The staffing of most hospitals in Scotland with pharmacists is insufficient to roll out seven-day NHS services while maintaining safe and effective care, the Royal Pharmaceutical Society (RPS) has warned.
Hospitals need additional pharmacists to fill current gaps in clinical care on weekends and require more resources if they are to fulfil ministers’ vision of seven-day working, RPS Scotland says.
However, the Scottish government has already stated there will be no new funding for the initiative. Instead, health b
oards will be challenged to fund the expansion of services from within existing budgets.
Health and Sport Committee of the Scottish parliament will hold an evidence session on the initiative on 17 March 2015. In
a submission ahead of the session,
he RPS said:
“There is a clinical gap in pharmacy input at weekends which cannot be managed within current resources and staffing levels.
Workforce planning is required to better understand capacity needs and to resource new services adequately. Local situations will require local solutions and consideration needs to be given to consulting the current workforce to manage change successfully, with new staff employed on seven-day contracts.”
RPS Scotland cited anecdotal evidence from hospital pharmacists who attended a GB-wide RPS summit on the issue in 2014. These pharmacists had warned of the need to benchmark current staffing and create additional posts.
The RPS said that without clinical pharmacy input on weekends, medication and pharmaceutical care issues usually detected within 24 hours can be missed for days, while medical and nursing teams “may be without pharmaceutical advice to assist with complex cases affecting prescribing decisions and patient care”.
This can lead to missed doses, prescription errors, a lack of medicines reconciliation and delayed discharge due to waiting for discharge medication, it stated.
Weekend clinical pharmacy teams are “fully supported” by multidisciplinary teams in admissions units when seven-day services are provided, RPS Scotland said. “Gaps in patient care are identified when this resource is not available and this clinical input is currently only available for short periods using extra winter pressure resource,” it added.
“The RPS welcomes this Health and Sport Committee session on seven-day working and is particularly pleased that pharmacists have been invited to provide a direct input to this session,” says Aileen Bryson, policy and practice lead at RPS Scotland. ”We have had input from across our membership, including hospital and community pharmacy, highlighting key areas that need to be considered in order to enable the delivery of high-quality pharmaceutical care in accordance with patient needs.”
The Scottish government said the “approach to funding for this programme will be to make better use of our existing resources” in a paper on seven-day services published in March 2014.
“The default position will be to use our existing total resources differently in order to deliver improved outcomes,” it said. “In relation to job planning, [NHS] boards retain their existing ability to plan jobs to ensure the correct balance between time spent on clinical care and other contributions to the wider NHS agenda.”
A spokesperson for the Scottish government confirmed the intention to fund seven-day working from within existing budgets, but said “individual situations” would be considered.