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Community pharmacy as a valuable resource

Development

Current innovation

1. Barry has already mentioned some of the groundbreaking work underway as part of Pharmacy in the Future. There is genuine enthusiasm about this work and I want to talk about some of it tonight.

2. The local pharmaceutical services is an exemplar for how services might look in the future.

3. And I am enthusiastic about LPS as it could, and should, liberate the NHS and pharmacists to provide services where they're most needed.

4. Enthusiastic because LPS should develop wider access. We all know that there are many people, particularly in our major cities, for whom English is not a first language. That there are already pharmacies providing interpretative services is a major testament to our society. Services like those provided by John Foreman and Tim O'Donoghue at Greenlight Pharmacy, providing services for a deprived Bangladeshi community in Camden. There are many people, particuarly in our major cities, for whom English is not a first language. Providing interpretation services, and services which are sensitive to their culture and to their religious beliefs is vital.

5. Enthusiastic because LPS should deliver also for people with extra needs, particularly whom are elderly and chronically disabled, some on up to 20 different medications.

6. I am also enthusiastic because LPS will make pharmacy the pivotal point in the interface between primary and secondary care.

7. And alongside all the other work we're doing on prescribing, help pharmacies work with GPs and other prescribers to ensure optimal prescribing.

8. I have no doubt then that LPS will encourage innovation, provide flexibility and help you make better use of your skills.

9. Let me move on to Medicines management whose services are swiftly becoming an established part of the community pharmacy - and the PCT - repertoire.

10. Medicines Management means different things to different people and covers a wide range of processes. From when it is decided to prescribe a medicine, through supply and review to ensure it is effective and remains the optimum treatment.

11. So far your role has been mainly around supply. However under any new pharmacy contract, the potential new GP contract and local initiatives funded by PCTs, we are looking for your role to be so much bigger. Minor ailment clinics, repeat dispensing, supplementary prescribing and even independent prescribing all offer opportunities for you to contribute to medicines management and ensure that patients get the most out of their medicines.

12. The scenario of opening a patient's bathroom cupboard and finding a stock pile of medicines unused will reduce due to you being able to use your skills and experience to increase patient's knowledge and understanding of their medication and take then correctly.

13. Medicines management therefore provides the right environment to:

14. Many millions of people will be able to benefit from wider adoption of these schemes

15. I should also mention Repeat dispensing which offers an important opportunity to enhance patient convenience, reduce burdens on GPs and cut waste - as well as better use of pharmacy skills, with 30 pilot sites going live later this year.

16. There is also work in hand with National Service Framework (NSF) leading on a generic medicines management framework for the NSFs dealing with longer term conditions such as diabetes and renal services where we can see a much enhanced role for pharmacists in monitoring patients, providing advice and bolstering compliance.

17. Pharmacists will soon be able to prescribe medicines at NHS expense, in partnership with hospital doctors or GPs - a move that has real potential to provide better and quicker patient care, as well as making much better use of your skills. It is frankly ridiculous to think that since the inception of NHS, patients have had to go to a hospital doctor or GP every time they need a prescription. Cannot be right. It is right that we use the skills that pharmacists have developed. I am very keen to see demarcations ended whilst I am the Minister.

18. Prescribing training for pharmacists will begin in the spring and the first pharmacists should be prescribing by late summer. DH making funds available through Workforce Development Confederations to meet costs of training.

19. Underpinning all our work to improve access and quality is our work to ensure skill mix is right..

20. I hope we all acknowledge that skills which are expensive to acquire are too easily lost if opportunities to make use of and enhance them are not available. That is what young pharmacists have said to me as I have met them.

21. So securing adequate numbers in the pharmacy workforce and developing the roles of pharmacists and their staff are central to the success of our pharmacy strategy.

22. There have been shortages in many parts of the service. But steps have been taken to address this, including the extension of NHS Careers to NHS pharmacy staff, and moves to recruit from outside the UK.

23. This is set against background of unprecedented expansion in pharmacy undergraduate numbers, with over a third more new students now than ten years ago. Overall, a 12% increase in the pharmacist workforce has been predicted between 1998 and 2003. New schools of pharmacy will provide additional graduates from 2007 onwards. And we are considering the responses to the discussion paper Pharmacy Workforce in the New NHS, I launched at the British Pharmaceutical conference Manchester last September.

24. The consultation stimulated considerable debate. It's fair to say it was mixed - some pharmacists, while welcoming extended roles for themselves, are less enthusiastic about developing the role of their support staff. I am looking to bring forward our proposals leading from this consultation as soon as possible.

Current concerns

1. But let me move on to the current concerns - OFT, the new contract and our work on generics - which Barry has already mentioned

2. On OFT, I made clear from the start I want to consider this in the context of our health policy objectives - of improving access and driving up quality whilst ensuring services for the most vulnerable and needy are protected.

3. Essential therefore to canvass views on the impact of the OFT's recommendations, which I have done. Met a wide range of stakeholders and more to meet. Views have arrived in their hundreds to my office, and I know that MPs have been deluged with petitions and letters supporting community pharmacy. Views have been expressed forcefully and passionately. It shows the degree of commitment your industry has to helping achieve our objectives and the importance the public places on the services you provide.

4. We are giving the report and the responses very full and careful consideration. I have heard Barry's call tonight for me to convene a key stakeholder group to take forward discussions on necessary changes. I promise to look at this as part of our response that we are committed to giving within 90 days.

5. On the national contract I have to part company with Barry that work stalled last year. I think we made good progress working with your Executive and quickly reached agreement on a broad framework. We have now brought the NHS Confederation into our discussions. But we have to look at this in the context of our response to OFT. It would be irrational not to. But once we have made our decision I shall be looking to devise, agree and implement the detail of the framework as soon as we sensibly can. I make no promises tonight but my hope is that next year will be the last year of the old and that April 2004 will deliver new horizons.

6. Our work will obviously be informed by the new GP contract, which signals the most ambitious attempt to reform services since the creation of the NHS in 1948.

7. Just like the new framework for pharmacy, quality will drive greater rewards. And patients will benefit from more services, transforming perceptions and experience of what to expect from primary care .

8. Even more, the contract proposes a much greater role for - and fresh, more diverse ways of working with - other primary care staff. Pharmacists are very much in the frame here:

9. My belief is there is a great deal of common ground understanding already on which we can build together.

10. And work will move forward in tandem with progress on generic medicines. Cost to the NHS is over £1bn. Use of generic medicines has increased from 47% of items dispensed in 1997 to 52% in 2001.

11. So it is an important element of NHS medicines provision. I am therefore pleased to see the good progress we are making in our discussions with generic manufacturers, wholesalers and community pharmacists over longer-term arrangements for the reimbursement of generic medicines. Our intention remains to implement a system that delivers reasonable prices for the NHS and reasonable returns for the generic supply chain.

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Funding

Conclusion

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