There are four areas I want to specifically focus on in this blog post with regard to pharmacy in Scotland and this specific review from Dr Hamish Wilson and Professor Nick Barber.
1. Public relations
This is an area which is growing in importance and needs to be given high priority. In recent times, we, as a profession, have faced some very unfavourable headlines/press stories, whether it's the Which? survey findings or the highly controversial and infamous 'Methadone Millionaires' story. In point 19 of the report, the image of the community pharmacy being seen as 'commerical' is mentioned and concerns were raised about staff changes and lack of continuity in terms of patient-pharmacist interaction when it comes to specifically communicating with the same pharmacist on a regular basis.
There is no doubt that community pharmacies have to be financially healthy in order to continue provision of the services they have to offer. They are not directly part of the NHS, but do provide NHS services which they are reimbursed for. Operating at a loss is no viable option. Community pharmacy contractors need to become profitable in order to survive. And I would go even further - the NHS can look to community pharmacy at a time like now when financial resources are becoming more finite than ever before. Community pharmacy provides excellent public health services to the public whilst at the same time maintaining a successful business model. Community pharmacy has nothing to be ashamed of when it comes to being branded as 'commercial', as long as it maintains it's professional and ethical commitments to healthcare and pharmacy service provision and remains within legal and ethical boundaries.
However, we pharmacists overall need to do a lot more when it comes to promoting a positive image of what we do and of ourselves. Operating within a new system which allows us to provide a consistent and high standard of quality, as suggested in point 19, is a very worthwhile suggestion and should be looked at further. The idea of a pre-booked appointment with a pharmacist within a system that fully supports this mechanism is understandable and I can see the logic behind this.
I would also suggest more of us should become media trained or develop an increased awareness of how to engage with the local and national media. Journalists will not just dismiss us hastily just because we happen to be pharmacists. They will listen if we have something worthwhile to offer them in terms of an enlightening story or development about what we can offer the public in terms of providing healthcare services.
Personally, as a presenter of a weekly radio show on Victoria Radio Network, I ran a regular feature up until July called 'Healthy Matters' where I enlightened listeners of the station in hospital, across Kirkcaldy and online about popular topics surrounding health such as healthy eating/living/exercise, smoking cessation and how to deal with the hot weather. Creativity goes a long way in any area of life and pharmacy is not exempt.
There are many ways for us to promote positive health and we pharmacists are blessed with the knowledge and ability to enlighten the public in a positive and helpful manner. And it will improve their perception of us as a profession.
2. Education/development
Pharmacists and pharmacy technicians have a professional obligation to commit to continuing professional development. NHS Education for Scotland, in my personal opinion, provide many excellent learning opportunities for pharmacists and after my pre-registration placement was completed south of the border, I benefited enormously from the seminars they had on offer towards the end of 2012 and in the early stages of 2013. I have no doubt that I will not be the only pharmacist who forms such an opinion or a similar assertion. Their support is vital and I am confident that it shall continue for a long time to come.
But the biggest challenge and worry for me is the lack of inter-professional networking. There is frankly next to none of it and sadly very little window for opportunity to enhance such opportunities to engage with other kinds of healthcare professionals. I recall at university taking part in inter-professional networking events which I found welcoming because it gave me the opportunity to talk to other healthcare professionals and share thoughts and ideas. But it isn't just the lack of inter-professional networking that worries me. I feel I'm not getting to know my other fellow pharmacy professionals in areas that I work in. And that's a shame because loneliness isn't exactly a comfortable feeling to experience. I like talking to new people and engaging with other people and that motivates and re-invigorates me. One of the benefits of the seminars provided by NES was that you got to communicate with other pharmacists and pharmacy professionals/employees.
The recommendation in bold on point 51 of the report is one of the most important - local networks, organised by local NHS boards, is an excellent idea. It will bring professionals and employees together, create new links and is especially important, because we have to remember that not every pharmacist or person involved in pharmacy is necessarily a member of the recently formed Royal Pharmaceutical Society. The fact that not everyone needs to sign up to the professional body means, inevitably, networking opportunities can only go so far. A recognition of the necessity for closer integration of pharmacy professionals can only be welcomed and seen as positive step forward, if the recommendation in point 51 is implemented.
3. Challenges for the profession
Point 60 highlights the need for pharmacists to be inter-connected with other healthcare professionals when it comes to accessing relevant information about a patient's medicines and care. The biggest drawback for pharmacists in community is a lack of access to doctor's notes and records for patients which limits our ability to make fully rounded and sound decisions in the dispensary. I haven't personally had much experience in hospital pharmacy but I can only imagine that they are more integrated into the healthcare team in hospital and that they are able to readily access patient notes, enabling them to make more substantiated decisions about a patient's pharmaceutical care.
There is no doubt that the Chronic Medication Service is an enabling platform for pharmacists to develop care plans and work more closely with GP's and provide long term care for patients who are taking specific medicines in the long term. But in reality, the service hasn't really taken off nationally and many issues remain and need to be resolved if CMS is to take off and become an overall success. It can still be an overall success but many issues need to be discussed and resolved in order to enable the service to flourish.
One of the other big issues that we face is tackling non-adherence to medicines. It is in the interest of the whole NHS that medicines prescribed and dispensed are used to it's full clinical effects in order to enhance clinical outcomes for patients and deliver value for money for our health service. Point 9 in the report states up to just over 15% of hospital admissions are a result of non-adherence to medicines and monitoring issues. Again we need to constantly remind ourselves in pharmacy that our role is not to be underestimated. We are the medicine experts after all.
4. The future
Despite the ongoing challenges and issues we face in pharmacy and healthcare in Scotland, I am very reassured by this honest, insightful and enlightening report. The duty for all of us in pharmacy is to constantly engage with stakeholders and our political representatives to push pharmacy up the political agenda and constantly reassure our colleagues across healthcare and society that we have a role in the nation that is worthwhile.
But we can be very proud of the health of the pharmacy profession in Scotland. Quite frankly, we are blessed north of the border with one of the finest contracts for community pharmacy that has ever been devised and implemented anywhere in the world. And I say that with no apology whatsoever. Smoking cessation, the minor ailment service and the provision of urgent supply - just a selection of some of the unique services we offer in Scotland that have benefited patients in the Scottish National Health Service.
I take my hat off to all past and current Scottish Governments for recognising our value in healthcare and continue to urge them to engage and listen to what we have to say for the future of pharmacy healthcare provision in Scotland. Many countries, worldwide, are taking a look to Scotland with interest and, dare I say it, envy and will no doubt be inspired by how far pharmacy has advanced in Scotland.
Thank you for the post. Very informative. The blog’s mind-over-matter approach is pragmatic and well-explained.
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