Memorandum by The Pharmaceutical Services
Negotiating Committee (PC 31)
The Pharmaceutical Services Negotiating Committee
(PSNC) is the body that represents community pharmacy on NHS matters
in England and Wales.
The PSNC wishes to respond to the Health Select
Committee InquiryPalliative Care.
Community pharmacists are experts in medicines
and play an important role in primary care NHS palliative care
services, facilitating patients' independence. They should be
an essential part of the unified planning and integrated, multi-agency
approach to high quality care for palliative care patients.
The network of community pharmacies provides
palliative care patients, their families and carers with on demand
access to primary care health professionals who can provide their
specific medicines and give advice on medicines related issues.
The main issue for community pharmacy arrangements
to give equity of access for patients to services is adequate,
1. Current Services
1.1 Community pharmacies provide access
to palliative care drugs through prescription dispensing and also
give on demand advice to patients, their families and carers on
medicines related issues as part of their general NHS community
1.2 The existing network of community pharmacies
provides excellent access to these services, with many also providing
home delivery facilitating patients' independence.
1.3 Community pharmacists undergo five years
training before qualification and are experts in medicines. The
development of medication review services via community pharmacies
is a main factor in the approach to total medicines care through
medicines management helping PCTs to meet certain targets, for
example in the NSF for Older People and the Vision for Pharmacy.
1.4 Under locally funded arrangements, some
community pharmacies provide out of hours access to palliative
care drugs, for example, across Essex. This service is especially
useful for emergency access by other healthcare professionals
such as Macmillan nurses.
1.5 Accredited training in palliative care
is available through the College of Postgraduate Pharmacy Education
(CPPE) to all community pharmacists.
1.6 Specific funding has been made in a
few areas, for example, East Riding and Hull, to train community
pharmacists as specialists, working as part of a multi-agency
team providing palliative care services such as syringe drivers
in patients' own homes.
2. Issues around provision of these services
2.1 There is no equity of provision of additional
services with the initiation of these services and relevant funding
left to local arrangement.
2.2 Although training is available there
is no protected time for community pharmacists and CPPE training
takes place in the evenings.
2.3 The wide availability of service provision
is dependent on the maintenance of the network of community pharmacies
2.4 PCT planning for an integrated approach
and multi-agency working in palliative care should include community
3. Patient Issues
3.1 Patient convenience, access and choice:
3.1.1 Patients can choose the community
pharmacy they wish to provide their services from an extensive
network: there is no appointment system.
3.1.2 There is good contact with carers,
family and patients as they also access pharmacies for other provisions:
advice is often requested in passing and not related to the collection
3.1.3 Many community pharmacies provide
collection of prescriptions (following patient choice of pharmacy)
and home delivery of prescribed items.
3.2 Quality of Patient Services:
3.2.1 Quality of patient services is governed
by law or local service specification.
4. Future Services
4.1 New Contract implications:
4.1.1 Negotiations are underway between PSNC
and the Department of Health on the New Pharmacy Contractproposals
include relevant supplementary services which would be nationally
agreed providing uniformity of standards on:
Medicines assessment and compliance support.
Further details on local pharmacy services and
the New Contract are available from the PSNC website at www.psnc.org.uk