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“New ways of working — delivering the
mental health pharmacy workforce” was held in York on 28
February. It was organised by the National Institute for Mental Health
in England New Ways of Working team in partnership with the College
of Mental Health Pharmacists, the Royal Pharmaceutical
Society and the United Kingdom
Psychiatric Pharmacy Group.
Ian Maidment is vice
chair of the UKPPG
Siobhan
Chadwick is workforce specialist
in the New Ways of Working team
Graham Parton is chair of the
UKPPG |
Graham Parton: significant variation in mental health pharmacy staff
levels across trusts |
Delivering the mental health pharmacy workforce
There is a significant variation in the number of mental health pharmacists
and technicians working in trusts across the UK, early survey results
show.
Graham Parton, chair of the United
Kingdom Psychiatric Pharmacy Group,
presented preliminary data on the first national survey of the mental
health pharmacy workforce carried out since 1996. The survey was commissioned
by the New Ways of Working in Mental Health team, which is part of the
Care Service Improvement Partnership. A postal questionnaire covering
workforce issues, activity and trust dimensions was sent to chief pharmacists
or medication management leads in January, and to date 39 out of 80 questionnaires
have been returned.
One notable finding is the significant variation in reported staffing
levels. The number of pharmacists per trust varied
from 0.3 to 16.6 whole time equivalents (mean = 5.2) equating to 0.03
to 1.9 WTE (mean = 0.764) per 100,000 population. Staffing levels for
pharmacy technicians showed a similar variation.
Some common themes emerged when chief pharmacists and medicines management
leads were asked about clinical activity. Clinical services to community
mental health teams were considered to be limited, ad hoc and non-structured.
For example, few community teams had access to
specialist medicines management advice. Respondents also commented on
the difficulties of working with service level agreements with other
organisations to
provide pharmaceutical services. These included poorly performing services,
difficulties in developing robust clinical services and the perception
that mental health is a low priority for the provider. Other areas highlighted
included problems with recruiting, retaining and training staff and the
increasing clinical needs of community teams.
Mr Parton concluded by suggesting that although the results will be forwarded
to the Department of Health, the whole pharmacy profession needs to consider
the findings —in particular the service organisational aspects
of providing robust clinical pharmacy services to community teams.
Other workforce issues
Working in isolation, a limited number of experienced clinical pharmacists
and, in some cases, difficulties with services provided from acute trusts
via service level agreements are all challenges affecting the provision
of mental health pharmacy services, according to Stephen Humphries, associate
director of the National Institute for Mental Health in England and chair
of the conference.
Dr Humphries described the overall concepts behind the “New ways
of working” (NWW) strategy — using staff to the best advantage
by ensuring the most appropriate use of each person’s knowledge
and skills. NWW is an innovative, collaborative change process, with
staff, service users and carers working together to improve practice
and quality for a modern and efficient service.
Peter March, associate director of the NHS Integrated Service Improvement
Programme described how the ISIP programme aims to help organisations
by delivering a single, consistent approach rather than the current systems
which are fragmented. Its role is to identify and share evidence-based
best practice, benchmarks and measures for performance by understanding
the processes for effective change delivery and maximising the benefits
from investments in people, process and technology.
The profile of mental health within the modern NHS was discussed by Peter
Pratt, chief pharmacist, Sheffield Care Trust. Giving delegates an outline
of psychiatric pharmacy in 1980, he suggested that although mental health
pharmacy has developed over the past few decades, it is still somewhat
of a “Cinderella service” failing to feature in Department
of Health strategic pharmacy documents. Mr Pratt pointed out that medication
within mental health is emotive and complex with risks including inappropriate
dosing, poly-prescribing, and inadequate patient monitoring.
The National Service Framework for mental health, despite not mentioning
pharmacy, acknowledges that clinical teams may lack medicines management
skills. Mr Pratt maintained that pharmacists within such teams need to
develop relationships with patients, carers, prescribers, other professionals
and the pharmaceutical industry, and understand that different groups
may have different viewpoints regarding the risks and benefits of treatment.
He calculated that for every clinical team to have access to an experienced
pharmacist the average mental health trust would need to employ 40–50
pharmacists. |
Hospital Pharmacist