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Scotland opens up debate on pharmacy applications

Cottage on lake in Scotland

Cottage on lake in Scotland

Source: Charlotte Leaper/

In some parts of Scotland pharmacy applications could be subject to tighter controls

Pharmacists should provide pharmaceutical care to the patients of dispensing GP practices in Scotland, according to a published by the Scottish Government this week (12 December 2013).

The consultation on control of entry and dispensing practices focuses on two issues: the stability of NHS services in remote, rural and island areas; and the processes that surround community pharmacy applications.

Scotland’s health secretary Alex Neil said: “We are asking the public for their views following increasing concerns from some dispensing GP practices and rural communities that pharmacy applications in these areas, if successful, might destabilise local services. This review is about ensuring that we have the right pharmacy provision in place right across the country to best meet the health needs of rural communities.”

The consultation proposes that some parts of Scotland could be designated “controlled remote, rural and island localities” where pharmacy applications would be subject to tighter controls. This includes introducing a “prejudice test” which would consider whether opening a pharmacy would adversely affect provision of existing NHS services, including those provided by any dispensing GP practice.

The consultation document explains: “Prejudice arises where the pharmaceutical services or primary medical services that people can rightly expect to be provided by the NHS would, in some respect, cease or otherwise be curtailed or withdrawn without the replacement of those services potentially affected.” Failing the prejudice test would lead to an application being rejected.

However, the consultation document is clear that people living in remote and rural areas should have access to pharmaceutical services even when medicines are supplied by a dispensing practice. It proposes: “Where the dispensing by a GP practice is necessary, it should be supplemented with pharmaceutical care provided by a qualified clinical pharmacist sourced by the NHS board to ensure the person-centred, safe and effective use of medicines.”

NHS boards could identify need in applications

On the wider issue of pharmacy applications, the consultation proposes a shift from an applicant-driven process to one in which NHS boards identify need. To do this, pharmaceutical care services plans (which each board produces) would be beefed up to become the main vehicle for planning, procuring and providing NHS pharmaceutical care. A “pre-application” stage would also be introduced in which pharmacy applicants would be expected to discuss their proposals with the NHS board.

Other proposals include: involving a community representative as an “interested party” in pharmacy applications, establishing a standard process for pharmacy practices committees and setting a time frame for such committees to make decisions.

Both Community Pharmacy Scotland and the Royal Electronicjuice are preparing responses to the consultation. Matt Barclay, pharmacy services manager at CPS, said: “Both the Wilson-Barber review and ‘Prescription for excellence’ outlined the need to consider how pharmaceutical care can be delivered to those who currently cannot access this expertise in medicines, in partnership with the skill set of other members of the primary care team. CPS believes the existing pharmacy network can play a role in the delivery of new models of care for patients.”

The consultation runs until 20 February 2014. The Scottish Government says that existing arrangements for considering pharmacy applications will remain in place in the meantime.

Citation: Electronicjuice URI: 11131852

Readers' comments (1)

  • The Scottish government needs to take a hard look at the English dispensing doctor situation before it moves forward with these plans.

    The main gripe from the dispensing doctors is the argument of 'cross subsidy' which has been refuted many times by the various ministers in Scotland as not a valid argument under the contracts and system. A payment is received for dispensing and a seperate payment is received for medical services. 

    If the situation is that the medical payment is not correct, then fix that, do not try and ruin a pharmacy system that is the envy of the UK because a group of lobbyists are making some noise. 

    Furthermore, dispensing doctors are paid to provide 'pharmaceutical services' in their contract; is this the government admitting that they are not actually providing pharmaceutical services, they are actually just providing a dispensing service? If that is the case their fees should be dropped for not providing a pharmaceutical service and that money can be used to actually provide a pharmaceutical service by pharmacists. I would not be happy with a situation where the doctors fees remain the same for providing a pharmaceutical service, then the NHS has to pay again to actually provide that service.

    This is the time to be strong and stand up for ourselves!

    Unsuitable or offensive? Report this comment

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