The effectiveness of en masse withdrawal. An untrusting customer’s run on the bank? A vociferous workers’ union strike? A globally observed ethical boycott? None of the aforementioned attract welcome publicity, but what if your controversial initiative faces virtually unanimous opposition scarcely moments after its unveiling...
With high blood pressure thought to affect as many as one in five people in Northern Ireland, thousands of people throughout the country could be suffering from the condition without realising it. Gordons Chemists have made blood pressure testing a priority for their health promotion strategy, introducing free testing events at ...
But that motto isn’t just for patients. If requests to contribute to community initiatives in health promotion are anything to go by, pharmacy is certainly at the top of most organisations’ lists for those to consult. This month NIPinF has heard about such projects drawing on the expertise of pharmacists from across Northern...
| Minor Ailments |
 |
 |
 |
| Written by Laure James - Editor Pharmacy in Focus | |
| Friday, 26 September 2008 09:34 | |
|
The entire dynamic of pharmacy shifted last month when the Department announced its pre-orchestrated attempts to reform the Minor Ailments Scheme. Contractors, backed by the Ulster Chemists’ Association (UCA) and the Pharmaceutical Contractors’ Committee (PCC), withdrew from the service en masse much to the Department’s probable shock and even now a resolution seems far from the profession’s grasp. The Department’s reaction, which was issued shortly after the Ulster Chemists’ Association’s official publication last went to print (NIPinF August) was one of disappointment, resignation and in part, shock. “The opportunity to provide an enhanced Minor Ailments Service has been rejected by community pharmacists,” a spokesperson said at the time. “The new service would have meant an injection of significant new funding of £1.5million each year which would have greatly increased the income for pharmacists, enlarged the range of services available to patients and helped ease the burden on GPs.” The new enhanced service now offers patients advice and medication for athlete’s foot, vaginal thrush, threadworms, head lice and Dhobie itch, as well as hayfever and coughs and colds. So if the Department is prepared to reinvest into this service, what is the problem? A new remuneration package, without having considered the inevitable increase in volume and workload, is clearly not worth accepting. The cost of providing the service during 2007/08 amounted to £1.242million for 182,000 consultations and these were just for coughs, cold and flu and hayfever. With an extended formulary, this could of course dramatically increase. Furthermore, were the same number of consultations made in GP surgeries, the cost would have been as high as £7.637million. “When it was announced that the formulary was to be expanded to include more conditions this was of course welcome news to pharmacists,” UCA president Paul McDonagh said. “However, to then restrict it by capping the number of consultations permitted each year and to have cut remuneration just counters all the work carried out to make this service more comprehensive.” Just a few days after this response, the PCC launched a bold campaign with a staggering majority support from contractors. ‘Save Our Service’ has been informing the public about why the service is currently unavailable and gathering petitions for lobbying purposes. “I think it’s important that this time pharmacists are correctly mobilised, stick together and improve our lobbying skills,” explained Anita Rooney. “I believe the Save Our Service initiative has been a successful way of doing this. GPs for instance are excellent at making themselves heard and pharmacists should be taking their example. Now it is time to preserve a future, we’ve got little alternative than to make our point known and listened to at all levels. Otherwise, by the time the new contract is introduced, our bargaining powers will have diminished.” “If arrangements between the Department and the pharmacy profession are not reached before the winter period then we certainly expect to see an increase in the number of patients wishing to see our GPs for common coughs and colds for which of course pharmacists can provide symptomatic relief,” Damien Denver, Vere Foster Medical Practice. “We would not expect to experience much of an impact from the fallout of this situation until then although we are certainly in support of Save Our Service and recognised the value of the service prior to our local pharmacies withdrawing. It is unsurprising that so many contractors withdrew.” Eoghan O’Brien from Bannside Pharmacy, Portglenone, was one such contractor. “Although I did withdraw from the service, I was reluctant to do so because it is such an excellent initiative,” Eoghan told NIPinF. “I have always been very much in favour of the extended role of pharmacists and the Minor Ailments Scheme was a great way of publicising how diverse our role can be, within the public domain and among patients.” When asked what could be expected in terms of a resolution, Eoghan was confident that an agreement would be reached soon. “There is certainly a positive vibe from both the DHSSPS and PCC, which is of course good news for community pharmacists and the public,” he said. “It is important that GPs are aware of the value of this service since it took a lot of time to introduce it. Furthermore, pharmacists were instrumental in explaining what the service involved and its benefits to patients. Posters do not always get the message across and sharing knowledge with our local GP surgery meant that we received a high volume of referrals which worked very successfully.” The PCC’s campaign has not only mobilised pharmacists but also patients, with over 15,000 signatories from 110 pharmacies by 22 August, and an extensive press drive throughout Northern Ireland. Belfast Telegraph editor Martin Lindsay recently described the decision to restrict the service as “puzzling” and called on the Department to seek a resolution. “It is up to the Department to find a way of resolving its dispute with the pharmacists and to get the service running again,” he wrote. “In the meantime, the real losers are the patients who used the service and who now have to wait much longer for assessment and treatment.” A little sensationalist for a service that largely treated common cold and hayfever symptoms, although issues surrounding access to healthcare and inequalities within the sector have now resurfaced, as Anita added. “We are simply concerned that patients, while in support of us now, will become frustrated at no longer being able to receive the service they were accustomed to.” The Department however have claimed that the PCC are the ones stalling negotiations and that they have been invited to discuss the needs of their membership on more than one occasion. “We had hoped that the Minor Ailments Service would have been the first element to be introduced as part of the new community pharmacy contract and the Department has made a series of offers over an extended period of time to the PCC to try and reach agreement on this,” explained an aggravated-sounding Christine Jendoubi, director of primary care at the DHSSPS, when she wrote to contractors last month. “Unfortunately, to date we have not been able to reach agreement with the PCC and contract discussions will need to continue. “Nevertheless, we feel that it is extremely important that the undoubted benefits of a Minor Ailments Service providing a wider range of therapies should be available to all patients, no matter where they live in Northern Ireland.” Health Minister Michael McGimpsey has since become involved in the Minor Ailments saga, having written to the Committee on 15 August, offering a meeting with the Department’s negotiating team and, by the start of September NIPinF understands that they were still awaiting a reply. So what would be so wrong with meeting with the Department? “It is certainly true that the Department had invited us to discuss matters but this was after they had decided to supersede the PCC,” explained Terry Hannawin, chief executive of the PCC. “It was a last resort to withdraw from the service and to begin our campaign but its support hopefully demonstrates to the Department that we do represent all pharmacy contractors in Northern Ireland and their professional interests.” |