Family health services authorities and community pharmacists at the purchaser-provider interface

Abstract

The views of both purchasers (family health services authorities [FHSAs]) and providers (community pharmacists) were sought on the development of community pharmaceutical services in the light of the 1992 pharmaceutical care report. Questionnaires were posted to the 480 pharmacists in charge of all community pharmacies in Wessex and to the 98 general managers of FHSAs in England and Wales. The questionnaires focused on reactions to those recommendations of the pharmaceutical care report which, if implemented, would have significant implications for the community pharmacist's workload. Both the FHSAs and community pharmacists indicated that, in their view, the skills of the community pharmacist are currently underutilised. Both groups expressed enthusiasm for the pharmaceutical care report recommendations that the following services should be provided: domiciliary services, disposal of unwanted medicines, supply of aids for disabled people, supply of compliance aids and adverse drug reaction reporting. Neither group was enthusiastic about pharmacists providing a therapeutic drug monitoring service from community pharmacies. On other areas, pharmacists were more enthusiastic about the provision of health advice, diagnostic/screening services and treatment protocols, while FHSAs favoured distribution of welfare foods, needle exchange, instalment dispensing and referral forms. Overall, both the FHSAs and community pharmacists were receptive to the principle of the development of the role of the community pharmacist within the primary health care team but expressed concerns regarding the training and workload implications.

Perceived factors influencing the development of primary care-based pharmaceutical care in Scotland

“…However, similar studies have also found remuneration to be an important issue. [6][7][8][9][10][11][12] Contractors are remunerated in the UK, as in many other countries, mainly on a fee for item of service basis, related to the number of prescriptions dispensed, although a practice allowance is also payable provided certain conditions are met. Some interviewees expressed the view that to an extent Scottish pharmacists were already paid for providing pharmaceutical care through these mechanisms, although the need for changes to both the remuneration structure and terms of the NHS contract was highlighted by many.…”

Responding to change: the case of community pharmacy in Great Britain.

“…The Government endorsed the extended role concept (DHSS 1988), and a subsequent joint report, by the Department of Health and representative pharmaceutical bodies, on the future of community pharmacy in the health service, assumed that the concept would be fully embraced by pharmacists (Royal Pharmaceutical Society of Great Britain 1992). In addition, the remuneration procedure for community pharmacists was changed to permit payment to pharmacists for additional services, such as locally negotiated services to residential homes (Hunt et al 1995).…”