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The 2012 Sigma Conference
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3/23/2011
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Delhi provides defining moment for pharmacy
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The Numark International Conference gave community pharmacy a timely reminder of the need to engage with health commssioners and patients as it approaches a crossroads which will shape the profession for years to come. Neil Trainis reports from Delhi...
A blend of Indian history and culture encountered community pharmacists who thought they had left their troubles at the departure lounges of UK Airports but were quickly reminded that the challenges facing them have not dissipated. A colourful, eye-opening sub-continental experience was a chance for an escapism of sorts for people already swarmed by a hectic workload and bogged down further by anxiety over the shape their profession will take once the Coalition Government's reformation of the NHS eventually gets into full swing. Numark's conference in Delhi, entitled From vision to reality; making it happen, was never intended to make tangible change happen in the space of seven days but it did give those who attended a juddering refresher course on the sobering debates that have swirled around community pharmacy. “Pharmacy's role is changing,” exclaimed Numark managing director, John D'Arcy, to an audience of community pharmacists, drug company executives and other delegates in a large conference room at the swish Oberoi Hotel. “We're moving away from the supply role towards the clinician.” In a nutshell, D'Arcy had encapsulated the flavour of the revolution pharmacy must undergo as it careers towards indelible change in a restructured health system, or “the most fundamental changes for the NHS since its inception since 1948” as he described it. Embedded in the warnings was a rallying call to pharmacists to be more proactive and engage with GP Consortia, whatever form they finally take, and patients at the front of the store, as opposed to popping up every now and then like meerkats, to use an overused stereotype. A sense of frustration perforated D'Arcy's musings. “Why does pharmacy have to fight for recognition on Health and Well-Being boards?” he pondered. “There is the feeling 'why is it GPs (being given integral roles in healthcare) and not the rest of us?' The Government has no idea at all about the logistic difficulties of running a pharmacy.”
Engagement
The two-day conference itself was packed with interactive sessions and debates on pharmacy engagement, the prospective shape of service commissioning, medicines use reviews and the concept of value. “The future is going to be about value. If there are services, there are questions as to why it should be viable,” remarked Numark's guest speaker, Dr James Kingsland, the national clinical commissioning network lead for England at the Department of Health. “Those who are showing value will survive. The same goes for pharmacies. Those who show value have nothing to fear.” The concept of value was not a comfortable issue for pharmacists to digest. “I'm worried about the idea of 'any willing provider' to be honest,” said one pharmacist during a break in the conference. “It smacks of a disbanding of free care and would change the NHS beyond all recognition – not necessarily for the better. It's all about the Government trying to make their mark and it's typical. It's alright for those ministers. They probably don't have to use the service.” A 4,000-odd mile jaunt to another continent had not allowed him or his counterparts to escape from the gathering storm of change back home. This was no jolly, even if there were pleasant distractions.The party took in awe-inspiring sights such as the Taj Mahal, whose romanticism briefly blunted the drudgery of life behind a dispensing counter. That was preceded by a trip to Old Delhi which took in a visit to the Jama Masjid, the principle mosque in the city, and Humayun's Tomb, the resting place of the Mughal Emperor Humayun. Pharmacists fearing they might be plunging towards the unknown back in the UK suddenly found themselves immersed in the unfamiliar in the ramshackle surroundings of downtown Old Delhi. There they jumped on to a fleet of Rickshaws and trundled, with some hazard, along the crowded, narrow, cobbled streets. Some of the passengers were sprayed by water pistol-toting Indian children oblivious to the poverty of their surroundings.
In Delhi the poor and the privileged are juxtaposed and the contrast was overwhelming. The rickety buildings and dirt-swept streets of Delhi's suburbs clashed sharply with the opulence and grandeur of the Rashtrapati Bhavan, the residence of the President of India. The final night of the conference back at the Oberoi was played out to the backdrop of Bollywood dancing where guests, donning saris and suits, momentarily lost themselves without totally forgetting that the reality of their situation will soon take hold once more.
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