Structure and organization of pharmacy

14


Structure and organization of pharmacy




Study Points



image How pharmacy is structured on a global and national basis


image How pharmacy within the NHS is currently structured


image The difference between primary, secondary and tertiary care


image The different roles and jobs undertaken by pharmacists


image The UK organizations which support pharmacy



Introduction


All countries of the world have medicines to treat ailments and maintain the health of their populations. The aims of each country will be to vaccinate even the youngest child against childhood diseases and provide medicines to treat them and the adult population. Generally, the pharmacist is the trusted healthcare professional that is given the responsibility for safe guarding and supplying medicines to the individual patient within the legal system of that country. Clearly, some countries will have more developed systems than others to control and supply their medicines and this will depend, to some extent, on the wealth of the country and its political stability. Concomitantly, the countries with more developed systems will have more pharmacists and more supply outlets for medicines. But with pharmacy and pharmacists worldwide, what structures and organizations are available to administer and support both countries and pharmacists in their endeavours to supply medicines to their populations? This chapter will consider global, state and local structures that organize and support aspects of pharmacy and pharmacists.



Global organizations


There are two major organizations that have an involvement in pharmacy worldwide. These are the World Health Organization (WHO) and International Pharmaceutical Federation (FIP).


The WHO is a directing and coordinating authority for health within the United Nations (UN). It provides leadership on global health matters, setting norms and standards, shaping health research agendas, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. It employs pharmacists in advisory and operational capacities. In the pharmaceutical sector of the WHO, the essential medicines concept was developed for low income countries and a Model List of Essential Medicines was produced. The essential medicines concept encourages countries to focus on access to those medicines that represent the best balance of safety, quality, efficacy and cost to meet the priority health needs in a country. The Model List of Essential Medicines was developed in the 1970s and has been revised regularly. The list consists of a ‘core’ of medicines that are the minimum required for a basic healthcare system, for example this would include analgesics and antibiotics, and a ‘complementary’ list, including essential medicines for priority diseases which may be cost effective but not, necessarily, affordable. Currently, the Essential Medicines List contains about 350 individual medicines and it is designed to guide the development of national and other essential medicines lists.


The WHO has a 6-point agenda to address health objectives, strategic needs and operational approaches. Currently, it is involved in patient safety campaigns and research, international health regulations, global vaccine safety initiatives and the role of pharmacists in tuberculosis care, among others.


FIP is a global federation of national pharmacy associations representing approximately 3 million pharmacists and pharmaceutical scientists worldwide. It has annual conferences and aims to set global pharmacy standards, through professional and scientific guidelines, policy statements and declarations, as well as collaborating with WHO and the UN. It publishes statements of policy on a wide range of subjects such as:



It also has projects on such topics as education initiatives on tuberculosis and patient safety, as well as producing a series of pictograms for labels to be used by patients without a working knowledge of a language.



Organization of pharmacy at a national level


Most countries will have a government, which will need specialist advice on all manner of subjects, including transport issues, financial issues and usually including health issues. And thus, the government will have specialist departments, for example, a department of health which will employ health professionals to advise the government ministers as and when the need arises. This section of the chapter will concentrate on the organizations in England, but similar arrangements exist in many other countries.


The Department of Health (DH), headed by the Minister of Health, is a department of the UK government which is responsible for health and social care matters and for the NHS in England. It develops policies and guidelines to improve the quality of care and to meet patient expectations. Among its employees, there is a Chief Pharmaceutical Officer to advise on pharmaceutical matters. It also employs other pharmacists in specialist capacities. A number of publications, such as the BNF and BNF for Children are published under the authority of the DH and the Joint Formularies Committee, which consists of representatives of doctors and pharmacists. The British Pharmacopeia Commission, which is responsible for the British Pharmacopeia (a collection of legally enforceable standards of quality for UK medicinal substances) recommends publication to the Minister of Health.


The Medicines and Healthcare Regulatory Authority (MHRA) is a UK government agency set up under the auspices of the DH (see Ch. 4). It regulates medicines and medical devices to check whether they work and are acceptably safe.


The National Patient Safety Authority (NPSA) monitored patient safety incidents including medical and prescribing errors. The key functions and expertise for patient safety developed by the NPSA has now transferred to the NHS Commissioning Board Special Health Authority. An off shoot of NPSA is the National Clinical Assessment Service (NCAS), which was set up to investigate concerns over the performance of individual doctors and dentists, but now pharmacists are included in their remit. The NCAS is currently hosted by the National Institute for Health and Care Excellence (NICE) and, in future, will be part of the NHS Litigation Authority.


NICE is currently a Special Health Authority and in the future will become a non-departmental public body. NICE currently publishes guidelines on:



In the future, NICE will, also, produce quality standards for people and services involved in providing social care.


The NHS Confederation is a membership body for the full range of organizations that commission and provide NHS services. The membership includes hospital trusts, commissioning bodies and independent and voluntary organizations that deliver services to the NHS.


Health Education England is part of the NHS and is a national leadership body responsible for ensuring that education, training and workforce development drives the highest quality public health and patient outcomes. Pharmacy and pharmacists come under the remit of Health Education England. At a more local level, there will be Local Education and Training Boards (LETB) which are tasked with developing the NHS workforce at a local level.


The Pharmaceutical Services Negotiating Committee (PSNC) is recognized by the DH as the representative negotiating body representing community pharmacy contractors on NHS matters. This committee negotiates the remuneration that community pharmacy contractors receive for NHS dispensing services and other pharmaceutical services, such as MURs (see Ch. 51).


The Veterinary Medicines Directorate, is an agency of the Department of Environment, Food and Rural Affairs and aims to protect the public health, animal health, the environment and promote animal welfare by assuring the safety, quality and efficacy of veterinary medicines in the UK (see Ch. 28).

< div class='tao-gold-member'>

Only gold members can continue reading. Log In or Register to continue

Related posts:

  1. Powders and granules
  2. Pharmaceutical calculations
  3. Public health
  4. Emulsions

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 24, 2016 | Posted by in PHARMACY | Comments Off on Structure and organization of pharmacy

Full access? Get Clinical Tree
Get Clinical Tree app for offline access