Pharmacists in Smoking Cessation

A NOTE FROM THE EDITOR Jack Shanahan, MPSI
Working in
Dolls’ Houses
New year, new issues – or so we all hoped. Instead, this
January started off with a real kick in the rear end.
On a landscape
of supreme
consistency,
there is a
single fount of
continuous torment: our everpresent
and all-consuming
regulatory body. The PSI’s
Pharmacy Assessment System
(PAS) should now be in full
flow in most pharmacies.
It is a monumental work
for most of us. In my view,
it poses a particular and
disproportionate burden on
those pharmacies that are on
the smaller side, specifically
those that have only one
pharmacist. In an era of
secularism, we take little
comfort in the PSI having a
spiritual vision, enshrining
the divine trinity of pharmacy.
One being as superintendent,
supervising and acting, all at
the same time and yet, all as
notionally separate entities.
Like a three-headed spatula.
While we are told that the
PAS gets easier after the first
six months, I certainly can
testify that I am finding the
process stultifying. If ever
there was a case of idleness
creating the devil’s work, this
project has to be a crowning
mortal sin. It takes a very
special type of committee to
dream up such a plethora of
checklists, twice. Then there is
the nagging suspicion. If this
means that we are effectively
doing the inspector’s work for
them, the real worry is what
comes next. If we have filled
out all the usual tick boxes,
what is left for the legion
of inspectors? Of particular
concern is that the PSI will
create new ‘standards’ that are
further designed to eviscerate
the smaller independent
pharmacy. The whole thrust
of the current approach to
regulation utterly ignores
the impact of the petty,
inane and arcane regulatory
itches that are required to be
scratched. For instance, we are,
it seems, expected to have a
device in the shop capable of
measuring liquids to a level of
.05ml. Although I have been
practising pharmacy for over
30 years, I have never, ever,
ever needed to measure .05ml
of a liquid. For clarity, that is a
little over three quarters of a
drop. Indeed, come to think of
it, I have never even needed to
measure 0.5ml of a liquid. Who
dreams this up? At what point,
in a standards committee’s
deliberations, does somebody
come up with the idea of
requiring pharmacies to have
equipment that is utterly
pointless? While I am sure that
somebody, somewhere, once
had to measure .05ml of water,
this is not normal; nor is the
expectation that we should be
equipped to do it.
It is at times like this that
you need to remind yourself
that the function of the PSI
is to protect the public. It
is not clear, now, that this
translates into a proper
vision. There seems to be a
sense of disassembling, of
breaking pharmacy down
into ever-smaller atoms of
standardisation. This is the
work of those that do not
understand community
pharmacy. It is clear that the
voice of experience is shown
a deaf ear in the deliberations
that produce standards, and
expectations, that are ever
more remote from the real
world. The fear is that we end
up working in dolls’ houses,
where every placement is
dictated by a petulant child
who can, at a whim, destroy
the whole edifice and start
again, without penalty or fear
of being reigned in. If you feel
my views are excessive, have
a look at the report of the last
PSI meeting’s public session. In
a country where community
pharmacy pays some of the
highest fees in the world, they
want even more money. Where
did it all go wrong? Read the
report and weep.
While we are on the issue of
standardising, there is some
good news elsewhere. We
should soon be welcoming a
secure clinical email service
into community pharmacy.
Healthmail has been around
for a few years, primarily as a
vehicle for secure electronic
communication between GPs
and hospitals. It was a natural
extension of the standards
developed for communicating
laboratory results, evolving
into a mechanism for
transporting confidential
health information. What
separates it from regular email
is the security that surrounds
it. It is like a private network,
where only verified users can
access to send and receive
email. So, for instance, an
email from a regular Gmail
account can never be received
on a Healthmail account.
While a few pharmacies in
Kilkenny had preliminary
access, it will soon be rolled
out to all of us. One of the
immediate benefits should
be the elimination of most
faxes that contain sensitive
information. For instance, it
should be possible to send a
list of current medications to
a secure email in a hospital.
This should provide a
degree of confidentiality to
a process that is currently
fraught with risk. The
processes surrounding the
implementation should
also help with the rollout of
ePrescriptions. Watch out
for more news as this useful
facility arrives to us all.
If you have any comments, queries or issues to raise, send
your “Letters to the Editor” by email to ipureview@ipu.ie.
IPUREVIEW FEBRUARY 2017 7