The first 18 months of primary care groups: Pharmaceutical implications

Aim • To describe how prescribing is being managed within primary care groups and trusts (PCG/Ts) and to identify areas of development over the first 18 months of their existence. Design • Data from self-completion questionnaires and face-to-face interviews Subject and Settings • The board members of a stratified, random sample of 57 PCG/Ts in England. Results • All except one of the 57 PCG/Ts had set up prescribing subgroups and 36 (63%) now had community pharmacists as members of these groups. There was evidence of the involvement of a wider group of stakeholders in the prescribing subgroups, including lay members. Pharmacists were providing dedicated prescribing advice to 55 (96%) of the PCG/Ts. In addition, 35 PCG/Ts (61%) were involving community pharmacists or nurses in other specific medicines management initiatives. Prescribing targets and priorities commonly reflected a combination of national priorities and a desire to develop priorities according to local need. There was a notable increase in the use of e-PACT and the prescribing toolkit in order to help with the monitoring of prescribing within the organisation. Although the organisations were clearly striving to meet the prescribing targets set by the national service frameworks and the National Institute for Clinical Excellence, there was unease about the financial and human resources required to deliver these targets. Conclusion • The infrastructure required to support medicines management within primary care is continuing to grow and develop, particularly through the use of community pharmacists, nurses and information technology. In the light of the requirement for all PCG/Ts to have medicines management services in place by 2004, these organisations will need to further develop innovative plans to use their available resources effectively and efficiently.