Finding the right solution?

Dr Bernard Leddy, the new president of the Pharmaceutical Society of Ireland (PSI), has plans for reform as the industry faces…

Dr Bernard Leddy, the new president of the Pharmaceutical Society of Ireland (PSI), has plans for reform as the industry faces a shake-up

SUPPORT FOR pharmacists with addiction problems, a new culture of professionalism and increased patient safety are top of the agenda for the new president of the Pharmaceutical Society of Ireland.

Some 10-15 per cent of pharmacists will face addiction problems in their careers, says the newly elected president of the Pharmaceutical Society of Ireland (PSI), Dr Bernard Leddy.

Leddy, who took up the presidency of the pharmacy regulator at the beginning of summer, has identified the establishment of an addiction support programme for pharmacists as one of the top priorities of his year at the helm.

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Pharmacists struggling with drug and alcohol addictions and their related illnesses is an issue that has been “swept under the carpet” for far too long, he says.

He hopes that a new programme aimed at supporting pharmacists with addictions will tackle the problem.

The programme, entitled the Combined Healthcare Professional Health Support Programme, has been in the planning stage for three years.

It is expected to be up and running by this autumn, and will be run as a joint venture with the dental profession.

Dr Joe Mee, who has overseen a similar project in the UK, will co-ordinate the programme and will train a network of pharmacists in addiction treatment.

Patient safety is at the heart of the initiative, he says: “If you have pharmacists who are impaired through drink or drugs, this will impact directly on patient safety.”

The aim, he says, is to help addicted pharmacists and other healthcare workers get back to safe working lives before a critical incident occurs.

The addiction programme will allow for “positive and sympathetic interventions”, he says.

Leddy, however, was keen to point out that the majority of pharmacists will go on to lead very healthy lives and safe practice after a successful intervention. The establishment of the addiction service is the culmination of a long campaign by the Lismore-based pharmacist.

Leddy completed a post-graduate addiction studies certificate course 14 years ago, and has been trying to get an addiction service established since then.

He has also expressed concern about the rate of suicide among pharmacists. “There are no hard figures but in 2006 and early 2007 there was anecdotal evidence of a very significant level of death by suicide among pharmacists.”

Leddy points to research in Britain in 1990 which indicated that after veterinary surgeons, pharmacists are the most likely to take their own lives.

There is no reason to believe that it is any different in Ireland, he says. In the absence of hard figures, he hopes to initiate research into the area.

Leddy, who is director and general manager of pharmacy chain Mari Mina Pharmacies, as well as a member of Lismore Town Council, takes on his new role at a time of great change in the pharmacy sector.

The new Pharmacy Act, passed in March 2007, replacing legislation dating from 1875 and the 1791 Apothecaries’ Hall Act, provides for a root-and-branch overhaul of the sector.

The Act introduces new inspection and enforcement powers, provides for a statutory complaints committee and sets new requirements for pharmacies, as well as pharmacists, to be regulated and comply with fitness to operate requirements.

The establishment of a new council of the PSI was the first element of the Act to be implemented.

The next step will be the regulation of pharmacies and pharmacists. This is due to come into effect in early autumn.

Under the Act, the PSI will insist on minimum standards for pharmacies.

These will include computers, child-resistant containers and private consultation rooms, says Leddy.

Further down the road, new professional training regulations will be drawn up. This will require pharmacists to keep their knowledge up to date.

Currently, there are no such requirements and Leddy says that this has resulted in some pharmacists who qualified in the 1950s and 1960s not opening a book since. “Advances in pharmacy move at such an incredible rate, continuing professional training is the easiest way of ensuring pharmacists keep up to date,” he says.

The Act is seen by many as a chance to “reprofessionalise”. Proposals for an expanded role for pharmacists in frontline health services will see even more dramatic changes in the sector, he says.

Minister for Health Mary Harney is currently considering an interim report from the PSI, which recommends that pharmacists play a much greater role in the provision of frontline care for patients.

There are 1,653 pharmacies in the State, and behind every counter is a trained graduate “willing and able” to do a lot more, says Leddy.

The PSI envisages pharmacists offering patients healthcare services such as health screening, management of chronic diseases, vaccinations and prescribing certain medications, he says.

This report, says Leddy, is a roadmap for the future of pharmacists and “lays out how we see pharmacies developing in Ireland over the next 15-20 years”.

For years, pharmacists have had to put up with the commonly held belief that “a pharmacy is essentially shopkeeping” and “the only difference between a pharmacy and a sweet shop is that a sweet shop sells sweets and a pharmacy sells drugs”, he says.

The profession itself, however, he says, has to get out of the “shopkeeper mode” and push to be regarded as a healthcare professional.

“Loyalty to the till and not to the patient should never be the way,” he says.

The new Act and the proposed changes to the role of pharmacists will create the structure to allow for change, he says.

It “will hopefully encourage those who still act like shopkeepers to change their ways”.

He cites the case of pharmacists selling excessive quantities of codeine-containing products such as Solpadine and Neurofen Plus.

They are clearly more motivated by the “fullness of the till than the wellness of the patient”, he said.

While he would not like to see codeine-containing medications and analgesics less readily available, Leddy says there is a strong case for a new category of pharmacist-prescribed drugs, which are sold without a doctor’s prescription, but are entered on to a patient’s record.