I constantly remind people that the two are different. The Pharmacist is the health professional and the Pharmacy is their place of work. The Pharmacy owner holds the independent contractor status with NHS England and the Pharmacist is employed to deliver all elements of that contract along with a team of suitably trained technicians, dispensers, counter assistants and in some Pharmacies Health Trainers.
The Pharmacy and the Pharmacist are both regulated by The General Pharmaceutical Council separately. So why do we make the mistake of thinking about them together and managing them as a single entity? I don’t know – it is history.
We must be brave and think about the future. We must try to give some separation between the two to allow the NHS and the Local Authority to commission exactly what they want. We need to set Pharmacits free and allow them to develop the services that the NHS wants and people need. This might require a new way of thinking.
We should allow the separation of dispensing from other clinical services.
Dispensing includes the receipt of a prescription, checking for accuracy and suitability, dispensing, advice and continued support. It should include a management element which supports patient registration, shared information and a mechanism by which the pharmacist can intervene when people don’t collect prescriptions. Introduce feedback mechanism to support better prescribing and a safety thermometer to support safer dispensing.
All pharmacists can supervise the dispensing process and offer basic advice to patients on their basic healthcare needs. These must be provided in a Pharmacy.
Clinical services may include public health commissioned services such as EHC and stop smoking, sexual health and contraception, weight reduction and general signposting. It also includes management of common conditions, out of hours and other long term conditions management.
The delivery of clinical services might require additional training and accreditation, perhaps the use of PGDs or independent prescribing and disease management qualifications. I have also suggested an intermediary prescribing status (independent community pharmacy prescriber (limited list).
Although clinical services can be delivered in the Pharmacy, they don’t have to be. They can be delivered in walk in centres, GP practices or out of hours premises. That is the point – a clinical pharmacist can deliver these services anywhere.
Perhaps the new community pharmacy contract should reflect this in some way. Perhaps we should have the main dispensing contract with the Pharmacy owner and the clinical contracts held jointly or even independently. It is important to know that the clinical contract is being delivered by a specialist pharmacist.
Specialist pharmacist chambers perhaps?