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GP Dispensing: Darzi's plan could benefit dispensing GPs

DDA chairman Dr Richard West reflects on how the themes of Lord Darzi's report apply to dispensing practices.

Lord Darzi's interim report 'Our NHS, Our Future' sets out four underpinning themes to his vision. He believes that the NHS should be: fair; equally available to all; personalised, tailored to the needs and wants of each individual; effective, focused on delivering outcomes and safe.

These four themes have been, and still are, the principles on which dispensing doctors rely when thinking about how they are going to deliver the service to their patients. They are themes that we can all stand up and support.

The report has had to look at the broad picture, some of which I can recognise in my own practice and the community and some of which does not reflect the area in which I live and work. But the themes can all be applied to the function of dispensing by GPs.

Integral to the community
One of the great strengths of a dispensing practice is the fact that it is an integral part of the local community. The practice staff get to know the patients very well and, because of this, provide a very personalised service.

This is reflected in the way that local delivery services have been built up. Each practice has a different system that allows all patients to have easy access to their medications.

Being able to pick up their medication on the way out of the surgery gives patients the best possible access to the medicines they need.

Yet patients in rural areas can still have problems in accessing OTC medications, so it would be a sensible move to allow dispensing doctors to supply a simple range of OTC medications to their patients. Currently, while patients can buy paracetamol from the local garage, they cannot acquire them from their local dispensing practice.

A key focus in Lord Darzi's report is integration of care and partnership working. In the dispensing field, I would hope that this will generate opportunities for pharmacists and dispensing doctors to work together to provide patients with the best possible service in a cost-effective manner.

There are some parts of the country where it is not possible for a full range of NHS services to be provided locally. In these areas, enabling partnership working would provide a cost-effective solution for the NHS and give patients choice.

These partnerships would give all patients access to all primary care services close to their homes, and allow both doctors and pharmacists to benefit from their complementary skills sets.

Quality scheme for dispensing
The Dispensary Services Quality Scheme (an optional scheme started in September 2006, as part of the GMS contract) has started the process of showing the effectiveness and safety of dispensing practise. The Dispensing Doctors' Association has worked with the National Patient Safety Agency in the past and would welcome further opportunities to work with them to improve patient safety.

The concept of providers being rewarded for the amount of work that they do, and their success in attracting patients, works very well for dispensing practices. We would welcome patients being given the opportunity to choose where their medicines are dispensed based on the quality of service that is provided to them.

I hope that when Lord Darzi reports next year, some thought is given as to how his recommendations will be delivered across the whole of England. It needs to be remembered that there are inequalities and deprivation in rural areas, which are often masked when the figures are put together for analysis. This group should not be forgotten. I can only hope that his report will be a catalyst to strengthen the service that rural patients receive.

Dr West is a GP in Bury St Edmunds, Suffolk, and chairman of the Dispensing Doctors' Association.

Your say on dispensing
Welcome to GP's new weekly page for dispensing GPs, where we will be focusing on issues that are of key importance and relevance to dispensing doctors. We want to hear from dispensing GPs about their practices and the issues that they face.

If you have any comments or views, please contact us at GPdispensing@haymarket.com

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