Agenda item

Dr Ellis Friedman, Joint Director of Public Health, PCT/NHS updated Members on Pharmacy and Prescription Services in the Borough.

Dr Friedman explained that his colleague, Neelam Bose, was responsible for the commissioning side and that the GP’s were providers.  Dr Friedman provided an overview of the various pressures in the community.  There was a formal requirement for a pharmaceutical needs assessment which concentrated on issues such as accessibility and out of hour’s services.  The last assessment was completed in 2011 which provided answers to Members questions.

Members had concerns about the prescription service not being transparent.  One of the concerns was that there were sometimes shortages of a drug given in comparison to what was on the prescription.  Dr Friedman said that was a serious matter and the pharmacist was obliged to prescribe the right number of tablets, if that was not done then the patient should complain. 

Members discussed repeat prescriptions and that these were given for some long standing conditions.  The individual would be required to be periodically reviewed and should have the correct medication and number prescribed each time.  Members also discussed loans for repeat prescriptions.

Members were also concerned about brands of medicines which then change which were not as good as the original and wondered whether this was because there was a cheaper supplier.  Dr Friedman explained that what was prescribed was what was written on the form.  A generic version was often used rather than a branded version as they were cheaper.  The generic drugs were tested for the same active ingredient used in the branded drugs.  If a patient had a particular reason for wanting a different drug, for example because they found the size or the shape of a tablet easier to swallow then it would be up to the patient to discuss with their GP.  If the GP changed the patient to the branded version then the pharmacy was obliged to dispense the branded version.  Ms Brittin stated that using generic drugs has saved the NHS millions of pounds.  Dr Friedman explained that it was rare that people did not take the generic forms of medicine when they were equally well tolerated and used as well as the branded versions.

Members asked how residents’ concerns were being monitored and addressed and why percentages quality feedback were lower in some wards than others and whether these percentages could be attributed to how many pharmacies were in a Ward.  It was noted that there was a pharmacy in one ward which had 20% feedback and others with 100%.  Dr Friedman explained that advice was given to pharmacies on how to improve the service offered.

Blood pressure measurements by pharmacists was discussed and Dr Friedman stated he would invite Ms Bose to provide Members with a written response on this – a lot of pharmacies did not provide this service.

Members asked if Hillingdon had too many chemists.  The national provision was 1 in 5000, whereas Hillingdon it was 1 in 3500.  Dr Friedman explained there was a wide range in Hillingdon and it was based on resident population.  Hillingdon also had a number of people that came into the Borough for work and this figure was not a particular concern.

Dr Friedman explained that the government changed the way pharmacies were regulated.  Pharmacies were now part of a market driven system which in turn created more competition as they were geographically closer.  However, the premises and equipment still needed to be fit for purpose.  Dr Friedman also highlighted that there was an increase of online pharmacies.

Members expressed concern that if a superstore opened an opticians or pharmacy within its store that it would close local pharmacies.  Dr Friedman explained that a wide range was acceptable based on resident population and a marker of convenience where people could get services from.

Members discussed free prescription and how it was known to a pharmacist if a patient was entitled to it.  Dr Friedman explained that it was a criminal offence to indicate on the prescription it was free if the patient was not entitled to free prescription and the majority of patients took their prescriptions to a pharmacy associated with their doctor.  The pharmacy recognised the GP signature and should take the necessary steps to see if the signature was valid or forged.  The prescription could not be rubber stamped it had to be signed by the GP.

Members questioned whether patients could go to a number of pharmacies and subsequently over prescribe themselves drugs such as the morning after pill.  Dr Friedman explained that if a drug was available over the counter then it was generally safe, although if you did take too much it could give complications.  Pharmacies should still give advice when giving over the counter drugs and patients should read the safety instructions as it was their responsibility.

RESOLVED:  That the presentation be noted.