotland.gov.uk/Publications/2013/09/3025 

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