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Celtic Comment: Scotland

Celtic Comment: Scotland

There are mixed feelings in Scotland about both the outcome of recent funding discussions and pharmacists in GP practices, writes community pharmacist Ross Ferguson.

So the global sum in Scotland has been increased to £177.359m, which represents an uplift of 1.44 per cent on last year's figure, although prescription volume has increased by 2.4 per cent. Details of the margin share arrangements (MSA) are still to be announced, but according to Matt Barclay, pharmacy services manager at Community Pharmacy Scotland, €the whole premise of the agreed MSA is that there is no less money flowing through the system to contractors this year than there was last year€.

Matt described the remuneration discussions as €long and difficult€ but explains that, €there was a realisation that no further concessions could be attained through further negotiation, so the CPS board accepted the offer with a view that cashflow was safeguarded for the contractor network for the coming year€.

Practice potential?

Meanwhile £16.2m has been set aside for health boards to employ pharmacists in GP practices. This equates to around 9 per cent of the global sum and one has to wonder if this investment reflects the Government's attitude to community pharmacy. The funding will pay for the deployment of 70 Band 7 and 70 Band 8a pharmacists by year three with a small amount of money being held for analysis and evaluation.

Pharmacists will be employed directly by the health boards and not by GP practices. The impact of these new pharmacists on efficiency and patient outcomes will be monitored as part of Prescription for Excellence via a central evaluation fund. One can only hope that these pharmacists have significant experience of community pharmacy, enabling them to understand how we work, the daily pressures we face and the services we deliver.

If they don't, then forging close links with local pharmacists will be challenging. It makes more sense to me that the roles these pharmacists are expected to deliver are carried out in community pharmacies in a less formal setting, without appointments, and with a pharmacist and pharmacy team with whom patients already have a relationship. I'd like to see investment in the current set-up as well as this new initiative.

With the appropriate technology and training, this approach could be the making of community pharmacy as we develop our clinical skills to engage more meaningfully with patients and provide patent-centred pharmaceutical care from the heart of communities.

In addition to this funding, another £170,000 has been allocated towards a programme of clinical skills training for pharmacist prescribers, and NHS Education Scotland (NES) is developing 'Teach and Treat' clinics that are being developed within the majority of NHS boards.

Record time

With the announcement that pharmacists in England are to have access to the Summary Care Record (SCR), Community Pharmacy Scotland and the Royal Pharmaceutical Society recently published a joint statement calling for pharmacists in Scotland to be given much needed access to the Emergency Care Summary (ECS) to improve patient care. In the meantime, Prescription for Excellence initiatives throughout the 14 health boards in Scotland seem to be gathering pace.

Various schemes are being trialled, expanded and rolled out. They include polypharmacy reviews in care homes and GP surgeries, community pharmacy medicines reconciliation, pharmacist-run prescribing clinics for asthma and pain, and PGDs for trimethoprim in UTIs, for example.

Hail to the chief

Scotland's new chief pharmacist, Rose Marie Parr, has only been in the job for a couple of months, but there is no doubt she seems a very popular appointment. Her previous role as director of NHS NES Pharmacy means that she is in touch with the skills, ambitions and potential of community pharmacy. An expectant pharmacy profession is keen to discover her plans and priorities, and we may get an insight when she speaks at this month's RPS Scotland seminar.

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