TRANSITION


COMMUNITY PHARMACY IN A CHANGING ENVIRONMENT


THE MESSAGE COULD NOT HAVE BEEN STARKER – HOW HEALTH AND CARE IS DELIVERED IN SCOTLAND IS CHANGING AND, THIS TIME, IT’S REALLY GOING TO HAPPEN BECAUSE THE PRESSURES ON


THE SYSTEM LEAVE NO ALTERNATIVE. ‘We have to be clear the difference that health and social care integration is going to make,’ said Vicky Irons, Chief Officer of the Angus Health and Social Care Partnership. ‘If we are passive about this or even resistant, there is a chance that we won’t make any difference at all and that would be a wasted opportunity. The emphasis now is genuinely about seizing some of these opportunities.’


is expected to practice what is being termed ‘Realistic Medicine’.


Vicky Irons was speaking at the recent Pharmacy Management Forum in Scotland, which focused on how the pharmacy profession delivers its full potential in the new world of integrated health and social care partnerships, where each professional


12 - SCOTTISH PHARMACIST


‘When I reflect on the passage of change in primary care over the last 20 years there is some consistency among the drivers of change,’ Ms Irons told her audience meeting in Dunblane. ‘Each of the reforms was seeking greater integration of services, more continuity, proactivity in care planning, less unscheduled care, more effectiveness, more community capacity, delegation of power and a shift in the balance of care. The spirit of the reforms was very similar, the intent similar, the objectives similar. Unfortunately, the results in the past were pretty similar too.’


This time, she told her audience of pharmacists, there is a determination that reform will happen, not least because the challenges are simply too big for previous delivery models to cope.


‘Take workforce, for example. The workforce that we require now does not exist, and it is getting scarcer. So we need support from the wider partnership, you guys, to help us extend our view to the very periphery of our current vision when it comes to workforce, because this is possibly one of the biggest risks to our being able to sustain a good future.’


The principle of partnership in decision making, both across professions and between carers and people, is at the heart of integrated health and social care. It is also a pillar of the move to Realistic Medicine being championed by Scotland’s Chief Medical Officer, Dr Catherine Calderwood.


Realistic Medicine seeks to ensure the healthcare people receive is of the greatest value to them as individuals, is most in line with their wishes and has the least potential to harm


(Left to right): Vicky Irons, Chief Officer, Angus Health and Social Care Partnership; Dr Catherine Calderwood, Chief Medical Officer for Scotland, the Scottish Government; Dr John McAnaw, Chairman, Scottish Pharmacy Board, RPS; Michael Pratt, Director of Pharmacy, NHS Dumfries and Galloway (Conference Chair)


them. It asks professionals to reduce wastage, to challenge variations in practice and outcomes, to treat illness rather than risk, and for each to take his or her own practice up a level as improvers and innovators.


Dr Calderwood told the Pharmacy Management Forum that pharmacists have been one of the single biggest professional groups to comment on Realistic Medicine, and their reaction had been overwhelmingly positive:


‘We are changing our thoughts, we are moving treatment out into communities, away from hospitals and, in doing that, I would say pharmacists are absolutely ideally placed at the right time to become more involved and I think we need, as has been the commitment of Prescription for Excellence, to really invest and develop the pharmacy profession.’


The chairman of the Scottish Pharmacy Board of the RPS, Dr John McAnaw, suggested to the conference that there was much in the changing working environment of Scotland’s pharmacists that


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