Specialist pharmacy services must be put in place for patients with IBD

An article published by The Pharmaceutical Journal in April 2021 states correctly that, of the nearly 200 inflammatory bowel disease (IBD) services in the UK, only 13% have adequate expert pharmacy representation in their multidisciplinary team (MDT).  

In the UK, around 500,000 patients have been diagnosed with IBD and this has a considerable impact on the wider economy. This chronic disease can affect all aspects of patients’ lives, often from a very early age, and care for patients with chronic diseases is best led by a specialist MDT.

For the first time, UK IBD Standards, published in 2019, embed and describe specialist pharmacy services as an integral part of the IBD MDT, and enable recognition and commissioning of expert pharmacy practice. Both IBD UK and the Royal Pharmaceutical Society’s (RPS’s) Faculty programme have set out a roadmap for pharmacy workforce development in IBD, and mandate units to develop specialist pharmacy services.

This workforce transformation will be enabled by providing capability (UK Clinical Pharmacy Association [UKCPA] training pathway), motivation (RPS credentialing) and opportunity (commissioning of expert IBD pharmacy services mandated by UK IBD standards 2019).

A self-reporting benchmarking tool has been developed for quality assurance of services by IBD UK, and this defines A–D descriptors for all standards (A=‘excellent, proactive’ care, D=‘minimal, inadequate’ care). Descriptors for the four IBD standards describing specialist pharmacy services were developed in two consensus workshops by IBD UK with expert pharmacy representation.

So far, benchmarking shows a low level of pharmacy IBD expertise in the UK. A minority of services, ward pharmacists and patients have access to expert pharmacists in IBD. Less than half of IBD leadership teams work with an expert pharmacist and only a small number of services have adequate specialist pharmacist expertise commissioned.

The benchmarking tool highlights the high need for expert pharmacists in IBD, advanced competencies in pharmacy IBD practice, training pathways to develop future expert pharmacists in IBD and prioritisation of commissioning.

The UKCPA Gastroenterology Interest Group and the RPS are responding to this challenge to ensure high quality pharmaceutical care for IBD patients:

• The UKCPA is developing a training pathway, starting in 2021, with a series of IBD webinars, and is in the process of developing and/or endorsing training programmes focused on improving gastroenterology pharmacy leadership skills. This will support practitioners to develop their IBD expertise;
• Together with the RPS and British Hepatology Pharmacy Group, the UKCPA is developing the gastroenterology core advanced curriculum and practice standards for expert practice, which will support expert pharmacists in their specialist training and RPS credentialing on the path to becoming a consultant pharmacist in gastroenterology. For anyone working in IBD, recognised expert status (i.e. advanced practitioner level) will be essential for future job prospects.

Pharmacists need to be in a position to influence the delivery of IBD services in the best interest of our patients and the IBD standards, and the UKCPA/RPS gastroenterology training workforce transformation plan puts this in place for future pharmacists wanting to work in IBD.

Anja St. Clair Jones, gastroenterology consultant pharmacist and IBD UK steering group committee member