Can opened - worms all over the floor..!

[Jeff]

There currently exists a healthy relationship betwen medicine and pharmacy in which many far sighted medics seek to commission pharmacy to enable them to treat their patients more effectively.

That's the sales pitch - the stark reality is that if independent professionals don't work together then their future independence is at risk.

Jeff

[Tony Schofield]

Which is why far sighted medics seek to work co-operatively and commission services from pharmacists..............?

It's not a sales pitch

[SolomonQ]

Which is why far sighted medics seek to work co-operatively and commission services from pharmacists..............?

very few of these far sighted medics around, and also why would they help pharmacies to get services commisioned for which they have no incentives, if anything they might lose out on a service they might be able to provide and get paid for

[Tony Schofield]

How do you know there are few of these far sighted medics around? In what forum have you personally discussed such developments apart from the whingeathon that is the internet?

Doctors who are currently bidding for the new practice procurements that were announced earlier this year are instructed to look at innovative service delivery. I personally know at least two groups who intend to make use of the community pharmacy network to delegate screening and patient management. They may pay pharmacists to do the work or pay pharmacists to use their premises so that nurse practitioners can do the work.

The payments they receive from PCTs will be performance and target driven. If paying pharmacists to do some of their work enables them to trigger a payment for reaching a target of course it makes sense.

I have seen the sums and it adds up.

By all means question me Solly but please, when you haven't a clue what you are talking about apart from personal prejudice and lack of ambition, don't sneer at what I say when such developments are happening as we speak.

I understand why pharmacists feel worried in the current climate. If I was worried I would sell up and get out. Believe me it is an attractive proposition. However, because I see a sea change in the way we will work and am excited by it I am have no intention of getting out. You should take comfort in that.

[openmind]

Tony, is there anything stopping registered techs getting a prescribing qualifiaction and doing say for example the addiction services project you do?

[Jeff]

very few of these far sighted medics around,

A minority perhaps, but a significant minority.

and also why would they help pharmacies to get services commisioned for which they have no incentives,

The incentive is their future independence and their ability to compete with employee based service providers.

if anything they might lose out on a service they might be able to provide and get paid for

The original GP idea (10-15 years ago - at any rate a few years before PCT where invented) was to employ pharmacists. I had a few such jobs, and even one offer of a practice partnership (but as now I preferred the hassle free existence).
That idea was to an extent placed on the backburner with the advent of PCT's and PCT pharmacists operating out of surgeries.
The growth of the multiple pharmacy and the employee GP has bought the risk to future independence into a sharper focus for both professions.
For many it's now the case that NOT working together is likely to mean losing out and getting paid for a service that they are able to provide.

Many - of both professions - prefer the hassle free existence and will just plod on till retirement. Those coming into the professions with any ambition - and those who still find the opportunities exciting can create the future.

Jeff

[Tony Schofield]

Tony, is there anything stopping registered techs getting a prescribing qualifiaction and doing say for example the addiction services project you do?

At the moment the list of health professionals who can be supplementary prescribers is on the DOH website and it doesn't include technicians. It does include podiatrists and I know of one who manages diabetics including prescribing insulin.

Independent non medical prescribers are restricted to pharmacists and nurses (possibly optometrists but I can't remember.). Dentists are classified as medical prescribers.

[openmind]

At the moment the list of health professionals who can be supplementary prescribers is on the DOH website and it doesn't include technicians. It does include podiatrists and I know of one who manages diabetics including prescribing insulin.

Independent non medical prescribers are restricted to pharmacists and nurses (possibly optometrists but I can't remember.). Dentists are classified as medical prescribers.

Thanks for that, Hats off to you for your frank and open views on the issues facing Pharmacy - It is most enlightening.
I am beginning to see (I think) the future way forward for successful professionals, that future doesn't lie in the tightly definined roles of the past but rather in the so called soft skills e.g. networking, innovation and the application of medical/pharmaceutical skills to an ever demanding patient group.
Have you ever considered a consultancy/lectureship role to demonstrate how it is done e.g. roadshows around the country?
I'm sure it would take off!

Part of peoples fear of the future (I'm sure) is the lack of any practical leadership from Lambeth and others.

[Tony Schofield]

Thanks for the vote of confidence!!

However, doing the "job" is time consuming enough and as you say Lambeth etc should be pointing out the positives of the future.

The future will be more cognitive roles. However, to discharge them will require the will to do them, the supervision laws to be amended (Responsible pharmacist etc), improved and recognised training for support staff and of course, pharmacists to improve their skills by further training:- particularly prescribing skills. Where it could collapse in flames is if pharmacists don't embrace it.

We have seen Category M adversely affect pharmacy income...shareholders as well as employees are earning less. Dispensing income will continue to wither which is a cause for alarm. However, as new roles present (White paper etc) pharmacists should embrace them as opportunities instead of complaining about them.

This seems to have been badly implemented by large companies who accept the roles and expect pharmacists to do them without adequate support. Obviously pharmacists will be resentful. Some clear and focussed leadership would not go amiss!