Agenda item

Mike Keen of the Local Pharmaceutical Committee, Julia Ross, Director of Public Engagement, West Kent Primary Care Trust and Jayne Macdonald Head of Primary Care and Community Contracts, Eastern & Coastal Kent Primary Care Trust will be in attendance for this item.

(Mike Keen, Chief Executive of the Kent Local Pharmaceutical Committee, Professor John Butler, the Chairman of Kent and Medway Pharmaceutical Regulations Committee, Julia Ross, Director of Civic Engagement, West Kent PCT, Jayne Macdonald, Head of Primary Care and Community Contracts, Eastern and Coastal Kent PCT and Anne Bretherton, Chief Pharmacist, West Kent PCT, were in attendance for this item)

(1)       The Chairman welcomed Mr Keen to the meeting and invited him to give his presentation.  Mr Keen’s presentation (attached as Appendix 3) covered the following:-

·              What is a Local Pharmaceutical Committee?

·              Where does it draw its powers from?

·              How does pharmacy help to improve services to patients?

·              How does pharmacy help public health?

·              What is control of entry?

(2)       Professor Butler from the Kent and Medway Pharmaceutical Regulations Committee, the body responsible for awarding contracts to applicants for pharmacies, explained that the number of pharmacies in Kent and Medway over the past 15 years had remained approximately the same.  However, the location of the pharmacies had changed; and large pharmacy companies had taken an increased share of the market.  There was a tendency to have more pharmacies in supermarkets and also to move pharmacies out of high streets and to co-locate with doctors’ surgeries, which ran in parallel with the increase in the redevelopment/relocating of doctors’ surgeries.  Professor Butler explained that in rural areas under regulations it had been possible since 1982, with consent, for doctors to dispense, as often in these areas it was not commercially viable for pharmacists to operate.

(3)       Ms Bretherton stated that in Kent the PCTs were looking at formally setting in place a Clinical Governance Framework based on the national programme.  East Kent PCT had the responsibility to carry out the performance monitoring visit.  In West Kent every pharmacy had a visit and pharmacist would go on the visit with a lay Member.  This visit would be pre-arranged and anything arising from it would form part of an action plan.  PCTs gave pharmacies help and support so that they could address any issues identified as requiring action.  In relation to a question on counterfeit drugs, she stated that the PCT had no influence as this was a national problem.  In relation to unused drugs, Ms MacDonald and Ms Bretherton stated that they headed teams of Prescribing Advisors who visited GP practices and supported GPs.  Members asked a number of questions, and received responses, regarding the following points:-

·              As regards the regulation of pharmacists, it was explained that they had a  professional code of ethics and that their professional  body, the Royal Pharmaceutical Society of Great Britain, played a regulatory role (although the regulatory and representative functions of the Society were to be separated under planned reforms to the regulation of healthcare professionals).

·              All pharmacies had to agree their opening hours with the contracting PCT. New pharmacies had to specify their total opening hours and their core contract hours, which had to be at least 40 hours per week.  When the Pharmaceutical Regulations Committee received an application, the applicant usually offered to open in excess of 40 hours, but contractors were able to withdraw from any commitment to provide additional hours (with three months’ notice).  The Committee could only accept the hours that were being offered – if the pharmacy did not offer to open on Saturdays or Sundays, or in the evening, then they could not be forced to do so.  Given a choice of applicants in the same area, the Committee would choose the one offering the greater coverage, other things being equal.

·              One of the problems with the regulatory system was that it was reactive. Pharmacists chose where they wished to provide services and there was no direct means of directing provision at underserved areas. PCTs worked to try and develop local pharmacy services where there were gaps. There were certain areas where pharmacists would not find it attractive to open up a pharmacy; on the other hand there were others areas that were “over-pharmacied” – for example, Westwood Cross Retail Park in Thanet, which did not necessarily need the four pharmacies that it had.

·              The Galbraith Inquiry, which was looking at the NHS pharmacy “control of entry”, was due to report before the end of June (although the report itself might not actually be published). This could lead to further reforms in the “control of entry” mechanism.

·              The provision of “advanced” and “enhanced” services by community pharmacists was a cost-effective way of providing medical help and advice in the community.

·              PCT prescribing advisors went round to every GP practice, to provide unbiased evidence on drugs, thereby acting as a counterweight to the targeting of GPs by pharmaceutical companies.  GPs valued this advice.

(4)       The Chairman thanked the presenters and representatives from the PCTs for attending the meeting and giving Members an interesting overview.  He stated that the NHS Overview and Scrutiny Committee hoped to be able to contribute to the discussion about the future of the “control of entry” regulations following the Galbraith Inquiry.

(5)       RESOLVED that the presentations and discussions be noted.