The October 2008 edition of the Pharmacy Management Journal is available here for download. During the month of October the new Pharmacy Management website will be going live, with the same URL of www.pharman.co.uk - all past editions of the Journal (going back to 1985) will be available online.

The July 2008 edition of the Pharmacy Management Journal is available here for download. The aim of the journal is to highlight good practice and equip the pharmacy workforce with management and leadership skills needed to develop the professional role.

You can now download a pdf version of the Pharmacy Management Journal. The April 2008 edition is available here.

It's easy to take things for granted. There are many frustrations with the time and effort it takes to introduce new developments but looking back over a longer time span can help put things in perspective. January is a traditional time for reflection and prediction so this will be done for the articles in this edition!

Topics in this edition explore leadership qualities and how to encourage patients to bring their drugs to hospital. An interview with a colleague in the pharmaceutical industry gives an insight into their role, a threat to the provision of services to nursing homes by Community Pharmacists is considered and the struggle that some women experience in reaching the highest levels in management is outlined

The efforts made by Essex Primary Care Trust (PCT) to encourage contractors to increase their uptake of Medicine Use Reviews (MURs) through the recruitment of a part-time pharmacist as a MUR Development Officer, as outlined in an article in this edition, is highly commendable.

Commissioning and providing – can they live together? This edition carries an article which outlines the experience of having a joint role for a Chief Pharmacist and other pharmacy posts across an Acute Hospital Trust and a Primary Care Trust (PCT). The paper summarises the benefits of this approach but explains that the arrangements were discontinued in the light of conflicts of interest that arose between the requirements of the provider unit on the one hand and that of the commissioning unit on the other. The article does suggest, however, that there might be scope for joint roles in the future which are linked to a PCT’s provider, rather than commissioning function.

New Pharmacy Contract - Still much to do! The new Pharmacy Contract has been a success in terms of raising the profile of the profession amongst primary care staff such as Pharmacy Advisers, Primary Care leads and Non-Executive Directors. Primary Care organisations now have a clear role in monitoring the implementation of the new contract by means which include visiting each pharmacy.

Whither Medicines Management in the new PCTs? Many Medicines Management staff in PCTs will now have a clearer idea about where they fit in the new organisation but full clarity and details will not yet be available, particularly where the new organisation involves a merger of a number of former PCTs. Does the PCT have a Senior Pharmacist? What is the grade of the post? At what level does the post report? What is the management structure for Medicines Management? Where does Community Pharmacy sit? Is there a pharmacist on the PEC? Does the staff bill have to be reduced and can this be achieved by vacancies? What will happen to the "provider" elements of Medicines Management – will they remain in the new PCT, possibly being charged out to GP practices, will they move into an arms length organisation or be employed by a GP practice? How will Practice Based Commissioning develop and what will be the links with Medicines Management? What will the impact be on current prescribing committees and how will they need to change?

Plurality. Payment by results (PBR). Access. Contestability. Choice. Granularity. Integrated Service Improvement Plan (ISIP). Agenda for Change (AfC). Knowledge and Skills Framework (KSF). Practice Based Commissioning (PBC). I seem to have used these words and phrases a lot over the last year or so! Those of us in the NHS are used to using a lexicon which is impenetrable to those not in the know. We have, however, recently been given a whole new armament with which to baffle and confuse! Such words and phrases clearly need to be set in the context in which they are intended if they are to be understood and used as shorthand to communicate with others. It might suit Humpty Dumpty to use words as he pleases but we need to have a more general understanding! In this edition we concentrate on PBC. The article provides a succinct oversight of the process and how many of the other concepts behind the words and phases indicated above are interwoven. However, having grasped the theory of PBC and the aspiration that it will shift resources from secondary to primary care, it is necessary to consider how it will be applied in practice. Some GPs will no doubt welcome the opportunity to become more closely involved with commissioning services – but will that apply to the majority? Can care be provided in primary care at less cost than secondary care without compromising quality? Is PBC here to stay or, like GP fundholding, will it be a transient approach? Only time will tell. In the meantime, PBC will be a key component of the NHS in the immediate future. Pharmacists need to be aware of the opportunities it can present during this period.

I have been on a course in which we had to design an animal that best described our team. It made me wonder what sort of mix of animals would be good in a pharmacy. You might think that Winnie the Pooh would be the main character in the book, or perhaps even Christopher Robin. For me however, Tigger steals the show. His enthusiasm, personable nature and drive to try out new things makes him a star. We need pharmacists like Tigger – not too many but enough to add that extra something. Self motivators with energy and a passion for their work. Yes, more Tiggers in pharmacy would be good!

Did you notice the College of Pharmacy Practice (CPP) logo on this edition of the Journal and wonder why it was there? The Royal Pharmaceutical Society of Great Britain (RPSGB) has updated the process for Continuing Professional Development (CPD) for pharmacists. In the light of this, some changes have been made to Pharmacy Management to assist pharmacists in maintaining their CPD and ensure that they are using appropriate reading material.

The latest reorganisation of the NHS has now been announced in a letter from Sir Nigel Crisp under the heading "Commissioning a Patient Led NHS". This brief communication will have a profound impact for pharmacists, particularly those in Primary Care organisations and secondary care Trusts. The key features are:

• a shift towards GP practices creating community based services and managing the commissioning budget. PCTs will, however, still place and manage contracts on their behalf.
• paving the way for more care to be provided outside hospitals.
• releasing savings in overhead costs by a 15% reduction in management and administration costs.
• reconfiguring and merging of PCTs and Strategic Health Authorities. Strategic Health Authorities will be aligned with Government Office boundaries.
• Preparing NHS Trusts for foundation status.
• A shift to PCTs securing services from a range of providers rather than providing the services themselves.

Business Plans, Budgets, Annual Reports, Risk Registers and Performance and Development Reviews are "de rigeur" for the end/start of a financial year but there have been some extras this time around! Agenda for Change has required much managerial time to update job descriptions and prepare Knowledge and Skills Profiles (KSFs). I have not yet seen any benefits from this but the outcomes of grading reviews are eagerly awaited. Commiserations to those who are not "matched" against a national profile – you will have to spend a good few hours to complete a Job Assessment Questionnaire (JAQ)! Ethnicity and Diversity questionnaires to gauge organisational performance and policy compliance have also had to be completed. No doubt colleagues can quote other examples of annual or short term actions which relate to their specific roles. More....

The 05/06 financial year proves to be a busy one for pharmacy! The new Community Pharmacy contract will be introduced alongside changes to the Control of Entry Regulations. New arrangements will come into place for the supply of home oxygen services and the provision of pharmacy services out-of-hours in the community will be overhauled. Hospital and Community pharmacy alike will have to cope with "Agenda for Change", which is a significant piece of work that will see the majority of NHS posts evaluated and graded to a common system followed by the introduction of a Knowledge and Skills Framework. That’s only some of the changes we know about. There will be others! With your help in writing up your experiences, Pharmacy Management will seek to play its part in helping raise awareness of key initiatives as they develop as well as helping to develop personal skills.

Make those New Year Resolutions now!

Now is the time for New Year resolutions. How about "I will write one at least one paper and get it published in 2005" as a starter? Pharmacy Management is here to help! In our last edition, Bob Leach provided guidance on how to write a paper. This is followed up in the "Bridging the Gap" section of this edition with an article that will help potential authors write specifically for Pharmacy Management. A key message is that "issues which have required special study or consideration are worth reporting and sharing with colleagues"...(continued)

Heading for a Fall?

You could be heading for a fall if you don’t read and follow up on some of the articles in this Autumn edition! "It is very important to publish your work so that your findings become widely available and so that the same studies are not laboriously and unnecessarily repeated by many others". That is a key message in the article entitled "Preparing a Paper for Publication". Most people reading this would concur with the view held but many will no doubt have failed in the past to write up a piece of work that would have been of interest to others. The reasons may vary but other priorities/pressures are contributory factors. It is important, however, that we develop a research culture within the profession which is linked to publishing papers if we are to develop a sound evidence base for future developments. The article in "Bridging the Gap" will be of particular interest to new authors who wish to be clear about the most suitable approach to be taken but more experienced writers will also no doubt welcome this "aide memoir". It is hoped that the article will give encouragement to colleagues to publish their work...(continued)

A Midsummer Miscellany!

"Supplier development" outlines a process to improve a supplier’s performance in the interests of meeting the needs of the company buying the service - in this case the pharmacy. The article in the "Secondary care Coalface" section describes a detailed and well-researched piece of work to audit wholesaler performance. There has been considerable emphasis on developing "clinical" pharmacy services in recent years, which has possibly, in some cases, been at the expense of developing leading edge practice in more traditional roles such as manufacturing and procurement. This article helps redress the balance and provides a useful model for those who wish to determine how they can obtain better performance from their suppliers...(continued)

Put a STEP in your Spring!

This month, the 'Bridging the Gap' section contains a most interesting article on the 'STEP' programme in South East London. The acronym stands for 'Structured Training and Experience for Pharmacists', an initiative that has led to improvements in recruitment, retention and job satisfaction. The programme operates through collaborative arrangements involving 6 PCTs, 5 acute trusts acute and 3 mental health trusts. The programme structure is based on 18 months in an acute unit followed by three placements, each of 6 months, in other organisations. Outcomes and feedback from participants have been positive. This initiative has made a giant step (excuse the pun!) towards breaking down barriers at the interface and developing a workforce that has an understanding of the delivery of healthcare across the wider health economy. The benefits that this will bring throughout the careers of the participating pharmacists can only be surmised but is likely to be considerable. The initiative has provided a valuable model. Do you wish to follow in its footsteps and perhaps take even greater strides (I couldn't resist it!) to develop a future pharmacy workforce that can rise above organisational boundaries and deliver a truly holistic approach to delivering pharmaceutical care?

Mulled wine

This is the time of year to enjoy a nice glass of mulled wine! The warmth and blend of spices combine to produce a pleasantly satisfying drink. The selection of papers and articles in this winter edition will hopefully have some similarities in providing an interesting mix which you will find stimulating!

This edition of Pharmacy Management contains a number of examples of changes that are occurring in the NHS. Pharmacists need to keep aware of these as they occur and realign their services accordingly. To what extent is Continuing Professional Development (CPD) an integral part of everyday thinking for you and all staff within the pharmacy department? The 'Secondary Care Coalface' article outlines how CPD has become a key driver in developing individuals but this has necessitated clear managerial support and commitment through facilitators, protected time for CPD and linkage with the provision of continuing education programmes.