English Pharmacy Board meeting: 5 April 2017

The Royal Pharmaceutical Society (RPS) English Pharmacy Board’s (EPB) second quarterly open meeting of 2017 was held at the School of Pharmacy, University of Nottingham on 5 April 2017.

Guests at the meeting included: Usha Kaushal, lead operational pharmacist at NHS 111 Yorkshire Ambulance Service (YAS); David Bearman, chair of Devon Local Pharmaceutical Committee (LPC) and of Devon, Cornwall and Isles of Scilly Local Professional Network (LPN); Beth Walton, a preregistration pharmacist and member of Notts and Derby LPF; Harry Cotterill, a pharmacy student at the University of Nottingham and a member of West Yorkshire Local Practice Forum (LPF); and John Sargeant, chair of Derbyshire LPC and Robert Severn, chair of Nottinghamshire LPC.

Pharmacists in NHS 111

Usha Kaushal briefed the board on the experience of pharmacists working for YAS’s NHS 111 service, a helpline intended for use by the public for urgent medical enquiries that are not emergencies. Between April 2016 and March 2017, Kaushal told the board that YAS’s NHS 111 line triaged 1.3 million calls, of which 9,446 were handled by pharmacists. A total of 5,515 of those calls were enquires about medication. After speaking to the callers, pharmacists were able to close 57% of the calls as suitable for home management. Kaushal also reported that 16% of pharmacy-related calls required a repeat prescription, and fewer than 2.5% were referred to A&E.

She added that as part of the NHS 111 team pharmacists also advise the other medical staff, preventing callers being directed to the wrong services and reducing referrals to out-of-hours GPs. According to Kaushal, such direct access to pharmacist expertise brings economic benefits to the NHS. However, she did highlight some current issues facing pharmacists working for the service, including the use of zero-hours contracts at band 7 and band 8a. This, she says, is causing some attrition from the role.

New models of local engagement

Christopher John, workforce development support at the RPS, asked the EPB panel to approve new models of local engagement created by the RPS’s local engagement task and finish group. After discussion with, and feedback from, local practice forum (LPF) steering group and members, three models of local engagement have been developed. The models are, essentially, frameworks for how a LPF can plan an annual programme of events. Each of the three models offers a different style and extent of member engagement, and LPFs would be able to choose the model best suited to their location and present circumstances. Such a system would, said John, encourage nationwide consistency in member networking opportunities — at present, some LPFs are very active while others, for various reasons, are less so.

Through research and discussion with members and LPFs, the local engagement task and finish group identified the need to extend digital access to local engagement. This could take the form of webinars delivered locally, rather than from RPS headquarters, and John also raised the possibility of using Periscope, a live video-streaming app used to broadcast over Twitter. Digital material could also be saved and stored online for greater access after the event. This approach is especially pertinent in rural areas — Alex MacKinnon, interim chief executive of the RPS, pointed out that many areas in Scotland, including the islands of Shetland and Orkney, already use digital communications to link with the Highlands.

The board approved the proposed models, and they will now be piloted across England during 2017. Following feedback, final models should be established by the end of the year.

Research focus

Catherine Duggan, director of professional development and support at the RPS, reported on activities from the RPS’s research and professional development and support departments. An ‘ultimate guide’ for pharmacists working in urgent and emergency care was released in January 2017, and an emergency supply ‘mythbuster’, dispelling two common myths on the subject, was published in March 2017.

Duggan also reported that data from the member-only confidential professional support service reveals that the top three areas of enquiry in recent months were professional development, pharmacy practice and pharmacy legal and ethical issues.

The RPS is also hosting, and has published, new professional standards for optimising medicines for people in secure environments. The NHS England immigration removal centres medicine improvement programme working group, with the health and justice sector, have developed these new standards based upon the RPS’s existing professional standards for hospital pharmacy services.

In terms of research activities, Duggan reported that the RPS museum has now completed installation of all new displays, and is currently finalising content on a new museum app designed to showcase highlights for the collection.

Beyond Brexit

Next, board member Sultan ‘Sid’ Dajani briefed the EPB on current Pharmaceutical Group of the European Union (PGEU) initiatives, and discussed options leading up to and beyond Brexit. The RPS is currently involved in 18 projects in 28 directives, including the Falsified Medicines Directive due to be adopted into UK law in February 2019.

Dajani said that it is important to note that at present, European law, managed by the European Commission, takes precedence over national law in all member states. We are still bound by EU rules for at least another two years. The RPS is “heavily involved” in European matters through the PGEU, and will continue to “fathom the effect [of Brexit] on international relations and global pharmacy”. Dajani said he is already investigating what a future RPS role would look like, including the possibility of associate membership.

The RPS may, he says, be needed “like never before” to ensure Brexit does not put UK patient access to medicines at risk of undue delay. This scenario could occur if applications for UK licenses come after the EU licence, because of the UK’s smaller population.

Campaigning

Heidi Wright, English practice and policy lead, and Neal Patel, head of corporate communications, updated the board on current and future EPB work programmes and campaigns.

Adding to Christopher John’s presentation on new models of local engagement, they advised that a local engagement lead would be recruited by the end of quarter two.

In terms of national engagement, Wright and Patel said the priorities were to increase member and public recognition for the work of the RPS, support the showcasing of additional pharmacist roles (building on the success of pharmacists in GP surgeries), to develop influential relationships, and to systemise the way the RPS responds, on a daily basis, to external demands. A Britain-wide RPS ‘elevator pitch’ and key messages would be developed by the end of quarter two. Working with the corporate communications team, a suite of examples illustrating how members improve the care of patients will be established.

National campaigns planned for 2017 include a high-impact, influential antimicrobial resistance (AMR) campaign, to launch in July or August, which aims to increase awareness of how pharmacists across the sectors can promote rational use of antibiotics. The objectives include local and national policy change, investment in pharmacy profession (including training and services), media coverage, and member engagement through participation in campaign activities, use of campaign tools and social interactions. Member engagement in the campaign will be considered a major success measure, Patel said. Claire Anderson noted that drug development should be featured as part of this campaign.

The current campaign focusing on long-term conditions was discussed, with Wright noting that the imperatives of the campaign include reduction of waste, tackling polypharmacy, reduction of waiting lists in A&E, and increasing the number of pharmacist prescribers. Board member Ash Soni highlighted the importance of early mental health interventions in the management of long-term conditions, too.

The RPS’s mental health campaign will begin in quarter three, with full objectives still to be confirmed. Looking ahead to 2018, diabetes will be a campaign focus. Finally, a series of short member-facing campaigns will be created, using as a hook the success of the RPS campaign to integrate pharmacists into GP surgeries. On this point, Patel emphasised that the campaign, which started in March 2015, had within two years reached the point that 2,000 extra jobs in surgeries had now been created — a success that ought to be played back to members. Similarly, access to the summary care record is now up to 97%. These figures show, said Patel, that the RPS has influence, and it is important that this influence is recognised.

Patel also introduced John Lunny, who has recently joined the RPS as public affairs manager.

Take-home messages

Throughout the meeting the clinical skills of pharmacists were repeatedly discussed, with Patel saying that we need to take a message to other organisations that pharmacist’s clinical skills should be used more.

A key message from the meeting was that the RPS could better promote to members the campaigns undertaken, and how effective these campaigns are. Patel used the example of pharmacists in GP surgeries, noting that the RPS began campaigning on this two years ago and that now 2,000 posts have been created in England. There was broad agreement with this sentiment, with Sandra Gidley, chair of the EPB, noting that while much has been achieved over the last six years, there is still much to do.

• The next open meeting of the English Pharmacy Board is scheduled for 22 June 2017.