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In this issue of SelfCare Tucker and colleagues report further on the use of a ‘dermatology vignette’ website to evaluate the diagnostic ability of primary healthcare professionals. Clinical vignettes have long been used as training tools to test the knowledge of clinicians, but they may have particular relevance to everyday pharmacy practice. Pharmacy consultations are often abbreviated exchanges and the pharmacist must be alert to all the clues provided. In skin diseases, recognising the typical appearance of common conditions may be pivotal to providing the right treatment or advice to consult a doctor. Replicating this situation in a training setting on-line, by the means of a clinical picture and the key elements of the patient’s ‘story’, has clear potential to improve the working knowledge of front-line pharmacy professionals.

One important role for this kind of tool may be in validating the ability of pharmacists to manage new clinical conditions following the approval of new non-prescription medicines. When a new class of medicines is ‘switched’, often the most critical issue is the mechanism by which pharmacists can assist people to assess their condition, and thereby their suitability for the new treatment. Training materials are always provided to refresh clinical knowledge when a new pharmacy medicine appears, but the testing of that training using typical clinical cases on-line may provide a simple but robust way to show the practical application of that knowledge. Substantiation of the clinical acumen of pharmacy staff in this way may go some way to reassure other primary care providers when a new extension of the role of pharmacy is debated.

Also in this issue, Mark Griffiths summarises an important presentation he gave on the role of the European Centralised Procedure in the re-classification of medicines. Readers ofSelfCare have previously heard the view expressed in this journal that there is a looming crisis in Europe around the flow of new medicines into self-care. Griffiths clearly articulates one source of this problem from the point of view of the consumer pharmaceutical industry. The potential role of self-care in the broader health economy has never been more important. This makes it all the more frustrating that the primary regulatory mechanism for re-classification of many newer drugs to non-prescription status in Europe now seems to function as a barrier to, rather than a facilitator of, innovation.