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December Monday
5 December 2005
L-R Pharmacist Valender Ubhi, Dr Howard Stoate MP, Doug Naysmith MP and pharmacist Dilip Joshi.
Dilip demonstrating computer records and systems to the MPs.
October Tuesday 18 October 2005 "Health outside hospitals" - a special meeting on the future of primary care was held at the House of Commons. Guest speakers were Dr Michael Dixon, Chairman NHS Alliance and Dr Fiona Adshead, Deputy Chief Medical Officer, Department of Health - pictured below with Chair, Dr Howard Stoate MP.
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.
July Monday 18 July 2005 On Monday 18 July, the Group visited Guy's & St Thomas's Hospital Trust. Departments to visited included, Intensive Care, A&E and General Medicine. Discussions took place with a Consultant Microbiologist, the Chief Pharmacist and Principal Clinical Pharmacist. Pictured below are (l
to r): Tony West - Chief Pharmacist;
Also in the party visiting St Thomas' were; Baroness Cumberlege CBE (Cons), Baroness Tonge (Lib Dem) and representatives of the Royal Pharmaceutical Society of Great Britain, PSNC, Company Chemists Association and the National Pharmacy Association.
Robot dispenser, Pharmacy Department, Guys & St Thomas' Hospital, London.
June Monday 20 June 2005 Inaugural meeting of 2005 Parliament and AGM Guest speaker Rt Hon Jane Kennedy MP, Minister of State (Quality & Patient Safety)
At the inaugural meeting and AGM, the following MPs were elected officers of the Group; Chair - Dr Howard Stoate MP Vice Chairs -Baroness Jenny Tonge and Baroness Julia Cumberlege Treasurer - David Heath MP Secretary - Mark Todd MP Following the elections, Chair, Dr Howard Stoate MP made the following comments; "The
All-Party Pharmacy Group plans to be at least as active as in the
last Parliament. We will maintain cross-party approach and constructively
examine the issues and continue to submit reports and recommendations
for action to Jane and other relevant Health Ministers. Examples
of major policy areas that we have examined include public health
and obesity, NHS IT modernisation, and the regulation of service
provision.
February Monday 21 February 2005 The All-Party Pharmacy Group met on 21 February 2005 to examine current and future developments in the use of IT in community pharmacy and NHS primary care generally, and between primary and secondary care. A summary of the meeting can be read here: Meeting summary Speakers included Harry Cayton, Director for Patients and the Public, Department of Health and Lindsay McClure, Head of Information Services, PSNC. 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.”
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