The RPS Welsh Pharmacy Board (WPB) launched its manifesto in November 2015 and has spent the past year working on making its recommendations a reality. Mair Davies, director for RPS Wales, reflects on progress so far.
What progress has been made since the launch of the WPB manifesto?
The 2016 Welsh election results changed the face of the National Assembly for Wales. The WPB’s manifesto has been incredibly useful in leading discussions with new and re-elected Assembly Members on the work the RPS is doing and where we hope to see the pharmacy profession going.
We now have recognition from the Welsh government that pharmacist access to individual health records is needed
Our engagement with Vaughan Gething, cabinet secretary for health, has been very fruitful, as we now have recognition from the Welsh government that pharmacist access to individual health records is needed and must happen at pace, IT permitting.
As well as government, we’re working with royal colleges, particularly the Royal College of General Practitioners, to make sure there is an understanding of why we need this access. It is becoming ever clearer that we also need to encourage behavioural changes among patients. Going forward, we need to explain the expertise of pharmacists and why they are the right people to see for anything related to medicines, including medication reviews for which access to the record is vital.
Integration of pharmacists into multidisciplinary teams across the NHS is gaining real traction now and the RPS can take a lot of the credit for this. In December 2015, we published ‘Models of care for pharmacy within primary care clusters’ with NHS Wales to address the needs of pharmacy and the wider primary care team and we’ve continued to call for greater integration of the pharmacy profession into NHS services. Now we have pharmacists in primary care clusters and GP practices and a huge request for many more.
During our care home campaign, we worked closely with Sarah Rochira, the Older People’s Commissioner for Wales, who champions older people across Wales. Pharmacists absolutely need to be involved in the management of medicines in care homes — the commissioner is an advocate for this and has the authority to challenge health boards on the delivery of changes to improve the use of medicines in care homes.
We’ve also worked with the Royal College of Physicians, the Royal College of Psychiatrists, Macmillan Cancer Support and the Alzheimer’s Society. But it’s not just the RPS board and staff; our members are doing a lot of work, too — there’s a collaborative approach to everything in Wales.
There is a huge need for us to use the skills of every health professional in Wales
Are you pleased with the Welsh government’s pharmacy commitments for 2016–2017?
We’re absolutely delighted with Gething’s statement confirming that there are not going to be cuts in the community pharmacy contract in Wales and that the contract is going to become more clinical and quality based. There is a huge need for us to use the skills of every health professional in Wales — we’ve got an increasingly ageing population with many long-term conditions and if you look at the principles of prudent healthcare it is all around multidisciplinary working.
Gething and Richard Lewis, the primary care lead for Wales, have promised an ongoing commitment to primary care in Wales. We’ve developed the Welsh Pharmacy Partnership in Wales, which brings together the chief pharmacists and the key contractual and professional pharmacy bodies to make sure that, as a profession, we’re heard with one voice. Working collaboratively at an early stage means we’re able to talk to the government knowing that everyone is supportive of what we’re saying.
What further work needs to be put into action?
Establishing a pharmacy-led Welsh chronic medication service — in which a pharmacist would offer patients structured support, advice and review of their medicines — is vitally important for patient care in Wales. We’re not envisaging there being a service for about another five years, but we will continue to call for this important service.
We’re also working on a campaign to help make space for pharmacists in the routine care of people with long-term conditions. It’s something we need to address because not only is current care costing the country a fortune but patients are not getting the most from the NHS. We have a role in demonstrating that if you involve pharmacists in long-term conditions, they can make a real difference.
It is incredibly difficult in times of austerity when budgets are continually being cut and the population is increasing and ageing
What challenges do you envisage in 2017?
Driving change. It is incredibly difficult in times of austerity when budgets are continually being cut and the population is increasing and ageing. There is a huge opportunity for pharmacy at the moment and the RPS has got a really big role to play in seizing that opportunity. In 2016, we managed to get into all of the strategic meetings — there’s no point coming in at the end when the strategy has been written and pharmacy isn’t in it. For example, in the writing of the Welsh dementia strategy, we have had a seat around the table from the start.
There’s a significant amount of work to do to transform community pharmacy and we will support community pharmacists to embrace changes to the contract and the changing shape of primary care in Wales.
We still have a lot of work to do around medicines management in care homes — it’s probably the most successful campaign we’ve had but we won’t sleep until we see our recommendations implemented across Wales. Long-term conditions are going to be a challenge because it hasn’t been very high on the agenda in Wales so we need to push it up. And the challenge across all of Great Britain is the rebalancing of medicines legislation with regulations that affect pharmacy practise, and making sure that is fit for purpose.
Finally, our medicines safety conference, held in Cardiff in November 2016, was an absolute success so it will be a challenge to improve on that in 2017.
What do you hope to achieve by the end of 2017?
I really want us to deliver a successful campaign that helps the public understand what a pharmacist does and to increase public confidence in seeing their pharmacist to get medicines advice. Demonstrating the evolving pharmacist roles and the breadth of underpinning knowledge involved in a pharmacy qualification is also a key area of work that needs attention this year.
One of our key work streams in Wales in 2017 is going to be palliative and end-of-life care — we’re going to develop the policy this year with a view to launching a policy and recommendations in 2018.
We will also continue to engage with Welsh government and the NHS to get them to understand that the RPS Faculty is a tool they can use to fulfil their governance as part of their quality assurance programme.