In January 2016, RPS Scotland launched its manifesto ‘Right medicine – better health – fitter future’. The document, which was released ahead of the Scottish Parliament elections on 5 May 2016, urges MPs to “resource and empower pharmacists to enable them to provide more patient care”. In the run up to the elections, RPS Scotland is working with current MSPs and new candidates to help generate an understanding of the role of pharmacists in Scotland and get pharmacy on the political agenda.
How many pharmacists were involved in developing the manifesto?
We have had input from more than 300 members overall. We sent out an electronic survey to all members in Scotland, polled the members at several local practice forum meetings, and discussed the issues with attendees to our first Scottish National Seminar held in August 2015. Members were also invited to give us their views informally through the virtual network, social media and through feedback from pharmacy stakeholder meetings.
What were the outcomes of the recent out-of-hours report and how are you planning to implement them?
Pharmacy had a good outcome from the national primary care out-of-hours review and our joint submission was well received. The primary focus of the recommendations was around access to the electronic record, increased use of the minor ailment service (eMAS), extension of the use of patient group directions (PGD) and the development of enhanced clinical skills for pharmacists.
We have been campaigning for access to the electronic emergency care summary (ECS) for years, but ultimately we want access to the electronic patient record. We plan to continue lobbying until we see progress.
Promoting and expanding what is provided under eMAS would help cement the position of community pharmacy as the first port of call for minor illness and we will work hard to promote this service to the public.
With regard to PGDs, some of our health boards have already started to introduce initiatives for conditions such as uncomplicated urinary tract infections in females, shingles and impetigo.
We would also like to see community pharmacists being part of anticipatory care plans for chronic conditions and a formal arrangement in community pharmacies regarding extended opening hours and a GP out-of-hours service. This would hopefully lead to a more integrated level of service provision out of hours, enabling the development of a national direct referral and clinical handover framework between community pharmacists and other healthcare professionals.
The joint RPS/NHS Education for Scotland seminar on 17 May 2016 will allow us to further discuss the recommendations made in the report.
Why do you call for pharmacists to be positioned at the point of admission in hospitals?
Having a pharmacist work at the point of admission will improve patient safety by ensuring that medicines-related issues are quickly dealt with before the patient goes to the ward. This will help prevent further risk of harm at the start of their hospital stay.
We’re also keen to see pharmacists in A&E, to attend to patients with minor illnesses normally treated in the community pharmacy. With enhanced clinical skills, a pharmacist in this setting could deal with a wider range of minor conditions, easing the pressure on the department and the health service.
England and Wales launched their care homes campaigns in February and March 2016 respectively — is Scotland planning to do a similar level of campaign this year?
Scotland launched its report ‘Improving Pharmaceutical Care in Care Homes’ in 2012, which made strong recommendations around improving patient care in the care home setting. We continue to work with the Scottish government and other stakeholders to implement these initiatives.
What is currently being done to support independent prescribers in Scotland?
National Health Education for Scotland (NES) is currently expanding the independent prescriber training programme to support the government’s ‘Prescription for Excellence’ plans. The Scottish government has also committed to investing £16.2m over three years to recruit pharmacists with advanced clinical skills, including prescribing, to work with GP practices. These pharmacists will have patient-facing roles and will provide care to patients with long-term conditions.
However, to produce an increased number of prescribers we need to increase the number of ‘designated medical practitioners’ to support the required competence assessment and sign-off. At present, only a medic can do this but we want to see the rules changed to allow experienced pharmacist independent prescribers to do this too.
How did participants at your Public and Patient Seminar in June 2015 view the role of pharmacists?
Participants at the seminar were astounded that we did not have access to their records in the community pharmacy. Also, they were not fully aware of all the services provided by their community pharmacy, and had little knowledge that there are pharmacists in hospitals. This reinforces the need to raise public awareness of what pharmacists can do.
What resources do you think pharmacists need to deliver better health services to the public?
Scottish members have stated that having more pharmacy technicians in the community setting would help support the delivery of better services by freeing up more of the pharmacist’s time to spend with patients. Another important issue for our members was pharmacists having protected learning time during the working day, similar to that enjoyed in GP practices. This would ensure that pharmacists can undertake professional development that will benefit the local populations they care for.
Have you made any progress with MSPs so far on the points in the manifesto in the run up to the elections in May 2016?
We’ve had a lot of interest in pharmacy visits from current MSPs and candidates planning to stand — several have already signed the manifesto to show support. With many long-standing MSPs standing down at this election, we have a lot of work to do to generate an understanding of the role of pharmacists among new candidates. We hope that some of our manifesto points will be included in those of the individual political parties — the concept of health literacy from an early age in the school curriculum was well received by those politicians we’ve engaged with so far.