Reforms to the NHS Pharmaceutical Services Regulations

1
Reforms to the NHS (Pharmaceutical Services)
Regulations

• Learning Exchange Events
• Part III March 2005
• Liz Perrett Consultant
• peter.dunlevy_at_dh.gsi.gov.uk
• mike.king_at_psnc.org.uk
• russellw_at_doctormail.com (russell walshaw)

2
Learning Exchange Events Part III

• Welcome
• Feedback from Part II LEE events
• Guidance and regulations
• Aims of the day

3
Applications by Pharmacists (already on the list)
- NOW

• Does not matter whether area controlled or non
  controlled
• Considered under Reg. 4 and whether N or D to
  grant.
• Does not take into account doctor dispensing

4
Rurality - NOW

• Maps and wellie boots needed!
• PCTs should have maps showing controlled and non-
  controlled areas
• PCTs may re-determine any area either on own
  volition or on application by LMC/LPC

5
Rurality - NOW

• Procedure set out in Reg. 9
• Cannot be considered again within 5 years unless
  substantial change of circumstances
• Current guidance

6
Applications by Pharmacists (not already on the
list) - NOW

• Considered under Reg. 12 and the prejudice
  test.
• If no prejudice, PCT goes onto consider whether N
  or D under Reg. 4.
• In doing so only takes into account
  pharmaceutical services provided by those on the
  pharmaceutical list.

7
Pharmaceutical Services by Doctors - NOW

• Only in circumstances set out in Reg 20
• i.e. patient
• (a) has serious difficulty or
• (b) is resident in controlled locality, more
  than 1.6km from any pharmacy AND doctor has
  permission to dispense.

8
Application by doctors to dispense - NOW

• Made under Reg. 21.
• PCT applies Reg. 12 and prejudice test.
• Can be a partial grant

9
What factors considered - NOW

• Prejudice - burden of proving prejudice on person
  alleging it
• No set formula
• Difficulties with confidentiality/fairness

10
Adverse effects - NOW

• Where there are adverse effects from a grant or
  in connection with a decision relating to
  rurality, conditions can be imposed to defer
  transfer of patients

11
Perceived Problems (1)

• When a pharmacist already on the list, applies in
  a controlled location a practice could have
  dispensing removed without a right to be heard
• Patients have no input

12
Perceived Problems (2)

• The prejudice is to Pharmaceutical Services
• The effect of this, is that it is immaterial
  whether one or more pharmacies closes down
  provided pharmaceutical services in general are
  not prejudiced