Pharmacy in the future – where does industry fit in?

Stephen Foster

Pierremont Pharmacy

Pharmacy in the UK is going through a period of significant change at the present time - indeed, Jeremy Holmes, the Chief Executive and Registrar of the Royal Pharmaceutical Society of Great Britain (RPSGB), has described it as a “seismic shift” in the management and control of the profession. The RPSGB has split in two, and there are now separate entities for regulation (the General Pharmaceutical Committee) and representation (the new Professional Leadership Body or PLB) as a result.

The practice of pharmacy is also changing significantly, and I am at the forefront of some of this work. Gone are the days when the pharmacist used to be an old man in a white lab coat, mixing up pills and potions in the back of the dispensary. You are as likely today to see a pharmacist sitting down with a patient in his or her consultation room, going through their medication as part of a targeted Medicines Use Review (MUR), taking their blood pressure or checking their cholesterol, or undertaking a more clinical intervention such as an INR check as part of their anticoagulation clinic.

So where do Science and Industry sit in this new environment? I believe that the future is in the formation of Local Practice Forums (LPFs), the “outposts” of the new PLB, which are set to replace the previous branch network.

LPFs are designed to bring together all of the different sectors of pharmacy under one roof, and their strength will lie in the development of closer links between not only pharmacists from the community and secondary care, but also those from the Primary Care Trusts (PCTs), industry, academia, research, the Local Pharmaceutical Committees (LPCs) and the Centre for Postgraduate Pharmacy Education (CPPE).

LPFs have six core functions, including professional networking, education, continued professional development and revalidation, practice research, mentoring of new or less experienced pharmacists, and supporting pharmacists returning to practice. However, as the LPF Lead for my patch in East Kent, I am looking at LPFs being much more – I also want the LPF to be the centre for the development of innovative pharmacy services, in collaboration with industry and academia.

My ideal scenario would be that services are informed and proposed as a result of practice research through the higher education institutions or schools of pharmacy in the locality, and that pharmacists tap into the wealth of expertise and information in industry to develop the evidence base for the service, and put together a proposal for the commissioners at the local PCT. This way, we all benefit from closer working relationships – the schools of pharmacy can undertake meaningful practice research with a measurable outcome, pharmacists are able to develop and implement innovative pharmacy services, and industry becomes a key partner in this new “partnership” – and probably shifts a lot more product at the same time!

"For too long, industry has been looked upon very sceptically by those in primary care..."

For too long, industry has been looked upon very sceptically by those in primary care – it has been a very useful ally when the PCT required £500 for a sponsored buffet, but at best, representatives of the particular drug company were lucky to be given a table at the meeting to present their new product when push came to shove. That, however, needs to change in the future, as industry wakes up to the idea that community pharmacists in particular are a vital part of their business, and not simply in existence to bribe with post-it notes and pens for information on their competition!

Even the big wholesalers have woken up to the fact that pharmacy has moved away from merely being a “supply” function to a “service around supply” model of care. Frequently, you will now see the likes of AAH, Alliance Healthcare and Phoenix Healthcare offering pharmacists the opportunity to train in one of their own-branded healthcare services, as they see the benefit of collaborative working in the extra sales they achieve as a result.

The other big move on the pharmacy horizon is Practice-Based Commissioning (PBC). I have been identified as the national pharmacy lead for PBC, with the responsibility for identifying and developing a network of regional and local clinical leaders for pharmacy. Working closely with the clinical leaders from the other primary care professions including general practice, nursing, dentistry and optometry, it is my intention to change PBC into something for the whole of primary care, rather than being the domain of GPs alone – as is currently the case.

We are already working more closely at a national level on such relationships, but it is my belief that we need to also work at a regional (SHA) level and at a more local (PCT or locality) level if we are to see these changes being delivered “at the coal-face”. The shift in commissioning and service redesign won’t happen in a locality unless pharmacists, GPs, nurses, dentists and optometrists are able to meet up, discuss the different options available, make clinician-led commissioning decisions, and put them into practice.

Again, if we are to develop and commission innovative new services, or redesign existing services for the benefit of the patient, then surely industry has a key role to play.

About the author:

Stephen Foster has over 15 years experience in the pharmacy sector, culminating in him opening Pierremont Pharmacy as a 100-hour pharmacy in September 2007. He is recognised as a leading innovator within the pharmacy sector and was one of the first pharmacists in the UK to sit on the Professional Executive Committee of his local Primary Care Trust. In addition to a number of existing professional affiliations, Stephen was also recently chosen to sit on the National Clinical Network for Practice Based Commissioning alongside leading healthcare professionals.

Stephen is speaking at the upcoming Science in Pharmacy conference on the 17th and 18th May organised by Management Forum. For more details on this event please email judith.black@management-forum.co.uk.

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