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Thursday 3 April 2008 The All-Party Pharmacy Group responds to the publication of the Pharmacy White Paper To read the Group's response, please click here.
On 26 June 2007 the All-Party Pharmacy Group launched its report into the Future of Pharmacy. The report can be downloaded [here].
All-Party Pharmacy Group Inquiry into the Future of Pharmacy To find out more about the progress of the Group's Inquiry please visit the Inquiry page Wednesday 9 August 2006 First evidence session held for All-Party Pharmacy Group's Future of Pharmacy Inquiry. The All-Party Pharmacy group today held the first evidence session for its Future of Pharmacy Inquiry. In the first of a series of public meetings representatives from Which? and Asthma UK gave detailed evidence about the public perception of pharmacies, controls of entry and the role of Primary Care Trusts (PCTs). Over coming months a range of witnesses will provide evidence on issues which impact the pharmacy industry and its key stakeholders. The next evidence session will be held after the Parliamentary summer recess. To read the news release on the Inquiry, please click here Pharmacy
Inquiry First Evidence Session news release Wednesday 21 June 2006 The All-Party Pharmacy Group announces Inquiry into the Future of Pharmacy. The All-Party Pharmacy Group today announced the launch of a major Inquiry into the Future of Pharmacy. It will be broad ranging, focussing on pharmacy services in primary and secondary care. The Inquiry will include an extensive consultation process and public evidence gathering meetings with invited witnesses. The Inquiry will culminate in a report with recommendations for the profession, policy makers and other stakeholders. The work of the Inquiry will begin in June, and the first public meetings will be announced as soon as possible. Information will be posted here. To read the news release on the Inquiry, please click here Letter to Rt Hon Patricia Hewitt MP, Secretary of State, Department of Health from Dr Howard Stoate and the All-Party Pharmacy Group - dated 30 November 2005 Dear Pat I am writing to you to set out the views of the All-Party Pharmacy Group on matters relating to your forthcoming white paper on primary care and social care. Our focus is on the role that community pharmacists can play in providing choice by delivering a broader services and improving access to primary care. I hope you will find our views helpful as you and your officials prepare the white paper for publication. As ever, I would be happy to meet with you or with others at the Department to discuss these matters in more detail. Evidence gatheringThe All-Party Pharmacy Group has been keen to hear the views of relevant stakeholders. In October we held a meeting attended by patient groups, PCTs, pharmacists, and the medical and nursing professions. The meeting was addressed by Dr Fiona Adshead, the Deputy Chief Medical Officer, and Dr Michael Dixon of the NHS Alliance. In addition, we have received the report of the Citizens' Summit and the other consultative events organised by the Department, and we have collected information about initiatives and developments already taking place in community pharmacy. Members of the Group are also engaged in visiting community pharmacies to speak to patients and users of pharmacy services, as well as to pharmacists and their staff. Key findings • Access to services is a high priority for the publicOne of the strong messages from your public consultation exercise has been that the public wish to see improved access to primary care services. As service users, the public want to know that the services they need are available when they need them in locations that are convenient, and that these services are provided by trusted, local community providers. Much of the feedback from the consultation exercise highlights community pharmacy as trusted and highly accessible. It has long been our Group's view that community pharmacies are in fact the most accessible provider of NHS services. Our recommendationAs you consider the introduction of service developments, we recommend that you have a special regard for the role that pharmacies can play. Their accessibility and trusted status, combined with the positive effect of the new contractual framework within which they are now operating, enables you to use them as a principal means of delivering improvements in primary care.
We see access to high quality services at the time of need as being an overwhelming priority. Providing the public with choices of services and provider is important as a means of improving access. However, people need good quality information so that they can make informed choices. They need to know about – their condition the role of different professionals and providers the role of self-care how to exercise choice.
Choice is a positive factor in the provision of NHS primary care services, provided it is carefully balanced with the need to ensure ready access to services. Providing an elderly person with a long-term condition the choice of using a new service provider located a significant distance from the person's home is not a choice at all. Ensuring that the patient is aware they can access expert advice, information and treatment from their local pharmacy, as well as their GP does present a meaningful choice. Our recommendationCommunity pharmacies are playing an increasing part in health education and promotion as part of the new contractual framework. Their role in information and advice, including signposting, should be recognised in the white paper as a means of developing and promoting choice.
Primary care providers need to play a greater role in promoting and sustaining good health. At present the emphasis remains heavily skewed towards treating illness. While it is of course essential that both roles remain in future, a better balance needs to be struck between them. This will enable the NHS to manage demand more effectively, make most efficient use of resources, and ensure better outcomes for patients and the public. Our recommendationCommunity pharmacy has a track record of promoting self-care, advising on healthy living, and identifying and treating minor ailments (thus in some cases preventing them from escalating). The new contractual framework is designed to harness this capability more effectively, and the white paper should recognise that the role of promoting and sustaining good health sits naturally with community pharmacies.
Your public consultation exercise and our own evidence gathering have emphasised a number of service developments of high priority. In community pharmacy, many of these are already in progress, and in our view the white paper should add support to initiatives already under way. Key services include -
Our recommendationIn all these areas there is a valuable role for community pharmacists to play. Many aspects are factored into the new contractual framework, and we believe the white paper should highlight the ability of pharmacies to deliver such services under the new contract, and encourage others – other health professions, PCTs and local commissioners – to make full use of community pharmacy.
The development of existing and new services requires a stable NHS environment and clarity as to decision making and responsibility. Community pharmacies and other service providers need to know that the investment they are required to make is for the long-term and that primary care funding is put in place on this basis. The commitment of NHS funding needs to reflect the commitment of pharmacy investment if services are to be successfully developed and rolled out. PCTs and local commissioners need to be focused and engaged. In the past, there has been difficulty getting local primary care managers to focus on how community pharmacy can help deliver improvements for patients. Much work has gone into addressing this problem and we have now reached a point where real progress has been made. This is largely due to pharmacy representation on PECs. Now, we have concerns that this progress will be disrupted by reorganisational issues at a time when your Department - and the public - wants to see service developments and improvements. We recognise that steps have been taken recently to reduce the level of disruption caused by reorganisational initiatives, but this remains a concern. Our recommendationWhile the new contractual framework is having a positive effect in this regard, the white paper presents a further opportunity to encourage PCTs and commissioners to focus on the ability of community pharmacy to meet local needs, and to continue (in some cases, begin) the process of engaging with Local Pharmaceutical Committees to plan service developments.
From our evidence gathering it is clear that many users of NHS primary care services want control over access to their health records. They are likely to recognise that if they want their pharmacy to provide new and extended services, their pharmacists will need access to their health record. We believe that many of the services that community pharmacy can provide in future are dependent on being connected into the NHS IT network. Access by community pharmacists to the national care record system is essential if services such as medicines use review and independent prescribing are to operate to optimum success. Specifically, pharmacies and GP practices must have IT connectivity. Failure to achieve IT connectivity will hamper service improvements. Our recommendationWe hope to see recognition in the white paper of the importance of this matter. Service developments will not take place as quickly as we all wish unless connectivity between pharmacies and GP practices is achieved. We are not aware of any technical barriers to resolving this. If you or your officials have any questions about the matters I have raised or would like any further information, please do not hesitate to contact me. Best wishes Yours sincerely
Dr Howard Stoate MP Chair
Tuesday 18 October 2005 The All-Party Pharmacy Group held a public meeting on 18 October 2005 to discuss and debate policy issues relating to the forthcoming Department of Health white paper on healthcare outside hospitals and the current consultation programme, Your Health, Your Care, Your Say.
The Group was joined by two expert speakers: Dr Michael Dixon, Chair of the NHS Alliance; and Dr Fiona Adshead, Deputy Chief Medical Officer at the Department of Health. Dr Adshead has special responsibility for public health.
Michael Dixon outlined the high quality primary care service that already exists in the NHS. Nevertheless he argued there were clear reasons to seek improvements and make changes. First, there is not enough primary care - there are some gaps in service, and more services should be developed both to meet need and to anticipate it. Second, access to services can be difficult. For example, patients wishing to access their regular GP at weekends are likely to find it impossible. Third, primary care services - though generally good quality - are not always well coordinated either within primary care it self or even more so, with secondary care and specialist services. Dr Dixon also emphasised that commissioning arrangements are not as effective as they could be, and responsibilities in this area were being reassigned. For all these reasons he argued further change was needed in primary care.
In terms of the key changes he anticipated or favored, he highlighted his wish to see practice-based commissioning establish itself quickly and to facilitate real change in commissioning of services and patient care. He expected to see service developments in community-based primary care, including in the pharmacy setting. These could include diagnostic services, mental health service provision, and out-patient services in the community. He highlighted the lack of clarity around choice: do patients want choice or do they want access to a good local service? Can both policy objectives be achieved together - choice and improved access to local services?
He called for greater management integration of front line services and staff, and cited the example of healthcare assistants and district nurses. In this example, reporting lines were different leading to a lack of co-ordination in service delivery. Change was required to improve service delivery.
He expected to see a greater and greater role for profession-led commissioning in primary care, aimed at extending the range f services and choices available to patients. He predicted further evolution of the clustering model, in which GPs and other primary care professionals operate in a cluster providing a broad range of health services, and possibly incorporating social care services. This need not mean co-location in the same premises, but would see professionals working under one 'badge'.
Dr Fiona Adshead argued that while the NHS needs to provide a good 'illness service' it also needs to provide a good 'health service'. At present the public does not have sufficient access to high quality health improvement services. Community pharmacy has a major role to play in delivering a better health service. The government is keen to find new ways of delivering health services in communities, and pharmacies represent a key resource in this respect. The distribution of pharmacies enables equitable access to services.
The forthcoming white paper would seek to address issues concerning how services are delivered, who the providers might be, and how those who currently make little or no use of health services can be reached in future. There was a need to ensure local services were coordinated and planned, and she saw a partnership role here for local government as well as local health organisations.
It was important that standards and outcomes were effectively monitored and measured. Dr Adshead expected to see the QAF develop further and she raised the issue of how best to use existing resources, such as the Healthcare Commission, to carry out performance monitoring and measurement.
During debate and discussion, a broad range of issues were raised, including: the distracting effect of proposals for structural change at PCT and SHA level; the broad role that community pharmacy can play in delivering public health objectives not only through services related to medication but others such as weight management advice; the concerns created by uncertainty over medium term NHS funding plans; the need to strike the right balance in prioritising illness services and health services; the effect of prescription charging policy on access to services and to treatment; and the importance of supporting pharmacy services in communities where other forms of healthcare provision may be sparse or of a low quality. The All-Party Pharmacy Group will submit its views to ministers in advance of the publication of the white paper on healthcare outside hospitals. Thursday 23 June 2005 Letter from Dr Howard Stoate MP to Patrica Hewitt, Secretary of State for Health, on today's speech on public consultation for primary care. Dear Patricia
I saw the lead story in The Guardian today which trailed your speech on the public consultation exercise on primary care. As Chair of the All-Party Pharmacy Group, the last couple of paragraphs of the article in particular caught my eye. It reports you as saying that electronic prescribing will help since a patient will be able to register a preference for a pharmacy then go direct to the pharmacist. These comments are not in quotes, but if accurate they do raise concerns on my part. By requiring patients to nominate a pharmacy (or express a preference) we could in effect be restricting choice. At present there is almost unlimited choice for patients. They can walk into any pharmacy, near their home, their place of work, or elsewhere, and have the prescription dispensed. Nomination, or expression of a preference, reduces that choice to the nominated or preferred pharmacy. Why should they not be able to go to a pharmacy other than that originally nominated or preferred? Rightly the government has put patient choice at the very heart of policy so therefore surely a system in which a patient's prescription is sent to a central hub would give patients far more choice to obtain their medicines when they needed it, whether at home at work or out of hours when a nominated pharmacy might be closed. I appreciate some may feel there will be issues of security and confidentiality but the Department of Health must have addressed these through the NPfIT initiative and the establishment of patient records and in any case this should not be an insurmountable problem.
It is not unheard of for a newspaper to inaccurately report a politician's remarks, so it may be that the printed words do not reflect your views. I would be very grateful if you could let me know.
The All-Party Pharmacy Group is one of the largest and most active all-party groups in Parliament. We have over 100 members, many of whom take a keen interest in pharmacy issues, and the wider healthcare environment. You may recall our role in the control of entry issue following the OFT's report on the matter when you were at the DTI.
We held an inquiry into electronic transfer of prescriptions and IT developments more generally just before the election, and submitted our findings to the then Minster, Rosie Winterton. I would hope that you would see our Group as an important stakeholder in relevant policy developments such as ETP and therefore feel able to consult us on intended policy developments in advance of their announcement. For our part, we have a strong track record of responding to such consultation with constructive contributions, which I believe Health ministers have always appreciated. I feel sure we can do this in this instance, and I would be happy to meet you or others at the Department to discuss the matter in more detail.
I look forward to hearing from you soon.
Best wishes
Dr Howard Stoate MP Chair
cc Rt Hon Jane Kennedy MP 5 April 2005 All-Party
Group quizzes main parties on pharmacy policies for general election
campaign
5 April 2005 MPs
welcome new pharmacy services 07770 536276/simonwhale@luther.co.uk News release 8 March 2005 “Action needed to safeguard patient choice when prescriptions go electronic” say MPs Report makes six policy recommendations on IT changesPatients should continue to have the choice of which pharmacy dispenses their NHS prescription when electronic prescriptions are introduced. That is among the main recommendations to Health Ministers in a report published today by the All-Party Pharmacy Group, a cross-party group of more than one hundred MPs and peers. Chair of the Group, Dr Howard Stoate MP (Labour, Dartford), said: “Patient choice is a key principle in NHS reform, and it should apply when paperless prescribing is introduced. Speaking as both a politician and a GP, I say it is important that prescribers do not direct their patients' prescriptions to a particular pharmacy. It should be for the patient to choose where to have their medication dispensed. The new technology should be designed to allow that to happen.” In its recent inquiry into developments in NHS IT, the All-Party Pharmacy Group heard evidence from experts, including concerns that when the electronic transmission of prescriptions (ETP) is introduced patients' freedom to choose may be removed, and prescribers (GPs and others) will direct patients' prescriptions to a particular pharmacy. Dr Stoate added: “Today, when a GP writes a prescription it is up to the patient to decide which pharmacy to go to for dispensing. That is how it should be in future when technological changes are introduced. To restrict that freedom of choice seems undesirable to us and it raises concerns about fairness and conflicts of interest. We are concerned that the direction of prescriptions will disadvantage many patients and many pharmacies.” In a separate recommendation, the Group has also called for the appointment of a clinical champion to improve communication between pharmacists and the government over the introduction of new information technology. Dr Stoate said: “The government has appointed clinical champions for the medical and other professions to improve communication around IT changes and to ensure those changes are understood and supported by professionals at the sharp end of NHS practice. That is a step we support, but it appears to have overlooked pharmacy. Given the importance of pharmacists in the delivery of primary care improvements, and the new pharmacy contract that goes live in a few weeks' time, we think the appointment of a pharmacy champion would be beneficial. Pharmacists are too important to primary care reforms to be overlooked.” “IT changes will be crucial to the successful delivery of services under the new pharmacy contract. We are confident that the changes being planned will improve patient care. But we do want to make sure that those changes are practical and reflect the need to improve communication between pharmacists and other health professionals. That is why we also want the Department of Health to ensure that pharmacists have access to all the relevant elements of a patient's electronic care record, so long as consent is given and confidentiality assured.” - ENDS - Notes for editors 1. The All-Party Pharmacy Group's report contains six policy recommendations to Health Ministers. These are:
Further information: Simon Whale 020 7618 9100 / 07770 536276 simonwhale@luther.co.uk The report to Ministers can be read here: report to ministers APPG RESPONSE TO THE YES VOTE FOR THE NEW NATIONAL PHARMACY CONTRACT Wednesday 1 December 2004 Speaking at today's meeting of the Group, focused on the issue of banning smoking in public places, Dr Howard Stoate MP (Labour, Dartford), Chair, said: “Pharmacists in England and Wales have voted overwhelmingly for the new national contract. This marks a watershed for community pharmacy and I'm delighted to see pharmacists embrace plans for change so positively and in such numbers.
The All-Party Group was set up to promote the potential andvalue of community pharmacy, and I think the profession has seen its profile raised hugely in recent years. Pharmacy has forced itself on to the healthcare agenda. It is now widely acknowledged that pharmacists are part of the NHS family and key members of the primary care team.
I want to see pharmacists clearly recognised as being just as important to the delivery of primary care as any other health professional. This new contract will give them the opportunity to do that by increasing their contribution to healthcare in the years ahead. Its an exciting time for pharmacy. It is now up to pharmacists to deliver, and I'm confident that by working closely with PCTs, GPs, other health professions and patients, they will. We will be looking in detail at elements of the new contract in the months ahead, and reporting our views in the run-up to its implementation in April.”
ALL-PARTY
GROUP RESPONDS TO GOVERNMENT ANNOUNCEMENT ON CONTROL OF ENTRY CHANGES
ALL-PARTY
GROUP STATEMENT ON NEGOTIATIONS OVER THE NEW PHARMACY CONTRACT 17 July 2004
MPs
CALL FOR PHARMACISTS’ FRONTLINE ROLE
APPG
TO HOLD SPECIAL INQUIRY INTO
DEPARTMENT OF HEALTH 20 April 2004 PHARMACY FOR FELLAS Winterton urges men to use their pharmacies Men were yesterday urged to make the most of pharmacists who can provide them with easy access to valuable health advice by Health Minister Rosie Winterton. Speaking at a joint meeting of the All Party Pharmacy Group and Men's Health Forum Rosie Winterton said: "Research shows that men can be reluctant health service users who make poor use of preventative services and can tend to avoid going to see the doctor unless they are in significant pain or an illness has become too serious to ignore. "Men are significantly more likely to die than women from a number of causes, including suicides, drug-related poisonings, lung cancer and coronary heart disease. They can expect to spend 15 years of their lives suffering from a serious or chronic illness. "The challenge for all of us is to reach these people, such as the 50 year old male smoker who does not routinely access health services but wants to give up smoking. Pharmacies have an advantage - people visit them when they are well, not just when they are sick. "Pharmacists' roles are changing and they are now providing smoking cessation courses; measuring blood pressure and body mass index, to actively support public health campaigns on smoking, diet, physical activity and reducing obesity. And it is through advice and provision of these services that pharmacists can help build on the very good news of a 10 per cent fall in premature deaths from cancer since 1995/1997, and a 23 per cent reduction in heart-related deaths between then and 2000/2002. "The government made clear in A Vision for Pharmacy in the new NHS published last year its intention to ensure an NHS where people have the greatest choice about the time and place they can seek advice and help. And this should apply to everyone, including men." Notes to Editors 1. The strategy for developing NHS Pharmacy services is set out in A Vision for Pharmacy in the new NHS, published on 17 July 2003. 2. The Men's
Health Forum can be contacted on tel: 020 7388 4449 and at www.menshealthforum.org.uk.
The Men's Health Forum is in partnership with the DPP: Developing
Patient Partnerships on a new campaign 'Pop down your local' to
inform men about the services available from pharmacies and encourage
more men to use the pharmacy for health advice and treatments. The
campaign - 'Pop down your local' - launching on April 29 has been
developed in partnership with a number of organisations including
The Royal Pharmaceutical Society 3. The All Party Pharmacy Group can be contacted via the website www.appg.org.uk which was also launched at the event.
APPG LAUNCHES WEBSITE Embargo: 5pm, 19 April 2004 The All-Party Pharmacy Group today launched its own dedicated website at www.appg.org.uk . Speaking at the launch in the House of Commons on 19 April 2004, Dr Howard Stoate MP chair of the APPG, said: “This is another indication of the momentum and profile that our Group is achieving. We are leading the way among all-party groups – our membership is amongst the largest, we have one of the busiest work schedules, we continue to influence government policy, and we have now become one of the very few parliamentary groups to have its own dedicated website. The site will grow over time, but already it contains information about who we are and what we do. You will find details of past and future meetings, and you can download all the reports and policy recommendations we have sent to Ministers since we were established. I hope all those interested in our work will visit the site and give us their feedback and views. This is an important time for pharmacy. The new national contract is being negotiated and the changes to control of entry have yet to be finalised, to name just two of the major issues. Our website provides another means for people to see what we think about these issues and what action we are seeking from Ministers.” For further information:Simon Whale – 020 7618 9100 or simonwhale@luther.co.uk
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