This report is compiled from notes taken during the meeting, is for information only and does not constitute formal minutes. Consequently, I take no responsibility for any inaccuracies, errors or omissions. Opinions expressed within the notes are those of attendees and have been included for completeness. However, this does not necessarily mean I agree with them.
Towards a strategy for Pharmaceutical Care
Hamish Wilson (Head of Division B-Primary Care Unit, SEHD) opened the meeting by setting the context for the strategy and pointing out that it will be a strategy for pharmaceutical care, not a strategy for pharmacy or pharmacists. He outlined the drivers for change and the objectives of the day, which were to get a broad-based input into the strategy and identification of key challenges and priorities.
The meeting broke into the first set of workshops to look at the opportunities provided by 'Our National Health', the main strategic issues to be tackled and the main practical challenges.
Opportunities
Strategic Issues
Challenges
The second set of workshops was intended to take forward the most important issues identified by the participants.
Meeting the Challenges
Community Pharmacy
Patients value quick dispensing. They will discuss some clinical conditions, but problems such as lack of privacy and in some cases poor access to a pharmacist mean they do not utilise the pharmacists expertise as well as they could. Incorporation of the NHS logo into all shop fronts would identify the link between community pharmacists and the NHS and improve the public perception of them as members of the primary care team. Involvement in patient forums and a strategy of public involvement in the pharmacy strategy would also help.
Proper marketing of pharmacy and publication of positive stories of the NHS in the media would help with the major selling of pharmacy that is required. Multidisciplinary learning would help market the profession to other professionals.
There were seen to be 5 requirements to proceed
Public Health
There are information gaps within the profession and beyond. There were suggestions that pharmacy constituencies be formed, whether mirroring MP or MSP constituencies or being a specific pharmacy constituency was open to debate. It would be very useful for contracting and needs assessment. Contracts and extended roles could then be allocated on a constituency basis.
Lifestyle advice should be provided, but it is important that all sources supply the same advice. A referral system is required, rather than suggesting the patient sees their GP, it needs to be a more formal system, and it should be possible to refer patients to the other professionals within the primary care team. It was noted that membership of the LHCC Public Health Group covers a wide range but that pharmacy was conspicuous by its absence.
Partnership
It is important that pharmacy engages with LHCCs and care teams. The recommendations of the LHCC Best Practice Reference Group must be considered.
There must be a commitment to map out and roll out successful model schemes.
Community pharmacy must engage with the hospital service. One way is the production of joint formularies. Realignment of hospital admission and discharge services would also be helpful. It was noted that some services were being relocated from Primary Care Trusts to LHCCs.
The partnership must be both horizontal and vertical. Managed Clinical Networks had many implications. Communication was vital. It was important to identify the right people and their responsibilities. They must be able to link with others in the unified boards, local authorities, GPs and other agencies outwith the health service.
The links with unified boards may mean considerable changes in the constitutions of advisory committees.
There must be investment in IT and a commitment to IT development, complete with timescales. For proper integration of IT systems, a common drug dictionary is required, so that e.g. on different systems Aspirin = Aspirin = Aspirin.
Proper partnership with the staff involved in all of this is essential.
What Next?
All of the papers produced at the meeting are to be compiled into a report and sent out to attendees. Delegates were asked to identify what they felt should be the next steps. The response was
It was agreed that there should be a clear plan of what steps are to be taken so that everyone is clear on the timescales. However, it was pointed out that political will and timings may preclude some or all of the above happening as fully as desired.
COLIN RODDEN Secretary for Scotland Guild of Healthcare Pharmacists 20.5.01