In a presentation to the Clinical Pharmacy Congress held in London on 27 April 2018, Ann Jacklin suggested that the second stage of the review could seek to recommend practical solutions to free up hospital pharmacists’ time to do more clinical work.
Jacklin said that this proposed “do once” drive would include a national database of educational materials, policies and procedures for all hospital pharmacists to share, including all patient group directions (PGDs).
The second Carter review will focus on efficiency in mental health and community trusts, but will also make some recommendations that it could “retrofit” to all NHS trusts, said Jacklin, who led the Hospital Pharmacy and Medicines Optimisation Project as part of the original Carter review.
Similarly to the previous Carter review into acute trusts — published in 2016 — the second review will say that hospital pharmacists in mental health and community trusts are spending only a quarter of their time in patient-facing roles.
In his first review, Lord Carter recommended that NHS trusts use at least 80% of their pharmacist resource for direct medicines optimisation activities, medicines governance and safety.
“It doesn’t look like we are meeting pharmaceutical need. Now that is not true for all trusts, but we are trying to find evidence of what good looks like,” Jacklin told the audience. “We might be saying something like, it is value to have pharmacy staff running clinics.”
Jacklin said she could not definitively confirm what would be in the final report before its publication and owing to local election “purdah”, but did say that all PGDs “look the same”, and that the review could recommend a system to stop duplication of paperwork.
She told the audience: “We are going to set up a ‘do once’ national system. We are going to take all that time it takes you that is not clinical, and we are going to stop it. And then we are going to retrofit it to the acutes.”
She added: “We don’t know how, but we are going to do it.”