|
Ray Fitzpatrick is clinical director of pharmacy at
Royal Wolverhampton Hospitals NHS Trust and chair of the Hospital
Pharmacists Group committee of the Royal Pharmaceutical Society.
He chaired this year’s Hospital Pharmacist conference. |
Coverage of this year's Hospital
Pharmacist conference
|
The title of this year’s Hospital Pharmacist annual conference
was “Pharmacy at the interface — bridging the gap”.
In theory there should be no gap for us to bridge, as we have been talking
about seamless care for at least a decade.
However, gaps do exist and have existed ever since the NHS was fragmented
in the early 1990s.
Some commentators have referred to the interface of primary and secondary
care as the “careless seam” rather than seamless care. If
we as health care professionals perceive there is a gap, how must our
patients feel?
NHS changes
It is timely and no coincidence that the interface was the focus of
this year’s conference, as there are major changes being implemented
within the NHS which will impact on interface working. In England we
are seeing the merging of strategic health authorities which in many
cases bear a striking resemblance to old regional health authorities.
Primary care trusts are also set to merge in order that their boundaries
will be more similar to those seen in social care. Here again, the similarity
to old district health authorities is not lost on some of us.
Furthermore, some trusts have been granted foundation status with much
more freedom to manage their health care business. However, not only
are the organisational structures changing, but also the systems and
processes which work between the various organisations.
Although the concept of money following the patient has been at the centre
of the NHS agenda before, only now do we have a funding system emerging — payment
by results, where this actually happens in practice.
The Government has talked about a primary care led-NHS for a number of
years, and with the advent of practice-based commissioning, there is
the opportunity for real, and perhaps radical change in the models of
care for patients. There is also a real drive from the Government that
patients should have more choice in where they want to be treated, and
a plurality in secondary care providers.
Practical examples
Therefore, this year’s conference was not only timely in its content,
but provided a line up of speakers with considerable expertise in various
areas of practice to discuss some of these issues in the context of medicines
management across the interface.
Richard Seal from the National Prescribing Centre described tips for
effective working across the interface, derived from the experience of
participants in the NPC’s hospital pharmacy medicines management
collaborative. Not surprisingly, communication featured as one of the
key issues.
Sharon Hems from Lothian Health Board presented a practical approach
to developing a joint formulary for primary and secondary care. Lothian
Health Board has been in the vanguard of formulary development for many
years, so this was an excellent model of good practice.
Another practical presentation came from Anita Hogg, clinical services
development pharmacist from Antrim Area Hospital in Northern Ireland,
who described her hospital’s approach to integrated medicines management
across the interface.
The emphasis changed a little when Sue Ashwell, director of medicines
management at Hinchingbrooke Health Care NHS Trust and Huntingdonshire
Primary Care Trust and Val Shaw, chief pharmacist, Greater Peterborough
Primary Care Partnership and pharmacy services manager at Peterborough
and Stamford Hospitals NHS Foundation Trust, described their pioneering
roles as senior pharmacy managers straddling both primary and secondary
care. What they described was in fact the role of director of medicines
management for a whole health community. Could this be the vision of
the future, many of us pondered.
The vision theme continued with Keith Farrar, clinical specialist at
CSC Computer Services explaining how the use of IT as part of Connecting
for Health could facilitate better medicines management across the interface.
Mr Farrar emphasised that IT merely facilitated better practice, it did
not change practice per se — that is our job.
The final presentation, from Duncan Jenkins, specialist in pharmaceutical
public health from Dudley PCTs, gave delegates a glimpse of the future,
albeit the near future, when he described practice-based commissioning
and payment by results. Although these issues may seem like the domain
of NHS managers, the audience was left in no doubt that they would impact
on day-to-day hospital pharmacy practice.
Delegates at the conference benefited from the experience of practitioners
from a range of different perspectives explaining why and how we could
bridge the interface between primary and secondary care. However, they
were given the clear message that the NHS landscape is subtly (or not
so subtly) changing. Clearly we must move out of our silos in primary
and secondary care, and start working together to take a more holistic
approach to medicines management across the whole health community.
|
Hospital Pharmacist