The Pharmaceutical Journal
Vol 268 No 7197 p661
11 May 2002

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Association of Scottish Trust Chief Pharmacists

Teamwork will progress pharmacy strategy

No group of pharmacists can deliver the pharmacy strategy for Scotland alone, said Frank Owen, chairman of the Scottish Pharmaceutical General Council. Different groups must work together, and local partnerships must include the pharmacy contractor committees.

Mr Owen said that all health boards are required to support the strategy and the SPGC will support bids through both trusts and boards by liaising with the Scottish Executive Health Department to ensure implementation of the strategy across Scotland.

An SPGC working group will review all plans across Scotland and engage with local contractor committees to involve as many community pharmacists as possible. Key priorities for the future are pharmacies becoming walk-in health centres, resource implications of repeat dispensing schemes, staff training issues, a new remuneration contact, continued links within model schemes initiative, electronic transmission of prescriptions and direct supply of medicines, and communications and data collections on current work practices.

Specialists in public health

The strategy's demanding agenda cannot be delivered without teamwork between pharmacy organisations in Scotland, said Lyndon Braddick, chairman of Scottish Specialists in Pharmaceutical Public Health.

Specialists in pharmaceutical public health have various roles in health boards and therefore have interests across the pharmacy spectrum. "Pharmacy for Health", a review of pharmacists' contribution to public health, has been commissioned by the chief medical and pharmaceutical officers for Scotland and is due to be submitted to the Scottish Executive Health Department by June. It will contain an introduction to public health issues, a policy context for public health improvement, issues relevant to pharmaceutical public health, the basis of pharmacy as a public health profession, recommendations for the future, and examples of current pharmaceutical public health contributions.

Current work on assessing pharmaceutical needs for local populations involves identifying a needs assessment methodology, developing resource packs, collecting information on current service provision, input to developing public health data sets, and creation of subgroups to address specific issues.

A pharmaceutical public health workforce needs to be developed to ensure that the profession has the skills required to deliver the public health agenda. Requirements include multidisciplinary working, involvement at both undergraduate and postgraduate education and training, standards for accreditation and revalidation of training, and the involvement of both specialist practitioners and the general pharmacy workforce.

trust chief pharmacists

Teamwork is the only way to achieve the strategy's goals, said Pat Murray, chairman of the ASTCP. Although strong partnerships have already been established within pharmacy, there is a need to work with other health care and social work teams while focusing on the patient and carer.

Describing work on improving patient health, Mrs Murray said that, building on Clinical Resource and Audit Group guidance, the ASTCP has worked towards developing clinical pharmacy in both primary and secondary care. There has been work towards optimising medicine use and developing guidelines for risk assessment for the patient journey to support the management of misadventure with medicines. The Model Schemes Initiative in Scotland shows examples of improving patient care, and the ASTCP is continuing to work with the director of the initiative. Development of pharmacy locality groups provides the opportunity to embrace many projects and bring together a wide variety of pharmaceutical care issues.

In the area of improving access, work has been going on to provide patient advice areas in community pharmacy and to improve pharmacy premises in general. Work is also being done with community pharmacies and secondary care colleagues to improve out-of-hours services. To support NHS 24, medicines information pharmacists have produced drug monographs and training programmes to help call handlers deal with enquiries about medicines.

The extension of prescribing status will also require a significant input from medicines information pharmacists. Partnerships are being created between pharmacy and other professions to develop supplementary prescribing for nurses and pharmacists.

On service redesign, Mrs Murray said that in 2001–02 cancer services had been the focus for joint work by ASTCP and the Scottish Executive pharmacy team. Pharmacy's contribution to cancer services has been recognised through major investment in equipment and staffing across Scotland. The lessons learned from the work in cancer will be extended into other.

Similarly, work for CRAG on preparing injectable medicines has been the result of close collaboration. The ASTCP has worked with the multidisciplinary team to review this area of high risk and produce a blueprint for the way forward. This document is out for consultation but appears to be receiving widespread acceptance throughout all professions in Scotland.

A key issue for the coming year is "one-stop dispensing", which should improve medication history taking, reduce waste and allow patients to control their own medicines. A working group has been formed to learn from existing UK experiences and to set standards and performance indicators for this important re-engineering project.

Information technology must be better exploited. Lessons must be learned from countries that have harnessed IT in different ways to release staff resources to concentrate on pharmaceutical care. Experience from a pilot project on electronic prescribing and medicine administration in Ayr will be used to help the rest of Scotland develop such programmes. Links between GP practices and community pharmacists in Irvine are also in the pilot stage and lessons learned from this require to be extended to the rest of Scotland.

The Society

Key action points for the Royal Pharmaceutical Society in Scotland were described by Alison Strath, chairman of the Society's Scottish Department. One area on which the RPSiS was focusing was the development of technicians as a profession in their own right with suitable training and infrastructure. Another area was linking pharmacists' continuing professional development needs to revalidation and fitness to practice. A further area was workforce issues. United Kingdom workforce planning needed a Scottish dimension and workforce planning in the Scottish NHS needed a pharmacy input.

In the area of clinical governance, the profession needed to define professional and service standards, to standardise practice, to take responsibility and to be accountable for its actions. Finally, in the area of leadership and communication, the profession needed to define and invest in leadership and ensure that communication was two-way throughout the service across all sectors.

Service redesign

In a keynote speech, Bill Scott, Chief Pharmaceutical Officer for Scotland, said that service redesign is necessary to empower both patients and staff and make use of current technology. The delivery of pharmaceutical care will reduce the risk to patients, but it will require support from both education and training resources and research and development programmes.

He added that the Scottish Executive is confident that pharmacy will grasp the opportunity and develop the service changes necessary to improve patient care.
— Contributed by Kate McKean (chief pharmacist, South Glasgow University Hospitals NHS Trust).