Noyce Peter R
The Workforce Academy, and School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK.
Ann Pharmacother. 2007 May;41(5):861-8. doi: 10.1345/aph.1K015. Epub 2007 Apr 24.
To describe the provision of patient services through community pharmacies in the UK, with particular reference to England, and to explore the research evidence and policy developments for enhancing the contribution of community pharmacy to primary care and public health.
In the UK, National Health Service (NHS) pharmaceutical services are delivered under contract by privately owned community pharmacies. In England, a new 3 tier structure for pharmaceutical services was introduced in 2005 comprising essential, advanced, and enhanced-level services. All NHS pharmacies must deliver 7 essential pharmaceutical services and provide evidence that they meet the requirements of a comprehensive quality assurance framework. In the first year of the contract, around 40% of pharmacies were accredited to undertake medicine use reviews, the first advanced-level service to be implemented. Meanwhile, up to 25% of pharmacies provide a variety of enhanced-level services; the most common of these is supervised administration of methadone as well as support programs for patients quitting smoking. New legislation is being introduced that will accomplish the following: allow pharmacists to acquire independent prescribing rights, require pharmacy technicians to be licensed, necessitate that both pharmacists and pharmacy technicians periodically demonstrate their continuing qualification to practice, and introduce the concept of the "responsible pharmacist" to the operation of community pharmacies.
Community pharmacy is now being recognized by the government as a mainstream contributor to primary care and public health. The current priority is to integrate services provided through community pharmacies into programs provided by other primary care professionals, through strengthening information technology and contractual arrangements. While major changes to the regulation of the pharmacy workforce are occurring, the quality management of community pharmacy services merits further attention.
The new NHS pharmacy contract and current legislative changes provide a basis for community pharmacy to become fully integrated into NHS long-term care and public health programs.
描述英国社区药房提供患者服务的情况，特别是英格兰地区，并探讨相关研究证据及政策发展，以增强社区药房对初级医疗保健和公共卫生的贡献。
在英国，国民健康服务（NHS）的药学服务由私人所有的社区药房通过合同提供。在英格兰，2005年引入了新的三级药学服务结构，包括基础服务、进阶服务和强化服务。所有NHS药房必须提供7项基础药学服务，并证明其符合全面质量保证框架的要求。在合同签订的第一年，约40%的药房获得认证可进行用药评估，这是首个实施的进阶服务。同时，高达25%的药房提供多种强化服务；其中最常见的是美沙酮监督给药以及为戒烟患者提供的支持项目。新的立法正在出台，将实现以下目标：允许药剂师获得独立处方权，要求药房技术员获得执照，要求药剂师和药房技术员定期证明其持续执业资格，并在社区药房运营中引入“责任药剂师”的概念。
社区药房如今已被政府视为初级医疗保健和公共卫生的主要贡献者。当前的重点是通过加强信息技术和合同安排，将社区药房提供的服务纳入其他初级医疗保健专业人员提供的项目中。虽然药房工作人员的监管正在发生重大变化，但社区药房服务的质量管理值得进一步关注。
新的NHS药房合同和当前的立法变革为社区药房全面融入NHS长期护理和公共卫生项目提供了基础。
