NEWS
A Future for Pharmacy within Health and Social Care Partnerships
longer sit with NHS Ayrshire & Arran. The staff and functions of these now sit in the HSCPs, with East Ayrshire HSCP hosting the team on behalf of all three HSCPs. This means that issues, like pharmacy contract applications, are sitting with the pharmacy contract team within a HSCP. A similar arrangement is in place for all mental health services now being hosted within North Ayrshire HSCP.
Allan Thomas, Lead Pharmacist, NHS Ayrshire & Arran
Following on from Harry McQuillan’s article in the last issue of Scottish Pharmacist, which examined the area of Health & Social Care Partnerships, Allan Thomas, Lead Pharmacist with Public Health and Community at NHS Ayrshire and Arran got in touch to give an overview of how they are developing their strategy and staying ahead of the game.
I read with interest the recent article by Harry McQuillan on Health and Social Care integration in your last issue.
As Harry pointed out, the three Health and Social Care Partnerships (HSCPs) co-terminus with NHS Ayrshire & Arran have had their Integration Schemes approved and the Integrated Joint Boards have already started to meet. New directors are in post and their structures are starting to take shape. The challenge is how pharmacy, both managed service and contracted service, fi t with these developing organisations.
Similar to many NHS Board areas in Scotland, pharmacy teams within NHS Ayrshire & Arran had already started to work with our three local authorities, in particular social services. This work was mainly around medication policies and support for employed carers, particularly where carers have a responsibility in administering medicines. Being close to these services we realised at a very early stage how important these HSCPs would become in the future for
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healthcare and the potential impact that would have on pharmacy in the future.
Again, like most NHS Boards, we have had Area Pharmacy Groups since the time of “The Right Medicine” or even before. Discussions with the Area Pharmaceutical Professional Committee (APPC) and Ayrshire Pharmacy Contractors Committee have led us to amend the constitutions of the Area Pharmacy Groups and the APPC. The pharmacist representative elected by members of the three Area Pharmacy Group now has a place of right at the APPC. This allows the body providing professional advice to the NHS Board to be able to keep in touch with any issues that may affect the profession that arise in the HSCPs.
The Schemes of Establishment for the HSCPs outline that a pharmacy contractor providing services within those HSCPs should represent the profession. The main input up to this point has been at the Strategic Planning Groups at the three HSCPs. These are very high level plans that outline the ambition for the health and well-being of the population of the HSCP. All three area plans contain some reference to pharmacy. The HSCPs are also now looking at smaller ‘localities’ within their borders.
Other changes are taking place that don’t have an obvious effect on the day to day work of community pharmacy. For instance, all the contractual elements of the four independent contractor services no
Pharmacy in Ayrshire and Arran does not have a representative at the Integrated Joint Boards. Representation for all independent contractors, GPs, pharmacy, optometry and dentistry, are provided by a new post of Clinical Director. These individuals have only recently been appointed but pharmacy, through both the managed service in primary care and the elected leads, are making contact with them to ensure they are aware of the major issues for pharmacy and to offer support in their roles. The roles are fi lled by GPs but all are aware of the wider health agenda and are aware of the role pharmacy can play moving forward.
Harry McQuillan’s article also outlined that substantial funding will be funnelled through HSCPs. Delayed Discharge was mentioned but there is also the Integrated Care Fund. The Integrated Care Fund is a £100m fund from Scottish Government for 2015/16 to support delivery of improved outcomes from health and social care integration, helping to drive the shift towards prevention of illness and further strengthening the approach to tackling inequalities. Pharmacy has been successful in accessing funding in two of the three HSCPs for three projects (in each locality)
• Funding for one day per week to allow a community pharmacist to attend the multi-disciplinary teams at Each Ayrshire and Girvan Community Hospitals. They provide pharmaceutical care input to the team for the patients being discussed, mainly around discharge. This allows them to understand the ongoing support required to keep the individual in their own home,
with obvious links to social services and pharmaceutical care under the Chronic Medication Service.
• More clinical input to patients in a care home environment. We hope to investigate the benefi t of having dedicated time for community pharmacists to provide the pharmaceutical care of patients linking with their care homes and their GPs.
• Use of pharmacy technicians to help vulnerable individuals manage their medicines, especially after discharge from hospital. Patients often get confused with changes to medication made and it is hoped the service will support them to get maximum benefi t from their prescribed medicines, linking with their community pharmacist and other specialist pharmacists where appropriate.
These are tests of change for pharmaceutical care of patients. They fi t with the visions for both Prescription for Excellence and the 2020 Vision for Health and Social Care. Pharmaceutical care and medicines management will be major elements in keeping patient’s care closer to home. Innovative ways of doing this need to be explored and pharmacy, as a profession, needs to examine how best to adapt to this changing environment and to engage with this agenda.
As yet, the impact on pharmacy of the new HSCPs can be hard to see. Many pharmacists have yet to recognise the potential of the HSCPs and as a result levels of active participation at Area Pharmacy Groups are patchy to say the least. We have very enthusiastic elected representatives from pharmacy within the HSCPs, who are doing a great job representing the profession, but the challenge now is in engaging all pharmacists, owners and employees, independents and multiples, managed service and independent contractors, to become active participants within the HSCP. All facets of the profession need to encourage engagement and participation or this could be an opportunity missed.
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