What were the biggest challenges for the RPS in your nation in 2014?
David Branford (DB): To engage with the healthcare agenda and in particular the NHS. The impact of the complete loss of the pharmacy NHS managed service infrastructure in the community and the lack of representation within any of the new structures is still being felt now.
We are continuing to campaign in these areas but, against a backdrop of NHS management cuts, it is tough.
We were active in engaging the senior leadership in NHS England and Westminster, including meetings with Lord Howe, parliamentary under secretary of state for quality, and health secretary Jeremy Hunt over the party conference season, as well as Keith Willett, who is leading NHS England’s urgent and emergency care review. I am pleased to be part of the urgent and emergency care delivery group, where our ideas for a wider role for pharmacists are being listened to and acted upon.
“We need to create up to 20,000 jobs for pharmacists”
David Branford, chair of the English Pharmacy Board
Mair Davies (MD): Undoubtedly, these were the Prudent Healthcare agenda and the ‘Trusted to Care’ report. These demand significant changes to the way health professionals work together to minimise patient harm and to create the conditions for shared responsibility between professionals and patients.
The Welsh Pharmacy Board (WPB) and the pharmacy profession have risen to these challenges by offering solutions to the Welsh Government, while increasing the profile and confidence in the profession.
John Cromarty (JC): There were quite a few challenges in 2014: firstly, influencing and agreeing on the many aspects of the proposed changes to medicines legislation on items such as the decriminalisation of dispensing errors and supervision, and the challenges around the Falsified Medicines Directive. It is really important that we get this right to improve pharmaceutical care and patient safety.
Other challenges included sustaining our substantial Scottish Pharmacy Board work programme while dealing with the increased volume of Great Britain-wide work on some of the important items just mentioned.
We also carried out engagement work with community pharmacists who are concerned about the implications of ‘Prescription for Excellence’ (PfE) – the Scottish Government’s action plan for community pharmaceutical care – for their practice and their role in its implementation.
What were your board’s main successes in 2014?
JC: Our main successes included our support for the principles and ambitions of PfE. It is important that the Society continues to play a leading role that is inclusive of the whole profession.
We delivered a robust political advocacy programme with the Scottish Parliament and raised awareness of the further contribution the profession can make to patient care. Important areas such as the Faculty, our Foundation programme and all our standards and guidance will help us achieve our ambitions.
“Raising awareness of pharmacists’ clinical role will be important”
, chair of the Scottish Pharmacy Board
Our successful antimicrobial resistance event at the Scottish Parliament on 18 November 2014 prompted a Parliamentary debate on this important issue that is scheduled for the New Year.
Delivering our ambitious work streams while still managing our costs within strict budgets has helped the Society get to a stronger place as an organisation.
MD: Collaborative working was definitely the theme for the WPB in 2014. We are working with the Royal College of General Practitioners (RCGP) and the Royal College of Nursing (RCN) on antimicrobial stewardship, and with the RCN on medicines management issues in secondary care.
We also worked with the pharmacy profession through the Welsh Pharmaceutical Committee to produce the ‘Your Care, Your Medicines’ report, and are currently producing ‘Prudent Pharmacy’, an electronic resource that will be incorporated into the Welsh Government’s resource to make Prudent Healthcare happen.
The Annual Medicines Safety Conference is also going from strength to strength and is now a key event in the Welsh healthcare calendar, attended by many professions, NHS Wales and Welsh Government.
Our major successes have been in taking forward the engagement agenda. In 2013’s ‘Now or Never’ report, Judith Smith, director of policy at the Nuffield Trust, challenged us to be on the lips of commissioners and at national level we have made real progress. Public Health England and NHS England view better use of pharmacies and pharmacists as a solution to many of the health service’s problems.
That we now have political backing for community pharmacist access to care records is extremely helpful in putting the NHS England pilot programme in place. The production of the first toolkit from the Innovators Forum, supported by English Pharmacy Board members Mahendra Patel and Claire Anderson, is a great achievement for a group that didn’t exist 12 months ago: expect more from his forum.
We had a presence at all three party conferences, and met with all front-bench teams. As we are heading towards a general election, it was vital that pharmacy got its message across.
What major issues will pharmacy face in 2015, and what does the RPS plan to do in response?
DB: Two major issues are workforce and localism. The burgeoning size of the pharmacist register and the refusal by government and universities to manage student numbers presents us with a challenge and an opportunity.
The RPS is focusing on five main priority areas that will provide a greater demand for pharmacists and be of value to the NHS. We need to create between 10,000 and 20,000 jobs for pharmacists and my view is that if we begin to create the clinical roles in the community in the same way as they developed in hospitals, then that is achievable.
However, if we see yet more schools of pharmacy open and the huge student intakes maintained, then there is no possibility of that number of jobs. We plan to keep the pressure on the student numbers issue.
The localism agenda presents us with another big challenge. Most pharmacy bodies are organised on a national basis, as is the community pharmacy contract. We are being very successful in getting pharmacy on the national agenda; we need to translate that into local action.
In order to take advantage of the potential for local services, all the local pharmacies need to be able to work together and collaborate more with other services, such as secondary care. In the past there would have been pharmacists employed to advocate for them and help coordinate them; now it depends on individual relationships and enthusiasms. We plan to lobby for pharmacist places by right on health and wellbeing boards and other key infrastructures in the new NHS.
JC: We need to unite the profession to support the implementation of PfE in the presence of strong government backing for improving the pharmaceutical care of vulnerable patient groups.
We will do this through local practice forums and, at national level, through our contribution to working groups and a national symposium to bring together pharmacy bodies. We intend to develop a strategy and work programme to support members who wish to engage with PfE in different ways, suited to their level and area of pharmacy practice.
We also aim to increase the proportion of prescribing pharmacists in Scotland and examine how to increase pharmacists’ involvement in direct patient care. We will work with colleagues from England and Wales to ensure the Rebalancing Medicines Legislation work delivers for the profession’s future.
Lastly, we will step up our advocacy to ensure pharmacists have access and input into a shared electronic patient record.
MD: This year, it is likely that the Welsh Government will progress their local service agenda, shifting more care into the community, and this will present real challenges for all health professionals, including the pharmacy team.
“The Welsh Government’s local service agenda will challenge the pharmacy team”
Mair Davies, chair of the Welsh Pharmacy Board
We have developed ‘Your Care, Your Medicines’ to support this and are currently working on a manifesto to help influence the future of primary and community care and the role of community pharmacy.
What are your priorities for 2015?
Our key priorities for 2015 are to promote the key principles of ‘Your Care, Your Medicines’; develop a manifesto for pharmacy to influence the 2016 Welsh Assembly elections; and to raise awareness of pharmacy with the Welsh public.
In addition, we will organise and host the 5th Annual Wales Medicines Safety Conference.
DB: We want to make sure pharmacists are included as part of the wider health team, creating new roles for pharmacists and challenging the status quo.
The board’s current priorities are our five campaigns: improving urgent and emergency care through better use of pharmacists; pharmacists and GP surgeries; pharmacist-led care of people with long-term conditions; pharmacist access to patient health records; and pharmacists improving care in care homes.
JC: We have a comprehensive and ambitious 2015 business plan, based around enhancing the role of pharmacists in the NHS through our advocacy work programme. We will launch and promote our manifesto intentions for the Scottish 2016 parliamentary elections and develop political engagement to promote pharmacists’ contribution to patient care.
We will support our members to develop their practice through our RPS Faculty, Foundation and Leadership and Mentoring programmes, and help to ensure our standards and guidance are put into practice, to improve patient care. In addition, we plan to support the Scottish Government’s PfE ambitions by helping the profession engage with this vision and ambition to improve pharmaceutical care for patients in a way that is inclusive, recognising some of the challenges that need to be overcome along the way.
Our work will continue with our various partnerships, including those with the Royal College of General Practitioners, NHS Education for Scotland, health and social care organisations, patient groups and the NHS, to maximise pharmacy’s position within healthcare for patients’ benefit.
Raising awareness of pharmacists’ developing clinical role will be important to gain support from patients and the public. It is also extremely important that we work with partners to develop leaders with expertise so that pharmacists can make an important contribution to the health and social care agenda.
We will argue and advocate that the government should commit more resources to positioning pharmacists in the healthcare system to achieve national pharmaceutical care ambitions. It’s going to be another busy and exciting year as we strive with all stakeholders to move the profession forward.