GOOD TO SEE LINDA REPORT

It was good to see Professor Linda Strand given strong coverage in last month’s ICP (p4). Linda is one of the originators in the United States of the practice of pharmaceutical care, which, if fully implemented, could transform pharmacy practice in this country. So what is ‘pharmaceutical care’? The classic definition is “the responsible provision of drug therapy for the purpose of achieving definite outcomes”. The aim is that pharmacists should prevent drug therapy problems occurring and resolve problems if they do occur. Drug therapy problems take a variety of forms: unnecessary therapy; dose too low; dose too high; adverse drug reaction; non-compliance; additional therapy needed. So pharmaceutical care should mean an end of ‘hope for the best’, where medicines are prescribed by medics and dispensed more or less as writ by pharmacists and the patient is left to get on with it. It would mean a much more active role for the pharmacist in supervising drug therapy. I remember looking at pharmaceutical care in great depth some time ago – in the past century in fact – and speaking about it with some excitement to a bigwig at the Pharm Soc, only to have what I was saying airily dismissed with the phrase: “Things are different in America”. But they are not that different: doctors diagnose and prescribe and pharmacists supply the prescribed medicines to patients. OK, there is no NHS, but there are other big third party payers, and the practice of pharmacy is basically the same. The pity is that the Pharm Soc has never got to grips with pharmaceutical care. If it had, it would not have sponsored the wishy-washy report on new models of care – a bit of this and a bit of that, helping out here and helping out there, but no big idea – that we saw published at the end of last year.

WHOSE WORD COUNTS ON THE PJ?

The following statement invariably appears on the leader page of the PJ: “The editor assumes total responsibility for the editorial content.” But who is the editor nowadays? Is it the “executive editor”, who appears at the top of the list of published staff names, or is it the “managing editor”, whose name was seen for the first time in the May 10/17 issue? Is it the publisher? Who really has the last word about what goes in? The publisher directed that there should be an obituary of Nelson Mandela, despite the latter’s absence of any pharmaceutical connection. So it could be him. The new managings editor’s job description includes scheduling of content and legal compliance. So it could be him. The executive editor is the only one of the three to have editorial experience in pharmacy. So it could be him. The managing editor’s post, by the way, was advertised fleetingly on the Society’s website, and the appointee, like the new publisher, hails from Nature. What a surprise! The executive editor’s post, another new one, does not seem to have been advertised at all. Meanwhile, an acting editor who had been on the staff for a long time and a double award-winning senior contributions editor have gone. We have had the pleasure of three long articles from the new publisher about the PJ relaunch, which he is masterminding. They don’t tell us much, least of all what we really want to know.

ONE RULE FOR THEM . . .

It’s nothing to do with pharmacy, but I note that doctors who have been found to have pre-signed abortion forms without seeing the patient seem to have got away with it. The chief executive of the GMC says that the practice is illegal. Nevertheless, the Crown Prosecution Service decided that a prosecution was not in the public interest and, in the absence of convictions, the GMC took no action against the doctors concerned. With strict liability still the order of the day for dispensing errors, pharmacists must be looking askance at such a lenient approach for the medics.