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Australian Journal of Pharmacy : May 2008
professional medic A T ion in review UK White Paper a blueprint By Bill Kelly, CEO, Australian Association of Consultant Pharmacy The UK’s proposal ThaT iTs pharmacisTs shoUld play a greaTer role in commUniTy healThcare can eqUally apply To The aUsTralian seTTing as The FiFTh agreemenT approaches. ‘Millions to benefit from improved access to treatment, check-ups and health advice from pharmacists’, said the headline to a press release on 3 April from the UK Department of Health announcing what is already being called the most significant proposal to further improve pharmaceutical services as part of an overall strategy for better patient care. The White Paper1 Pharmacy in England. Building on Strengths —Delivering the Future sets out a vision recognising that pharmacists remain a significant untapped resource for delivering accessible health services to people who need them the most. As highlighted by the National Electronic Library for Medicines review,2 the Paper, which builds on the earlier (2007) Review of NHS Pharmaceutical Contractual Arrangements and The Future of Pharmacy reports, not only outlines the major roles that pharmacists, pharmacy technicians and other pharmacy staff currently play in delivering services in the NHS, but also identifies major health inequities and challenges, and where and how pharmacy can improve access and health outcomes. In short, it showcases what pharmacy offers now and how it can offer more in the future. 40 Key proposals In particular, the White Paper proposes that pharmacies will: • Become ‘healthy living’ centres promoting health and helping more people to take care of themselves; • Be able to prescribe certain common medicines and be the first port of call for minor ailments for people who do not need to go to their GP (with significant savings in GP’s time and costs); • Provide specific support for people who are starting out a new course of treatment for long-term conditions such as high blood pressure, high cholesterol or asthma where commonly 50% may not take their medicines as intended; • Offer screening for those at risk of vascular disease and certain (sexually transmitted diseases, such as chlamydia; • Work more closely with hospitals in providing safe seamless care; and • Play a bigger role in vaccination. The paper identifies the need to support research and innovative practice, and to promote the development of a sound evidence base that underpins and demonstrates how pharmacy delivers effective, high- quality and value-for-money services. It emphasises the need to improve the awareness and understanding of the public and others of pharmacy’s role and the services it provides. The AusTrAliAn journAl of PhArmAcy vol.89 mAy 2008 While acknowledging how pharmacists have specific expertise in the use of medicines and play a critical role in promoting the safe use of medicines; to reduce unnecessary hospitalisation and support patients as they move between hospital and the community, improved targeting of medicines use reviews (MURs), and their health outcomes have also been identified. WOrKinG With GPs But two key proposals stand out. One is the promotion of closer working relationships between GPs and pharmacists, through a shared understanding of how their respective clinical roles can help deliver more personalised and effective care for their patients. As the UK’s National Pharmacy Association chief pharmacist Colette McCready said ‘... we want to take our place as a more full and active partner in primary care, working with GPs. New pharmacy services, from medicines use reviews to supplementary prescribing, work best when there is communication and trust on all sides—GP, pharmacist and patient’. WOrKfOrce enhancements The other key proposal relates to the enhancement of the pharmacy workforce, including opportunities now available to pharmacists to become prescribers; to develop special interests in defined clinical areas, or to practise as consultant pharmacists. In other words, transforming pharmacy into a clinical profession and, with this, regulation similar to that of other clinical professions.