FOCUS: HEALTH PR - Looking up and over the counter/Pharmacists may soon be able to dispense some medicines which were previously prescription-only, lessening the burden on GPs. But the PR task of re-educating the public will not be small. Hilary Freeman r

The Government is planning to empower pharmacists to end a NHS vicious circle. At the moment, sufferers of common ailments are required to see their GPs for prescription-only medication, but often cannot get an appointment for days. Meanwhile, it is estimated that GPs spent a third of their time on unnecessary consultations.

The Government is planning to empower pharmacists to end a NHS

vicious circle. At the moment, sufferers of common ailments are required

to see their GPs for prescription-only medication, but often cannot get

an appointment for days. Meanwhile, it is estimated that GPs spent a

third of their time on unnecessary consultations.



The Crown Review of Prescribing and Supply of Medicines, a

Government-appointed committee, will report on the future of prescribing

this spring, after months of consultations with representatives from the

NHS, the pharmaceutical industry and pharmacy chains. A key player in

the debate is the Royal Pharmaceutical Society (RPS), which is pressing

the Government to change the law so that pharmacists are defined as

practitioners under the terms of the 1968 Medicines Act.



The RPS has requested that some prescription-only drugs - such as

antibiotics for cystitis and eye infections, inhalers for asthma and

contraceptive pills - become available from the pharmacist. It also

wants over-the-counter (OTC) medicines to be available on the NHS to

people who are entitled to free prescriptions. This would take some of

the pressure off GPS and better employ the skills of pharmacists.



Pilot schemes are already underway to decide whether an extended role

for pharmacists is a valid and cost-effective option. These include a

head lice treatment trial in Nottingham (see panel), a repeat medication

trial and a trial in which pharmacists can prescribe medicines in a

mini-clinic.



Independent of whether or not the Government decides to change the law,

the demands of the RPS are symptomatic of an industry undergoing

revolution.



The growth of the OTC sector has been well-documented. What is clear is

that pharmacists can no longer afford to be described as the ’invisible

face of healthcare’. This has tremendous implications, not only for the

NHS but also for PR practitioners in the healthcare sector.



The RPS has just published a booklet Pharmacy in a New Age, which

presents the pharmacy profession’s strategic plan for the 21st Century.

Before compiling the publication, the Society consulted all of its

40,000 members.



One thing quickly became clear from the replies - nearly everybody who

responded highlighted communication as a major issue for

development.



Beverley Parkin, head of PR at the RPS, says the development of better

communication needs to be at the heart of the future of the pharmacy

service, as pharmacists shed many ’hands-on’ tasks, such as preparing

medicines, and develop new roles as advisers on all aspects of medicines

and their uses. ’People’s perception of pharmacists is changing,’ she

says. ’Until now, they have been out of the line of vision. But

pharmacists are highly trained. They have skills in pharmacology and

know more about medicines than any other health professionals. Now, they

want a wider audience to appreciate the value of what they do. To do

this, they need to become better communicators.’



The RPS’s response has been to reinvent itself as an effective advocate

for the profession, with both internal and external communications high

on the agenda. But the RPS cannot win the communications battle

alone.



It requires the support of the healthcare PR sector.



Parkin says: ’We need a partnership approach. We need more dialogue and

communication with PR consultancies and help with materials to educate

the public and support pharmacists.’



Britain’s largest pharmacy chain, Boots the Chemists, endorses both the

RPS’s recommendations and its communications strategy. Corporate

spokesman, Tim Legge says: ’There is a great role for PR to play to help

inform the public of how they can get the most from their

pharmacist.’



But are PR practitioners ready to face the challenge? The healthcare PR

sector appears to be split between consultancies who already view

contact with pharmacists as an integral part of their activity - and

therefore foresee little change - and those who believe an enhanced role

for pharmacists may lead to a complete shift in approach.



Allison Hunter, communications and media relations manager at Novartis

Pharmaceuticals UK, says pharmacists are not a new audience. ’Just as

the pharmaceutical industry has been working with an expanded customer

base for a number of years now, so the audience for those of us working

in healthcare PR has already widened considerably.



’Pharmacists have always had expertise and interest in pharmaceutical

products, but if that expertise is deployed in a different way, so their

profile in PR programmes or campaigns will undoubtedly take on a new

dimension and it might well open up a host of new avenues,’ she

says.



Peter Field, managing director of Shire Hall Communications, says there

is already a considerable pharmacist involvement in PR focus groups.

’Pharmacists have always been part of the PR target audience because of

the unique position they have at the customer interface. I don’t foresee

too much change,’ he says.



PR agencies cannot now afford to be complacent about their knowledge of

pharmacists, particularly if they have viewed them as the dispensers of

OTC medicines. Gareth Zundel, group PR director at Harvard PR, says that

working with pharmacists with prescribing powers would require a change

of mind set. ’In the past, we have tended to treat pharmacists as a

retail audience. There is now a need to treat them as a professional

audience.’



This view is echoed by Dr Martin Godfrey, head of healthcare

communications at Hill and Knowlton. He believes pharmaceutical PR

consultancies will have to re-prioritise their key audiences. ’At

present,’ he says, ’pharmacists are low down on consultancies’ list of

people to try to promote services and products to - they don’t have much

influence. But, if they begin prescribing, they will shoot up a level,

joining doctors. Representatives will target pharmacists as they target

doctors now and our promotional effort will have to change. We will need

to compile sophisticated information about pharmacists and replicate it

on databases,’ says Godfrey.



But it is not just the pharmacist who will need to be targeted. If the

role of pharmacists is enhanced, then their assistants will also have

more responsibility.



’While the consumer may enter the pharmacy seeking a conversation with

the pharmacist, it is more likely that the initial conversation will be

with the assistant. PR strategies and tactics targeted at assistants

need to be undertaken in parallel to communication with pharmacists,’

says Rebekka Thompson-Jones, senior account executive at Cohn and

Wolfe.



An enhanced role for pharmacists and their assistants will almost

certainly create a wealth of new business opportunities. Grayling has

already worked with the Proprietary Association of Great Britain (PAGB)

on a cold and flu initiative. According to head of healthcare, Peter

Holden: ’One of the key messages was that ’there are lots of remedies

available in the pharmacy, so consult your local pharmacist’’.’ He

predicts that more pharmacists will be included in focus groups and that

pharmacist opinion leaders will be identified and targeted.



Hill and Knowlton’s Godfrey foresees the explosion of a new media

market.



’A bigger slice of the promotional cake will be spent on pharmacists.

Advertisers will begin to focus on them. New magazines, journals, tapes,

videos and educational conferences will be aimed at them.’



Whatever the outcome of the Government committee on prescribing, there

is one issue on which the RPS, pharmacists and healthcare PR

practitioners are unanimous: safety. Lynne Herbert, account director at

Greenlines Healthcare Communications believes it is paramount.



’Pharmacists’ prescribing powers will be limited to those clearly

defined areas where it is safe for the public to bypass their GP,’ she

says. ’It will not happen overnight - it is likely pharmacists will

require additional training. But overall, it makes a lot of sense to

make pharmacists more accessible. They are a highly skilled resource and

a valuable asset to PR consultants.’



HEAD LICE: SCRATCHING THE SURFACE OF THE PROBLEM



A case of head lice is an unnecessary headache for most GPs - it is a

consultation which could be better handled by a pharmacist.



Head lice treatments are available over the counter, but many of those

who receive free NHS prescriptions or have children who are entitled to

free medicines are unable to afford them. Since head lice is

predominantly a childhood affliction, the current system is not

working.



Nottingham Health Authority may have come up with a solution to this

problem. It is the official sponsor of the Nottingham Head Lice Project,

a three-month pilot which, if it is successful, may ultimately help

persuade the Government to change the laws on prescribing.



The Project started in January and involves schools, community health

professionals and over 30 pharmacists. ’The aim of the project is to

promote the role of pharmacists as the first point of call for advice,

diagnosis and treatment of an important but not critical condition,’

says Alicia Parry, communications and PR officer for Nottingham Health

Authority.



In Nottingham, people with suspected head lice visit their pharmacist

and are given a wet comb to demonstrate that they really are

infested.



This ensures that only real cases are treated and avoids misuse of

pesticide lotions. The patient is given a small quantity of one of two

treatments authorised by the health authority. The pharmacist then fills

out a specially devised form and submits it to the HA for NHS

reimbursement.



Joy Wingfield, chairman of Nottingham Local Pharmaceutical committee

says the success of the pilot will depend on both economics and public

contentment. ’The questions we have to answer are: Can we do it for the

same money or less? And: will the public accept the additional role of

pharmacists as mediators and facilitators of medication within certain

parameters?’



The scheme will run until the end of March and will be followed by a

thorough evaluation process. Wingfield says preliminary feedback is

positive.



’The health authority hopes to extend the pilot across Nottingham and

there are also plans to extend it to include other medications, such as

those for thrush,’ she says. ’This pilot is a real first and shows there

are ways of prescribing within the NHS. It’s an chance to use

pharmacists’ skills to tackle such a condition in an effective way.’



MERGERS: PR AGENCIES NEED TO STAY ALERT IN TIMES OF FLUX



The merger between Glaxo Wellcome and SmithKline Beecham - dubbed the

merger of equals - collapsed in late February over the failure to agree

on the division of top jobs.



Glaxo Wellcome had reportedly objected to SmithKline Beecham managers

taking half of the jobs in the new company. Glaxo Wellcome’s

prescription medicines business is much larger than that of SmithKline

Beecham.



The problems were reportedly exacerbated by structural differences

between the two organisations. Glaxo Wellcome runs a much more

decentralised operation than SmithKline Beecham.



That failure proves that deals can be easy to plan but difficult to pull

off. Just weeks before news broke of the proposed Glaxo and SmithKline

Beecham merger, SmithKline Beecham was in talks with American Home

Products.



History, however, is on the side of the merger. Recent years have seen

mergers between Amersham and Nycomed, Pharmacia and Upjohn and Glaxo and

Wellcome to name but a few.



Mergers affect not only the personnel working within the drug companies,

but also the PR consultancies which represent them. When a merger is

proposed, pharmaceutical companies often shut the door on any outside

communications networks and take charge of their corporate PR.

Consultancies representing these companies are either gagged or are

simply unwilling to talk about the specific implications of a

merger.



Scott Clark, managing director of CPR, which has worked with Glaxo

Wellcome and SmithKline Beecham, says that mergers benefit the PR

industry as a whole. ’Mergers open up the job market. If people are made

redundant or choose to leave, it gives us access to many new skilled

people. Many of these people will choose to join consultancies.’



The downside is that if client contacts jump ship, years of

relationship-building may go to waste and there is another, short-term

problem. ’A newly merged company will often freeze its PR and marketing

budgets while it reorganises,’ says Clark. ’This can lead to loss of

revenue.’



Catherine Warne, head of healthcare at GCI Healthcare believes if

agencies do a good job, they will be retained. ’PR consultancies are

employed for a number of factors - knowledge, experience and

personality. A good consultancy should be an important asset to the

marketing team. Their knowledge, awareness and understanding of issues

are an important contributory factor to the success of the brand,’ she

says.



What is clear is that mergers force PR companies to keep on their

toes.



Clark is emphatic. ’There are two types of agencies: those who fear

change and those who embrace it. The ones who embrace it and become more

global in their outlook will benefit, the others will be pushed out of

the market. The only thing we can be sure of is that there will be a

next deal. We haven’t seen the end of the mega-merger - so be

prepared.’



MEDIC ALERT: EDUCATING HEALTH PROFESSIONALS IN PR



Healthcare PR has been laid open for pharmaceutical companies in a new

bi-annual book entitled Communique.



A spin-off of Pharmaceutical Marketing, the monthly magazine for the

pharmaceutical industry, Communique claims to be ’the essential guide to

using and choosing PR and medical education’.



Project manager Ciaran Duck says the idea for the book was conceived

after research revealed a gap in the market.



’We originally intended to write a series of features in Pharmaceutical

Marketing about PR. Prior to this we carried out detailed market

research and held focus groups with pharmaceutical consultants.’



The research uncovered some surprising facts. ’The main point to emerge

was that clients in the pharmaceutical industry did not understand PR.

They didn’t know where medical education ends and PR begins.

Furthermore, they had no training in PR. We identified a huge skills

gap.’



Still more worrying was the discovery that pharmaceutical company

personnel did not trust the PR sector: ’They were afraid they might be

’short-changed’ by PR, because they didn’t understand what PR

practitioners did and were unable to evaluate their roles.



’We realised we needed to educate clients from scratch about what PR

practitioners did. A series of features was not enough,’ says Duck.



Due to be updated every six months, Communique is both an information

tool and a directory. It is divided into two halves: how to use PR and

how to choose the right agency for the job. It is written by PR

professionals working in the healthcare sector and analyses campaigns,

profiles PR agencies and details the amount spent by each agency on PR

and medical education.Each chapter is illustrated with case studies.



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