Posted by: Ranveer Bassey29 MAY 2013
Ever tried to read the DrugTariff? It's mind-numbingly boring withits lists of numbers, confusing sections and pages that helpfully inform you are"intentionally left blank". All thishides the fact that its content has an unrivalled impact on how pharmacy ispracticed.
Look at pharmacy through a DrugTariff lens and you'd think pharmacists' primary expertise is dispensingmedicines. You will find few referencesto patients in it. We shouldn't besurprised that pharmacists are hidden in the dispensary. If we are rewarded to lick, stick and pour,we will lick, stick and pour.
I'm not sure of the historicalcontext which led to the contract being developed in this way. Today we would not recognise supply ofmedicines as our defining factor. Thephrase ‘medicine optimisation' captures where our expertise lies.
The current disparity between theprofessions view of itself and how the profession is practiced is a result of misguided incentives in the pharmacy contract. Evidence of the power of these incentives isfound in the fact that introducing Medicine Use Reviews did more for changingthe profession than thousands of pages waxing lyrical about pharmacists beingexperts in medicines.
It is impossible to talk ofchanging the profession without talking about changing the pharmacycontract. Yet this occurs disappointinglyoften. Indeed, our professional body talks of a vision impossibleto implement without substantial influence over the pharmacy contract.
The British Medical Associationrecognises this sentiment. It hascommittees that negotiate contracts which impact the medical profession, mostnotably the GP contract. Pharmacy needsto do the same. The PharmaceuticalServices Negotiation Committee (PSNC) should be integrated with the RoyalPharmaceutical Society (RPS).
This would give the RPS controlof the levers which steer the profession. Its talk of pharmacists' expertise, and the evidence it gathers, would feeddirectly into contract negotiations leading to the high-impact, concrete actioncurrently lacking.
It would also give the professiongreater control of its future. Thosewho currently guide PSNC negotiations are driven primarily by commercialinterest. The spirit of how theprofession views itself practicing is lost. Hence the current culture gap between pharmacists and those who employthem, as manifested by a focus on targets rather than patients for example.
It would be a sad reflection of theprofession if our changing role was driven by a belief at the Department ofHealth that supply is over rewarded. Much better that we recognise we're underutilised ourselves. A PSNC integrated into the RPS is the bestway of expressing that.
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