Select Committee on Health Written Evidence


Memorandum by the Chief Executive of the National Pharmaceutical Association (PI 116)


  I write following my appearance before the Select Committee on 11 November 2004 to provide additional information on a number of issues raised during the session.

  The NPA represents the owners of community pharmacies in the UK. We have in membership the owners of around 11,000 pharmacies—just about all except Boots. In representing the interests of our members we inevitably have extensive contact with pharmaceutical manufacturers and their representatives. We have regular contact with the industry associations (ABPI in the case of prescription medicine manufacturers and PAGB in the case of the manufacturers of non-prescription medicines) to explore areas of mutual interest and to ensure that we keep abreast of developments within each other's sectors. On a similar basis we have contact with individual manufacturers on an ad hoc basis.

  There is considerable interest in community pharmacy at the present time given its changing role. As a means of helping manufacturers understand the changing face of pharmacy so that this can be incorporated into their strategic planning, we have established a corporate members programme—NPA Matrix—through which manufacturers can have a structured dialogue with the NPA's senior management team. We have six Matrix members, each paying a membership fee of £10,000.

  We also look to the industry for sponsorship. This is principally to support training and education materials or resources to improve pharmacy practice provided by the NPA to its members. For example, we have had sponsorship to help cover the costs associated with our medicines counter assistant course, a dispensing technician course, CD-ROMs covering the Drug Tariff and Pharmacy Law and Ethics, and a guide to implementing standard operating procedures (SOPs) into pharmacies. This sponsorship is a means of keeping costs down for our members. In 2003 we received sponsorship of £54,000. The additional costs associated with the design, printing and distribution of our SOP pack were settled directly by the sponsor with the agencies carrying out the work. We are currently seeking sponsorship of a resource we are producing to help members understand and implement the requirements of the new pharmacy contract, which has just been agreed with the Department of Health.

  I should stress that this sponsorship relates to the design, printing or distribution of our materials. However the detail contained in these resources is the sole responsibility of the NPA and materials are normally written and developed in-house. The NPA therefore retains full editorial control over the content. Any sponsorship is recognised through the inclusion of the sponsor's name and logo within the material.

  As one would expect, manufacturers produce their own materials for pharmacists and pharmacy staff. We actively encourage manufacturers to produce objective material, which is truly training or education material rather than company propaganda. To help them achieve this we offer an NPA Training Seal service where the NPA will vet material to ensure they achieve this objective. We charge a fee for this to reflect the time and effort we put into examining their materials. Total revenue from the Training Seal in 2003 was £32,000. A brochure giving further information on the Training Seal is enclosed.

  One of the issues raised at the evidence session on 11 November was Patient Information Leaflets (PILs). In dispensing prescriptions, pharmacists face an obligation to provide fully labelled packs and patient information leaflets to patients. Their ability to do this is however frustrated by the fact that they are obliged in many cases to provide the exact quantity written on a prescription. Where a prescription calls for the same quantity as contained in a patient pack, there is no problem; a fully labelled pack with a PIL will be provided. In cases, where the quantity is at variance with the patient pack quantity however, the pharmacist must "break bulk" and issue the required quantity from a larger pack. As there will only be one PIL in the pack this means that subsequent supplies will be made without a leaflet. Clearly this places pharmacists in an invidious position. Attempts by the DH and MHRA to solve this conundrum have not been successful. The last proposal was for pharmacists to either photocopy or download PILs from the internet. For a variety of reasons—principally those of safety—the proposals were rejected by all stakeholders as unworkable.

  Pharmacists endeavour to issue leaflets whenever they can. However even where leaflets are issued, they are difficult to understand or interpret by many patients. The reason for this is that leaflets are principally legal defence documents rather than an attempt to provide comprehensible information to patients. At the meeting I read out an extract of one such leaflet. The PIL I selected was for Delta Cortril (a brand of prednisiolone). A copy of this leaflet is enclosed.

  We have not done any work on improving the content of PILs to make them easier for patients to understand. However, the Committee on Safety of Medicines is undertaking work in this area. They have established a working group to look at PILs. A consultation document toward improving the utility of PILs is, we understand, to be published soon.

December 2004

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