Community pharmacy: moving from dispensing to diagnosis and treatment
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2298 (Published 11 May 2010) Cite this as: BMJ 2010;340:c2298
All rapid responses
Dear Sir
Allyson Pollock (Community pharmacy: moving from dispensing to
diagnosis and treatment, 11 May 2010) expresses concern at a shift of NHS
services ‘from general practice to private for profit community
pharmacies’. Throughout, Professor Pollock applies a false distinction,
since GPs and community pharmacists are in fact both independent
contractors to the NHS. Like GPs, pharmacists are under a professional
obligation to act in the best interests of patients and the vast majority
more than live up to those expectations, regardless of the setting in
which they work.
Yours faithfully,
Nanette Kerr
Director of Pharmacy, National Pharmacy Association
Competing interests:
None declared
Competing interests: No competing interests
... some more current information to this discussion to help
readers make their judgements?
The authors and the most readers may be unaware that the
European Court of Justice ruled on the ownership of
pharmacies by non-pharmacists on May 19th 2009,
http://curia.europa.eu/en/actu/communiques/cp09/aff/cp090044
en.pdf
concluding that on grounds of public protection EU Member
States may legitimately decide that:-
"OWNERSHIP AND OPERATION OF PHARMACIES CAN BE RESTRICTED TO
PHARMACISTS ALONE"
The Royal Pharmaceutical Society code of ethics for
pharmacists states:-
"You are professionally accountable for your practice.
This means that you are answerable for your acts and
omissions,regardless of advice or directions from your
manager or another professional."
http://www.rpsgb.org.uk/pdfs/coeppt.pdf
but the European Court of Justice says:-
"......the operation of a pharmacy by a non-pharmacist may
represent a risk to public health, in particular to the
reliability and quality of the supply of medicinal products
at retail level.
The Court also finds that it has not been established before
it that a measure less restrictive than the exclusion of
non-pharmacists would make it possible to ensure just as
effectively the level of reliability and quality in the
provision of medicinal products to the public
that results from the application of that exclusion."
May I also bring to the attention of readers a recent
article in the Pharmaceutical Journal
http://www.pjonline.com/node/1010929?
utm_source=newsletter&utm_medium=email&utm_campaign=editors_
choice_14052010
Competing interests:
Member English Pharmacy
Board Royal
Pharmaceutical Society GB
Communications Officer
Pharmacists' Defence
Association
Competing interests: No competing interests
"Deregulation and changes to the NHS community pharmacy contract in
England and Wales have allowed for the shift of clinical services from NHS
primary care to the for profit community pharmacy sector."
So all doctors live on charity alone and refuse to draw a wage,
ploughing any and all surpluses back into patient care? None of them are
employed by a limited company?
I don't think so.
I'm saddened that people are still perpetuating the myth that there
is somehow something "wrong" in making a living from a day's work when
healthcare is involved; and that doing so is the exclusive domain of the
community pharmacist.
It's a shame that an article so obviously and clearly biased in its
inaccurate assumptions as this one can be accepted for publishing in any
professional journal.
Whilst this response could be seen as defamatory towards the report's
authors and even the BMJ, I do not believe it is nearly as defamatory as
the original article is to community pharmacy as a whole in it's constant,
biased, emphasis of profit.
Competing interests:
Working in community pharmacy
Competing interests: No competing interests
A cost minimisation of a National Minor Ailments Scheme in Community Pharmacies in England
Richardson and Pollock (BMJ 2010;340:c2298) make some interesting
points in relation to the current position and viability of community
pharmacy. Certainly there is plenty of scope for the expansion in the
evidence-base of the cost effectiveness of community pharmacy services.
Recent research suggests a substantial potential cost saving with the
expansion of minor ailments schemes in community pharmacies (1). Using
data from six Primary Care Trusts (PCTs) in England the base-case model
gave a potential cost saving of £550,717 based on 308,199 consultations
when consulting a community pharmacist instead of a general practitioner
(GP). Extrapolation resulted in potential cost savings of £56 million for
a national community pharmacy minor ailment scheme.
Given the recognition that around one fifth of GP workload is
inappropriately taken up dealing with minor ailments, and that community
pharmacies are better placed to manage these minor ailment consultations
being the most accessible health care resource in primary care, these
findings have important implications (2,3,4). This is particularly the
case currently given the financial squeeze facing the National Health
Service (NHS) and the current drive to move healthcare service into
primary care.
Expanding the provision of community pharmacist minor ailment scheme
provides a substantial cost saving over consulting a GP. Further research
to obtain quantifiable data is recommended to fully assess the impact of a
scheme nationally in England, and exploration of the health benefits
between consulting a community pharmacist and a GP. This project
demonstrates that greater provision of minor ailment consultations through
community pharmacies has few costs and potential benefits
References:
1. Sewak NPS, Cairns J. A cost minimisation of a National Minor
Ailments Scheme in Community Pharmacies in England. London: City
University, 2010
2. Department of Health. Partial Impact Assessment of proposals to
expand the provision of minor ailment services. London: The Stationary
Office, 2008
3. Proprietary Association of Great Britain (PAGB)/Pharmaceutical
Services Negotiating Committee (PSNC). Joint PAGB/PSNC Submission to the
Pharmacy White Paper. London: PAGB/PSNC, 2007
4. Royal Pharmaceutical Society of Great Britain. The New Horizon –
Pharmacy in the New Age. London: Royal Pharmaceutical Society of Great
Britain, 1996.
Competing interests:
The author has just completed an MSc in Economic Evaluation in Healthcare and is a Primary Care Pharmacist at a central London PCT. His work predominantly concentrates on improving the effectiveness and cost-effectiveness of medicine use and pharmacy-led primary care initiatives.
Competing interests: No competing interests