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An open letter to Andrew Lansley Dear Andrew Lansley, Quality, accountability and leadership: this is what you have called for to achieve your vision for the NHS. And community pharmacists are ready to deliver, writes Jennifer Richardson. Terry Maguire: Cutting NI MAS is not about saving money Everything is politics. How true. The best we can do is to take our position and then fight, negotiate or concede. Clinical debate: Should we pre-empt guidelines? When do you change your practice and adopt new recommendations? Two emotive issues reared their heads this week that struck at the heart of when we change the advice we give to patients. Xrayser: We’ve become the ministers of health truth
clinical debate: Should labels be harder to read? Labelling, it turns out, is a can of worms. Following on from the Pandora’s Box of whether antibiotics should be labelled by times (a debate that’s still raging in our news analysis this week), another angle on how we label medicines has cropped up – from a pretty unexpected source. Xrayser: A pharmacist’s Christmas Carol It’s Christmas next week, there’s snow on the ground, so sit by the roaring fire with the C+D and let me tell you a story. David Reissner: What actions should warrant a conviction? There have been countless consultations affecting pharmacy this year, but one issue stood out from the crowd. Xrayser: It’s Saturday – rate me and my dancing skill I might occasionally bemoan the rush to IT solutions, but I do love gadgets, so of course I have one of those overhyped, overpriced iPhones. Now even the former health minister Lord Darzi has got in the act with his NHS rating application. Clinical debate: More evolution than revolution The public health white paper doesn’t represent a revolution in medical thinking, like the advent of sanitation in the Victorian era, or the clean air acts of the 1950s. The Victorian Pharmacist on Christmas decorations Sir, I have recently dressed my shop window for Christmas, and wish to give you a rough sketch of its appearance, so that you may enjoy some cheer at this festive time. Xrayser: Is ‘lack of confidence’ really the problem? Reading the patient self-care articles in last week’s C+D made me think about my own OTC consultations. Do I really take ownership of minor ailments, or – as suggested by the BMA – do I have a “lack of confidence”, and should be encouraging more patients to come back to me rather than onwards to their GP? Mike Hewitson: Delivering the NHS’s QIPP agenda Mr Pot, meet Mr Kettle. That’s how I feel about the NHS QIPP drive right now. Xrayser: Has the ‘care’ in primary care disappeared?
David Reissner: You have two choices: silence or a stand It's a difficult time for PCTs. Their abolition has been announced, so they are dead men walking. However, the government has insisted that they carry on business as usual, consulting on pharmaceutical needs assessments and publishing final versions by February 1, 2011. From the draft PNAs I have seen, there will be both legal and practical problems which I expect to write about in future... The Victorian Pharmacist: on courage and devotion
Xrayser: We deserve respect from the government We know January brings another category M famine of indeterminate depth, and now we learn that “ludicrous” pricing errors are still being made. It feels as if the parcel I send to the NHS Pricing Division contains not prescriptions but lottery tickets, though without the jackpot. Andy Murdock: Tackling the ever-increasing rise in scripts Last week, Lord Howe visited one of our pharmacies in Vauxhall, south London. It was apparently his first visit to a community pharmacy and an opportunity to talk to him about the role for community pharmacy in the new NHS landscape. The Web Hunter has an app for that
Xrayser: Occasionally taking stock is a good thing 04/11/2010
Duncan Rudkin: Offering the opportunity to uphold standards 04/11/2010 As the date for renewal of the licence to practise approaches – for this is what renewal of registration really is of course – we should perhaps pause and revisit the changes that have triggered a new approach and therefore a payment date in November. The Victorian Pharmacist on flyers 04/11/2010 Sir, A little novel style in the composition of a circular can do no harm, and as such I asked colleagues for suggestions to put fresh life into my business. In response I received 30 responses, but I cannot say in quality of style or originality they are quite so excellent as I had hoped. Xrayser: Patients don’t know which way to turn 28/10/2010 A member of staff showed me a cutting from the paper this week with the headline, “Drinking alcohol could slash the risk of arthritis”, and said: “That’s rubbish – I drink regularly, and look at my arthritic hands!” Terry Maguire: The end of conference season? 28/10/2010 Conference season has ended for another year and this year I attended only two. It could have been six; I’m sure some colleagues attended even more in that lazy space between the beginning of September and mid-October. The Web Hunter on a digital champion It is good to see that the Coalition has appointed internet entrepreneur (and Telegraph columnist) Martha Lane Fox as UK digital champion... and she claimed in her Telegraph column last week that the DH’s consultation into how information technology can help patients take more control of their health shows real appetite for a shift towards Andrew Lansley’s “No decision about me without me” ideal. Editor's comment: Should we change the model? 19/10/2010 Enter stage right, Alan Milburn. As health minister and then latterly as health secretary in Tony Blair’s government, it’s fair to say that there are few people who better understand the problems facing the NHS. Duncan Rudkin: Upholding standards and professionalism As a patient going into a pharmacy I can cope with the idea that pharmacies are set up in different ways from a business point of view and my experience as a customer may be quite varied in different locations. But I do want to know that in all those places the professional staff are working to the same norms, with the definition of “safe and effective” care being consistent. Xrayser: Don’t forget to ask what patients want I’ve been reading the C+D investigation into PCT commissioning of enhanced services with great interest – not only because I am a provider, but also because I am a patient... Reader of the week: Colin Dougall Meet Lloydspharmacy prescribing pharmacist Colin Dougall, who couldn’t live without his piano and who probably isn't the right man to call for help with your plumbing. The Victorian pharmacist on poetry Dear Sir, Recently a correspondent, who wishes to be known as Instanet, sent me an amusing verse on what the future may hold for our profession. I enclose it for consideration of publication... Editor's comment: Geography matters The phrase ‘postcode lottery’ was much in vogue a few years ago, with journalists keen to highlight the unfairness of geographical variability in healthcare access. C+D has this week resurrected the term – justifiably, I think, as our 2010 PCT Investigation reveals all-too-predictable but nonetheless mind-boggling variability in local spending on pharmacy services. The web hunter: embracing technology Normally, I like to use my column to have a rant about something, poke a stick at the angry bears out there or just give my take on subjects that are touchy to pharmacists. This week though, I am going to try to be upbeat and positive. Nick Barber: The power of a pharmacy research network Do me a favour. Pick a busy day in the next week and count how many prescribed items you dispense that day, and how many of them have ‘as directed’ on them... The dispensing turf war 23/09/2010
Xrayser: Division of pharmaceutical church and state Our new professional regulator, the General Pharmaceutical Council (GPhC), didn’t waste much time flexing its new-found muscles last week. Within hours of taking over from the RPSGB, it released an insightful breakdown of how the previous regime had dealt with the discipline of its members – and if I’m honest, it doesn’t make for comfortable reading. The Victorian Pharmacist: employment of females Sir, It has come to my attention that there has been a great deal of discussion regarding the employment of females in the trade. A college of pharmacy for women has been established... Andy Murdock: Pharmacy now has to evolve to survive Pharmacy minister Earl Howe commented on the healthcare white paper by saying the government wanted “community pharmacists to expand the range of clinical and public health services they deliver..." The further financial strain placed on pharmacy as a result of the latest £140 million category M clawback means some creative thinking will be required to deliver this aspiration. Xrayser: Are we profiteering or making a living? Ever since the Drug Tariff settled on the quixotic basic price and discount scale system of reimbursement, pharmacy has been a balance of profit and loss – we know when we dispense on some prescriptions we lose, and on some we gain. Sometimes we make a big profit, but that’s business. So when is it profiteering? David Reissner: How do the new GPhC standards measure up? At first sight, the GPhC standards are rather like motherhood and apple pie: hard to find anything to disagree with. Even though they largely replicate the RPSGB’s standards, a fresh reading and some small changes, mean there are some eye-catching items. Xrayser: Assessing the threat to your business Our PCT has started to widely publicise its pharmaceutical needs assessment (PNA), the document that will shape not only what services need be commissioned from pharmacies, but also where. The web hunter: seeking a solution to stock shortages As our exclusive 2010 Stock Survey reveals, there are some serious issues in the UK medicines supply chain. And as the story gains traction in the wider media, it is interesting to see what aspects of our findings are teased out. Max Gosney: Stock shortages are shame of the NHS 02/09/2010 Patients howling in despair after being told they must wait days for life-saving medicines. It’s a harrowing scene you might expect to encounter in some war-torn, third-world country. Yet it’s something you’ll witness every day in UK pharmacies in 2010. Duncan Rudkin: Upholding standards and trust in pharmacy 01/09/2010 As pharmacy gears up for the transfer of regulation, the GPhC has confirmed that its new corporate strapline will be “Upholding standards and public trust in pharmacy”. This is a summary of what the organisation is for. So what’s the thinking behind it? The Victorian pharmacist: efficacious medical gleanings 02/09/2010 I have recently come to benefit from the following medical gleanings, which have proven most efficacious. As such, I have therefore listed them below. Ear ache can be resolved by the following simple method, which provides almost instant relief... Jennifer Richardson: The first cut is the deepest 26/08/2010 “The first cut is the deepest,” warbled Cat Stevens in the swinging sixties. If only his much-covered hit had been a prophecy for pharmacy services in this era of austerity. If only, after the coalition government unveiled its first, brutal budget, the rumblings we heard last month of minor ailments services being slashed were the end as well as the beginning of pharmacy’s worst nightmare. Nick Barber: Medicine adherence – just a phone call away 25/08/2010 Some years ago I had been working with specialists in the usability of technology, studying computerised dispensing systems, when it finally struck me – in a Homer Simpson-like ‘D’oh’ moment – that medicines are technologies, too Xrayser: Mutton dressed as lamb 25/08/2010 There’s only so many range extensions you can bring out before retailers will rebel against this lazy form of business, because the public are only going to spend their diminishing disposable income on something genuinely new. Clinical debate: We can’t afford wait in STI war 26/08/2010 The latest statistics on sexually transmitted infections in the UK are just stunning. There is simply no other word for it. And it’s a problem that means pharmacists have their work cut out. Prepare to defend your services 19/08/2010 Lock up those enhanced service agreements and start rehearsing your excuses for avoiding all contact with the PCT. One look at this week’s C+D (p4) confirms our worst fears over who’s going to feel the pain from the financial squeeze on trusts. David Reissner: What’s the problem with making a profit? 18/08/2010
Xrayser: Cheer up – it’s not all bad news 18/08/2010
The Victorian Pharmacist: Back in the 1820s... 18/08/2010
I recently received a note from Mr Joseph Sidney Lescher, which gives reminiscences of the drug trade in his younger days. Andy Murdock: PCT short-termism makes no sense Reports that PCTs are scrapping minor ailments schemes in a bid to cut costs says more about the asymmetry of primary healthcare funding than it does about the value of the schemes themselves. The Web Hunter: We want to hear from you In the modern world of publishing, room in print has become scarcer and competition to appear in the printed word has become fierce. Sue Sharpe: Deliver more for less by improving adherence Adherence services should be seen as a fundamental part of pharmacy's role, not as a 'nice-to-have' clinical add-on Xrayser: Why have they reinvented the NHS wheel?
No need for aspirin when flying
Air travel poses no significant threat to cardiovascular health for most patients, according to media outlets this week. So what does this mean for sunseekers preparing to jet off on their summer holidays when it comes to preventing DVT? Xrayser: Making the best decisions – do the maths 15/07/2010
The Victorian pharmacist: German views Earnest advice on not pressing corks with the teeth, holding powder-envelopes in the mouth or shaking up mixtures with the finger over the mouth of the bottle and a firm recommendation that no dispenser should come to work in his dressing-gown and slippers. Dealing with decriminalisation disappointment 01/07/2010 A deal to decriminalise dispensing errors has been on and off more often than teenage sweethearts. David Reissner: Where was RPSGB during Lee prosecution? 07/07/2010 The RPSGB should have a better understanding than the Crown Prosecution Service of whether a case merits prosecution, but the Society stopped bringing prosecutions a long time ago. The Society’s abdication of responsibility left a vacuum that the less well-informed CPS has filled. Clinical debate: rich-poor gap hints at new role 08/07/2010 Last week, the nationals revelled in old cliches about the health differences between rich and poor after the National Audit Office (NAO) exposed a gulf in patient health. Reading between the lines of the report, it could be the government intends for pharmacy to play a substantial role in the solution to this public health puzzle. Terry Maguire: Paying the price for free prescriptions 02/07/2010 Since April 1, when Northern Ireland (NI) abolished prescription charges, there has been surprisingly little media attention. Mike Smith: Time for sector to make a stand 11/06/2010 With the NHS financial landscape looking decidedly bleak, Alliance Healthcare chairman Mike Smith believes only a united pharmacy front will see the sector survive Mark James: DH action or pharmacy unity - which first? 10/06/2010
Another year and we have yet another pharmacy minister at the Department of Health. I wonder how long before we hear the first speech praising pharmacy, but offering no concrete commitments. The Web Hunter: small should be beautiful I got married a fortnight ago and for our honeymoon my wife and I went to Venice, a wondrous city full of fantastic architecture, tiny canals, expensive food and con-artist gondoliers. Coalition health policy: more of the same? 27/05/2010 There’s been precious little mention of pharmacy’s role in long-term conditions or public health – actually, there’s been zero mention of pharmacy’s role in any of the government’s health policy documents. Nick Barber: In search of the entrepreneurial spirit 28/05/2010 I have spent a remarkable few weeks filming The Victorian Pharmacy for BBC2. It has been great fun... what came over to me most strongly was the entrepreneurial spirit of the Victorian pharmacists.
Sue Sharpe: No guarantees for pharmacy in Lib-Con NHS 21/05/2010
It has been a cataclysmic fortnight in Westminster and a remarkable few months for British politics. We are undoubtedly in uncharted political waters. But as our politicians get back to the business of governing, we must assess what this election means for pharmacy. More needs to be done to relieve workplace pressure
The Web Hunter: online hustings were an excellent spectacle By the time you read this, David Cameron will be the new prime minister and we might even have a new opposition party for the first time in 88 years Smoking bans have no effect? Do the maths 13/05/2010 In a new series, C+D’s Chris Chapman looks at the evidence behind the headlines. This week, he looks at the figures behind smoking bans. Terry Maguire: Regulating homeopathic remedies 29/04/2010
My attempts over the past few years to ridicule colleagues who support and promote homeopathic remedies and to get them to stop seemed to amount to nothing. I had, I thought, completely misjudged the extent of human credulity...
Sue Sharpe: This is no time for complacency 24/03/2010 At last week’s Community Pharmacy Conference, I was struck by how far our profession has come in the past 10 years... community pharmacy is at the heart of the health policy agenda in a way it has never been before.
Ravi's Blog: students count the cost of OTC medicine 29/03/2010 Two female university students came in together to the pharmacy today for ‘the morning after pill’. Without getting into the debacle of asking whether it was a coincidence they both needed emergency contraceptives at the same time, I simply made sure their requests suited the criteria. Mike Hewitson: A tale of two pharmacies which are you? 24/02/2010 Imagine two identical pharmacies in two different PCTs. The first has a very pro-pharmacy PCT; the second exists in a wasteland where monies negotiated at national level for pharmacy are diverted to fill the PCT’s financial black hole. But how can some PCTs be allowed to effectively opt out of a national funding deal to balance their own books?
One rule for doctors, another for the rest 18/02/2010 If you’ve read my jottings about pharmacy’s disciplinary procedures, you will know I have not always been complimentary about them.
Xrayser: Its not easy being perfect 11/02/2010
When evidence doesnt match reality 11/02/2010 Should community and hospital pharmacists have separate leadership bodies? 11/02/2010 It is regrettable that the new professional leadership body (PLB) has got off to a potentially inauspicious start for an organisation that is intended to be the representative body for the whole of pharmacy, Colin Rodden writes. We cant afford not to pay the cost of advice 03/02/2010
Making POM to P switches a surefire success 03/02/2010
Ravi's Blog: Did good propaganda sway Boards' election? 02/02/2010
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Xrayser: We need a Mary Portas -style shake-up 07/07/2010 A while ago, an NPA friend asked if I fancied having Mary Portas come round. If you are not familiar with this lady, you can catch her TV programme on Monday nights, where she acts as a sort of troubleshooter on high street shops... Perhaps we do need Mary Portas to shake us up, not just individually but as a profession. Sir |
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I’ve talked before about the potential harm from the misreporting of health stories, but I can’t get past the fact that this is the price we pay for a free press.
As you may have noticed, Chemist+Druggist has started offering its CliniCal app. Its premise is simple – 132 formulas and scoring tools, featuring everything from BMI and cardiac risk scores to creatinine clearance and dosing regimen calculations. But what else is out there?
We all know that public services can only ever improve, and new policies must always be an advancement, so a radical shake-up of the NHS was inevitable – after all, a new government can’t just put its feet up and say “If it ain’t broke, don’t fix it!”, so we have to have yet another white paper – this parliament’s attempt to reinvent the NHS wheel. 
“If you were to spend the rest of your life with your peeing condition the way it is now, how would you feel about that?” An odd question for Mrs Xrayser to ask me, especially at work…
I walked into the pharmacy this morning, and saw another sackful of returned drugs. I feel like showing our overflowing drug disposal bins to every patient who raves about the current drug shortage and saying: “Help yourself to some of the £100 million worth that goes unused.” With such anxieties, why is medicines adherence such a problem?
For reasons unknown, I was recently invited to an MHRA meeting to investigate how the public might get better access to medicines.
I was not surprised to read who won the seats for the England and Wales Pharmacy Boards given all the 'encouragement' to solely vote for these particular candidates.
