It’s been a busy time for pharmacy and for the Royal Pharmaceutical Society in Wales, with the implementation of significant changes to the Community Pharmacy Contract Framework, advances to technology now available within community pharmacies, and the first ever inquiry into the contribution of community pharmacy by the National Assembly for Wales.
Our focus has been firmly on representing our members’ views on decisions affecting future practice, ensuring we support our members through any changes and developments to pharmacy practice and pharmaceutical care. Throughout 2011, and continuing this year, we have concentrated on a diverse range of work including non-medical prescribing and medicines safety, to both advance the role of pharmacists and to improve patient safety and patient care in Wales. As well as this, we’re continuing to raise the profile of pharmacists in the eyes of the public and patients, their expertise, their role in healthcare and the services they offer.
Highlighting pharmacists’ role
In September of last year, the National Assembly inquiry into community pharmacy led to a period of intense activity for the Welsh Pharmacy Board and for the Society in Wales. The inquiry gave us the unique opportunity to highlight the opportunities the community pharmacy contract offers patients in Wales and the potential it provides for service improvement, ensuring community pharmacists can play a greater role in supporting patients in medicines management and understanding their health. We also demonstrated to the Committee the opportunities for patients, health professionals and Health Boards that have unfortunately been missed since the introduction of the contract in 2005.
During the inquiry we called for the pharmacy contract to be used more innovatively to enable community pharmacists to spend more time with patients, provide an effective public health role contributing to self-care, and play a greater role in the treatment of minor ailments and the routine management of chronic conditions. We also recommended that pharmaceutical care should feature more prominently in Health Board planning and that action should be taken to ensure community pharmacists can be appropriately incentivised to provide quality clinical care.
The final report of the Committee is expected shortly and will be the culmination of several months’ work by the Health and Social Care Committee, examining the contribution of community pharmacy to health in Wales. It is anticipated that the report will contain several recommendations to the Minister for Health and Social Services and will have the potential to inform and influence future government policy on pharmacy service developments in Wales.
Bringing pharmacists together
The Welsh Government announced in March that a new scheme designed to provide easy access to advice and treatment for common ailments is to be introduced across Wales. The national scheme, which will involve assessment and supply of treatment, will make community pharmacists the first port of call for ailments such as hay fever, warts, head lice, sore throats and indigestion.
This is another endorsement by the Welsh Government of the role that pharmacists can play in managing patient health and is good news for patients. Pharmacists are the experts in medicines, and we have long argued that this expertise should be put to much greater use in improving health and widening access to health services.
There will be a move towards patient registration, which will improve the relationship between patients and their community pharmacy of choice and will enable pharmacists to deliver the best pharmaceutical care when providing this new service. It’s also good to see that the service will have a phased implementation period, as this gives us the opportunity to work with Welsh Government and our members in Wales over the next 12 months to help develop this service and make sure it delivers the best outcomes for patients and fully utilises the expertise of pharmacists in Wales.
Towards the end of last year, changes to the community pharmacy contract brought together pharmacists from both community and hospital for the first time. The changes, implemented in November, saw the introduction of a discharge medicine review service, targeted medicines use reviews, and changes to clinical governance requirements. We were conscious of how we could support our members in delivering these services, so we held workshops across Wales to find out how they could be successfully delivered locally, by working together. The workshops made it clear that the changes would have a significant impact on hospital pharmacists, as they would on community pharmacists. Many community pharmacists, while supportive of the changes, had to understand and implement them in a very short space of time, with those in hospital settings feeling they were unaware of the changes and what they were expected to do.
It was also clear from the discussions with our members that vital to the success of the Discharge Medicines Review Service in particular, is the need for good working relationships between pharmacists and GPs. We have recently met with the Royal College of GPs to talk about how we can work together to enable the timely and accurate transfer of patient information and patient letters between hospital, GPs and community pharmacists following hospital discharge. We’ll be working with the RCGP in Wales during 2012 and examining how we can improve communication, join up patient care and share information.
Medicines safety is still a huge priority for the Society and our members in Wales, and is an area of work where pharmacists can really lead the way. Last year we launched our report on Medicines Safety and called for the NHS to develop a strategy specifically aimed at reducing avoidable medicines related harm. Our message was similar to what we were saying to politicians at the same time: pharmacists are the experts in medicines. Pharmacists need to be integral to all aspects of medicines management, they need to be the educators of other health professionals on the safe and effective use of medicines and, perhaps most importantly, pharmacists need to be given sufficient time to spend with patients in order to help them understand their medicines.
Working with high profile partner organisations, we’re continuing to develop and promote this work throughout 2012, and will be focusing on specific areas of medicines safety such as high risk drugs, high risk settings like nursing homes, and helping to improve adherence. Later this year, we will be launching a Quality Improvement Guide specifically aimed at pharmacists with 1,000 Lives Plus (the national improvement programme for Wales), and this summer will see the Society host a GB wide medicines safety symposium, which is a great opportunity for the profession to share the latest developments in this field and for all pharmacists to get involved.
Technology and pharmacy
Community pharmacies in Wales have seen advances in the technology they are able to use, with the 2D barcode system now being used in all community pharmacies (those able to use it) to scan in prescriptions. After working with NHS Wales Informatics Service for a number of years to help support and shape the new system, we’re confident that it will help to improve patient safety by reducing transcription errors and will allow pharmacists to spend more time with the patient, advising them on their medication and ultimately improving adherence. We’ll be continuing to promote firstly the use of new technologies in pharmacy. And secondly, the difference it is making to pharmaceutical care.
One of the areas the Welsh Pharmacy Board has been keen to develop is the role of pharmacist prescribers in healthcare delivery. We’ve been involved in the work of the medicines management sub-group, which was tasked by the All Wales Medicine Strategy Group (AWMSG) with looking at how non-medical prescribing has been taken forward, especially the recommendations of the Non-Medical Prescribing (NMP) conference report which we held in partnership with Royal College of Nursing Wales and National Leadership and Innovation Agency for Health, back in 2010.
Recently, the AWMSG was presented with a paper by the chair of the medicines management sub-group Marc Donovan, which recommended the need for a national prescribing strategy, and proposed a number of pilots including one in community. We were pleased to see these recommendations were agreed, so during this year we will look at opportunities for supporting the delivery of this work in Wales.
In the spotlight
We all want to see pharmacists and the role of pharmaceutical care represented fairly and accurately in the media, so we’re really concentrating on raising the profile of the profession in Wales among the public by working closely with the media to ensure the profession’s voice is heard. Thanks to the work of the Royal Pharmaceutical Society, pharmacy has had an increased presence in the news of late, with the profession’s expertise in medicines being widely discussed, as well as a number of health campaigns which have highlighted the important role of the pharmacist in patient care. This builds on important messages about the local community pharmacy being a place patients and the general public can go to for help, support and advice on a range of matters. You can see the latest collection of media highlights on our website, www.rpharms.com.
Campaigns in Wales alone, such as type 2 diabetes risk assessments offered through community pharmacies, and GB health campaigns targeted at raising awareness of signs and symptoms of bowel cancer, and annual events such as No Smoking Day, all put pharmacists on the same level as other health care professionals when it comes to offering services and support.
Local practice forums
In 2011 every single RPS member in Wales benefited from access to a local practice forum, as well as access to online forums just for members as a way of keeping in touch with local issues and events across the country. The LPFs bring together pharmacists from all sectors in the same locality and allow them to work together on projects as diverse as inhaler technique training, improvements to transfers of care, rural healthcare, mentoring and patient focused projects such as adherence.
This year will continue to be a busy one for RPS in Wales and we welcome the input, comments and recommendations from all our members to ensure we are representing their interests in the decision making circles in Wales.
Paul Gimson is Director for Wales at the Royal Pharmaceutical Society