Select Committee on Health Written Evidence


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 Inquiry—Palliative 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, sustained funding.


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 pharmacy services.

  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 pharmacists.

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 of prescriptions.

  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 Contract—proposals include relevant supplementary services which would be nationally agreed providing uniformity of standards on:

    Medicines assessment and compliance support.

    Medication review.

    On demand availability.

    Monitoring and audit.

  Further details on local pharmacy services and the New Contract are available from the PSNC website at

February 2004

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