The week before Christmas

Am I glad this week is over? Oh yes. Anyone who knows anything about community pharmacy will know that this is the busiest time of the year, along with Easter. For some reason people go crazy and panic, and seem to think the GP surgery is closed for four weeks and the pharmacy closed for three weeks, as opposed to four days and three days. This week I've been working at what is already a busy pharmacy, and it has just been non-stop over the last week. They are on schedule to do 20,000 items in December. At least the boss will be happy.

I was expecting the pharmacy I was at today to be busy, given it's the last day they are open before Christmas, but it wasn't too bad, and I only had to make one emergency supply, which must be some kind of record. Just as well it was a Saturday though, otherwise I'd probably have spent half the day on the phone to a GP, trying to figure out why he had given three months worth of Crestor 10mg daily to a lady who hasn't been on any other statin, and who hadn't even been told what their cholesterol was.

So, I've got a couple of days off, and some time to get acquainted with a good bottle of Scotch and some good books, before turning my attention to the changes that are coming my way next year.

Astra Zeneca to follow in Pfizer's footsteps

Pfizer recently announced plans to change the way their medicines are delivered to pharmacies, hospitals and dispensing doctors, as reported here and here. Pfizer are changing from the current and successful model where manufacturers sell their products to wholesalers, who then sell it on and deliver it, often twice daily, to pharmacies. Pfizer want to introduce a system where pharmacies purchase direct from them, with deliver by one company. In this case it happens to be Unichem, the wholesale arm of AllianceBoots. There has been much debate in the letters of the Pharmaceutical Journal over the impact this move will have.

Well, surprise surprise, another company, Astra Zeneca, have decided to follow in Pfizer's footsteps, as reported in The Times. If these distribution arrangements are allowed to stand, it is likely that other manufacturers will jump on the bandwagon. This would be disastorous. The current model is resilient and works very well. The proposed model is anticompetitive and will not have the resilience of the current system. The future of independent regional wholesalers would also be in doubt as it is easier to make a profit on branded drugs as opposed to generics. Oh, and spare a thought for us poor overworked pharmacists. At present I only have to deal with one wholesaler, a regional independent wholesaler which is part of the company I work for. If anything is out of stock at the warehouse it is automatically ordered from Unichem or AAH by head office. My life is very simple at present. If Astra Zeneca use AAH as their delivery agent, and Sanofi choose Phoneix, Lilly someone else and Novartis yet another company, then ordering will be made so much more complicated and time consuming. And it's not like I don't have enough things to do as it is.

Thankfully, some MPs are on the ball, and have signed a motion opposing Pfizer's move. This system will be bad for the NHS, bad for pharmacies and most importantly of all, bad for patients. Please write to your MP and let them know how concerned you are about this.

The RPSGB: to split or not?

The Royal Pharmaceutical Society is a unique body in healthcare. It is responsible for both regulating and representing pharmacists. Doctors have the GMC to regulate them and the BMA to represent them, while nurses have the NMC to regulate them and the RCN to represent them. Pharmacists just have the RPSGB. The Society was founded in 1841 by Jacob Bell with the aims of 'uniting the profession into one body, to protect its members' interests and to advance scientific knowledge'. Regulation was added on in 1868 and was built upon, culminating with the Pharmacy and Poisons Act in 1933 which established the Statutory Committee as a disciplinary body.

Although the Society was originally established to represent it's members, it seems to have been focussing more on regulation than representation. The Statutory Committee has a far better reputation as a disciplinary body that the GMC, and you can take a look at its decisions here. The representative side seems to have slipped somewhat recently. The BMA and RCN are both far more effective as representative bodies than RPSGB. How often do you see pharmacists in the media, compared with doctors and nurses? And consider the extension of prescribing powers to nurses and pharmacists. This was announced in November 2005, after a long consultation. Nurses were ready to go almost straight away and I've already seen quite a few prescriptions from nurses. It took the RPSGB until August 2006 to come up with a curriculum for pharmacists to train as independent prescribers: almost a year!

The Society needs to cast off the regulatory role and get back to doing what it was originally founded to do: represent pharmacists. This needs to be done as soon as possible, to protect the assets of the members before the government tries to cream them off. Individual pharmacists also need to blow their own trumpet more. This article about nurses applies even more so to pharmacists. Some community pharmacists also monitor warfarin therapy, and are better placed than nurses to do so, due to our education and we do not need lots of specialist training.

Pharmacists need to claim back our Society, grab any opportunities that come our way, and let the public know what we do.

Continuing professional development

It is a requirement in the Pharmaceutical Society's Code of Ethics that pharmacists undertake continuing professional development. CPD includes continuing education (doing courses, going to workshops, reading articles etc), but takes it a step further as you have to consider what impact your learning has had. I do not have a problem with keeping up to date; I read journals, go to workshops and am doing a postgraduate diploma. What I do have a problem with is the way CPD has to be recorded. You have to complete sections on reflection, planning, action and evaluation. The Society has set up a whizzy website to help pharmacists and registered technicians with CPD, but it is just so slow. My first CPD entry took well over an hour. I am pushed for time as it is, why can't the Society treat its members like adults and just allow them to get on with their jobs.