History

History

The hospital pharmacist’s role in medicines management was recognised as long ago as 1955 in the Linstead report on hospital pharmacy. In this report the role of the hospital pharmacy included:

·      to assist in the development of new methods of treatment

·      to promote economy in the use of medical supplies

·      to assist in efficient prescribing by advising upon the nature and properties of medicaments, and selection of the most suitable substances and the form in which they should be prescribed.

These principles remain true today, particularly as both the range and com-plexity of medicines have increased enormously. In the intervening years, milestone reports such as the Nuffield report in 1986, the Department of Health circular on clinical pharmacy in 1988, Pharmacy in the Future in 2000 and the Audit Commission report on medicines management in hos-pital reinforced the role of the hospital pharmacist at the centre of medicines management. More recently, the General Medical Council’s own research identified that almost 10% of prescriptions written by junior doctors con-tained errors: these were only prevented from reaching the patient by other healthcare staff, primarily hospital pharmacists.

Although systems to manage prescribing have a longer history in hospital than in primary care, more attention has focused on primary care prescribing costs with more central initiatives (for example, practice detailed prescribing information (PDPI) data (previously called PACT data), primary care trust (PCT) pharmaceutical advisers and general practice incentive schemes). This is not surprising since in 2000 the majority of NHS expenditure on medicines was in primary care. However, we have noted that more recently secondary care prescribing costs have been the larger area of growth.