OPINION


Déjà Vu; T


he pharmacists gathered were considering the future of pharmacy and the rookies in


the room were jumping up and down keen to tell us when déjà vu struck hard.


The vision we pieced together looked remarkably like something I had seen before. Back when everyone was partying like it was 1999 - because it was - PSNI published Vision 2020 its future for pharmacy not dissimilar, I confess, to Pharmacy in a New Age - the bright vision for pharmacy from the Royal Pharmaceutical Society.


Pharmacy, it seems, has known for some not inconsiderable time what its professional future should be; (1) Pharmaceutical Care (Medicines Optimization), (2) Supporting citizen Self Care (Common ailments) and (3) Public Health (Health + Pharmacy). Logically, you might think, the pharmacy bodies should by now be getting on with it.


A few weeks earlier, somewhat confused and disoriented by the election of Jeremy Corbyn as leader of Labour, I was in Birmingham attending the Royal Pharmaceutical Society (RPS) Conference.


It was a great conference which surprised me since, in the last 10 years, conferences had given me little by way of inspiration but plenty by way of potential liver damage. At this conference I listened, I learned, I stayed out of the pubs and I really was inspired. The format was excellent; big policy stuff followed by discussion on the services that would deliver the policy.


Ash Soni, RPS President was, as you might expect, presidential and asked us all to "practise to the top of our license". A new concept to me, it


46 pharmacyinfocus.co.uk


articulates the essence of modern professional regulation. Professionals must act in the best interests of their patients and within their competence. When professionals do this no one can find fault.


Pat Oakley, a pharmacist with a talent for policy development, outlined the Five year Vision for clinical practice. It was clear that GPs would need to be doing more "real medicine" and therefore "Citizen UK" needed to get on with self-care for common ailments and for this needed community pharmacists.


Martin McShane, Director of Long Term Conditions, outlined the massive challenges the NHS faces. The elderly, particularly those over 80, suffered an average of four chronic diseases and took more than 8 medicines daily.


Medicines Optimisation was the policy and pharmacy was the delivery. Roy Lilly was more stand-up comic than Health Service pundit but he delivered a barnstormer of a speech that had us rolling in the aisles, yet when he finished and we were being encouraged to go speak over coffee to our sponsors on their stands, it was unclear, beyond telling us how wonderful and exceptional we are, what else exactly he had said.


Duncan Selbie, CEO of Public Health England, looked unkempt, like someone who slept the morning on a park bench. He spoke soft Celtic notes in short quiet bursts like someone who has just finished a long satisfying joint.


He told us how great we are, that five things; smoking, hypertension, poor nutrition, lack of exercise and alcohol caused all the health inequalities in the UK.


a painful condition


Déjà Vu happens when least expected. In late September I was in Antrim attending an industry sponsored leadership course when I suffered a brutish attack, writes Terry Maguire.


Pharmacists, he concluded, were key to delivering public health services at a local level; public health pharmacy. Having gorged on the top level policy stuff we went to workshops where we heard from pharmacist trail-blazers and discussed how their ideas might better design pharmacy services to address the big NHS priorities.


Public Health Pharmacy seems to be putting much store by Healthy Living Pharmacies but these suffer from a lack of clarity on what they actually do and how. Supporting self-care and dealing with common ailments has been with pharmacy since the 1840s so it is puzzling why, after all this time, we still can't translate this into a commissioned service.


Medicines Optimisation was a really hot topic and where GP-based pharmacists were changing the world with clinical medicines reviews that involved "de-prescribing" (yes, new to me too but a phrase to watch) community pharmacists were still only indolently box-ticking their way through MURs. If HSCB adopted John Hamill's (McMullen's Pharmacy) respiratory intervention, MURs would be much better fun and give some real outcomes.


So back in Antrim, it was disappointing that, as a group of some of the best in the profession, we were only now arriving at a place first charted over 20 years ago but which to many in the room seemed like a new continent.


A pharmacist working in a GP practice claimed she left community pharmacy thoroughly bored but really wanted to get back if she could, and I am paraphrasing her here, "practice to the top of my license" as she was currently doing in the GP practice. She was quickly admonished by an ex-


contractor who claimed never to be been bored in 30 years of practice "looking after patients".


Failure to appreciate that current community pharmacy practice delivers little more than the medicine is worrying especially at a time when pharmacy multiples are creating dispensing hubs with super-fast dispensing robots.


For some of us the lack of insight was palpable and I did wonder what our pharmacy organisations get up to when they meet. When the good members of; the Pharmacy Forum, UCA and CPNI get together for their monthly chin-wags what is on their agendas beyond navel gazing and cups of tea.


These organisations ought to be the voice of pharmacy and must be the means by which our individual wishes and aspirations are heard, otherwise they are not fit for purpose. But we can't blame the organisations if we fail to contribute choosing to fester and complain in splendid isolation.


What is clear is the talent and passion within the profession. The challenge is to channel that passion towards a more clearly defined and agreed vision.


What is disappointing, for me at least, is that it takes an industry sponsored event to get this going; but for how long. I just don't want the younger members at that meeting, twenty years from now, to have to suffer the déjà vu I am still recovering from. n


These views are entirely those of the author and do not necessarily reflect the opinions of either Profile Publishing & Design Ltd or the Ulster Chemists' Association.


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