WCR Column
01 April 2008
AAH is the only wholesaler serving all four nation states within the UK, my colleagues and I therefore take great interest in how pharmacy is developing in different ways in each country.
Although community pharmacy in Wales has the same basic contract as their counterparts in England we are already seeing areas of divergence in terms of patient services and health priorities. This is a trend I expect to gather pace in the years ahead.
Wales has led the way in abolishing prescription charges with Scotland aiming to follow that example and Northern Ireland considering it. This, of course, stands in contrast to England where the prescription charge was increased recently.
Wales has also benefited from a successful nation-wide smoking cessation service involving community pharmacy whereas in England commissioning similar services from community pharmacy remains patchy.
In addition, community pharmacy has seen an evident willingness by Ministers and officials to engage in a constructive dialogue with pharmacy bodies and the willingness of those bodies to co-ordinate and co-operate. Take, for example, the NPA, CCA, RPSGB Wales Board and CPW working together to identify and share best practice with LHBs.
More recently, the Welsh Assembly Government has initiated a consultation on major restructuring of the NHS in Wales which would move away from the internal market and create an approach to healthcare which is different and distinct from that in England.
The recent launch of 'Designed to Improve Health and the Management of Chronic Conditions on Wales - Service Implementation Plan 2008' by the Welsh Assembly provides an ideal opportunity to highlight the role pharmacists can play in chronic conditions management.
Pharmacists often see their customers on a monthly basis, being at the forefront of this programme can surely benefit patients by keeping them in best health for as long as possible and thus reduce the need for admissions into hospitals. I believe this shows a great belief that pharmacy in Wales can be preventive rather than reactive.
However, just as there are differences and divergences between community pharmacy in England and Wales, there are continuing shared concerns and aspirations.
The impact of Category M is of concern in both countries as is the desire to see a remuneration regime which is fair, transparent and stable.
Pharmacists share a desire to play a stronger role in delivering primary healthcare services to local communities and often frustration at how difficult it can be to engage local commissioning bodies, be those PCTs or LHBs.
The recently published Pharmacy White Paper sets out an exciting vision for community in pharmacy in England. If all the proposals are delivered in practice it would be a huge stride forward for the profession. It could and should help tackle some of the issues which have plagued community pharmacy including the ability of PCTs to commission effectively.
It does, of course, beg the question of what this now means for community pharmacy in Wales. Scotland has already embarked upon its particular path for the future of pharmacy north of the border and Northern Ireland is due to announce shortly the terms of its new contract.
Will the positive proposals in the Pharmacy White Paper be extended to Wales or will the Welsh Government want to develop its own, distinct vision for pharmacy?
Either way, looking forward, I think there are three areas on which community pharmacy needs to focus.
Firstly, consider the look and feel of the pharmacy. When the patient walks through the door do they see a professional healthcare environment or a retail outlet? As service provision and remuneration for providing services become more important then clearly it has to be the former not the latter. Always remember that there is a lot of support and advice available from AAH among others on refits, consultation rooms, merchandising and marketing.
Secondly, pharmacies need to grab every opportunity to deliver new patient services. I appreciate that at times this can feel like an uphill battle, but it is one which community pharmacy needs to fight relentlessly. At some point we will reach a tipping point where community pharmacy is recognised by patients and policy makers as the obvious health pathway for services such as diabetes screening, smoking cessation advice and treating minor ailments. It has taken some time and considerable effort, but the White Paper in England now recognises the role which community pharmacy could play in providing these services.
Clearly, we are still not quite there yet. For example, at present it is estimated that around 20% of a GPs workload, which equates to 57 million consultations a year, is related to minor ailments. This cannot be an efficient or effective way of delivering patient care.
Finally, perhaps the biggest challenge facing community pharmacy is how to engage effectively with local commissioning bodies and fellow healthcare professionals, in particular GPs. I think the potential of community pharmacy will only be realised when local GPs and pharmacists work together to agree how best to direct patients to and from each other depending upon the patient's clinical need.
I remain optimistic about the future for community pharmacy in Wales. That is good news for AAH because out future success depends upon your success. As the needs of community pharmacy has changed, so too has the support available from us; be that technology, professional services, financial support or help to make your business more profitable.
It will be an exciting year ahead of us and my colleagues and I at AAH look forward to working with you to make it a successful and profitable one too.
Mark James
Group Managing Director of AAH Pharmaceuticals Ltd
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