The NHS Plan¹ proposes 500 new one-stop primary care centres by 2004 in which pharmacists can work alongside GPs, dentists, opticians and other health care workers. The Nuffield report on pharmacy² suggested that health centre pharmacies would enhance professional integration. There is a belief amongst some pharmacists that move to a health centre would reduce the commercial emphasis and allow more emphasis upon health care issues. Paradoxically, Kirit Patel chairman of NPA stated in 1999 that "the biggest threat to pharmacy at present is the move to one-stop health centres"³.

A list of health centre pharmacies was assembled based on a fax-back survey of all pharmaceutical advisors in the UK (1998). Following a literature review, a self-completion questionnaire was designed and piloted. 153 questionnaires were mailed in January 2001. Two follow-up reminders were sent. Responses were analysed using SPSS-PC. The response rate from the self-completion questionnaire was 70% (n=107).

The findings of the survey demonstrated the reality of working in health centre pharmacies mirrored the tensions between the ambitions of policy and the commercial reality. The operational demands of the location were a constraint on the achievement of the stated professional ambitions of pharmacists for greater integration and service development. 87% (n=92) of respondents considered that the health centre location gave more opportunity for teamwork between the different health professions. 86% (n=91) considered that the working in a health centre was less commercial than in a high street. Analysis of the responses to open-ended questions on perceived advantages and disadvantages of the health centre pharmacy showed two main advantages: convenience and greater professional integration."I think its brilliant and more worthwhile being a health centre pharmacist".

At the same time, disadvantages were that a loss of counter trade and an increased dependence upon income from dispensing meant reduced scope for business and resulted in an increased workload that impeded joint professional working.In the health centre we are reduced much of the time to production line dispensing. There is seldom time to give patients advice – but what is the alternative?

The presentation will use selected quotations and vignettes from the study and from the pharmacy literature to illustrate the contradictory ambitions of the three stakeholders: the Department of Health, the contractors and the profession.

References

1. Department of Health. The NHS Plan. London: Department of Health, 2000.
2. Nuffield Foundation. Pharmacy: a report to the Nuffield Foundation. London: Nuffield Foundation, 1986.
3. Facing up to the threats. Chemist and Druggist, 17 July 2001.