INTERVIEW
clinical experience. Meanwhile, we absolutely know that we need to change the technicians’ training because it’s no longer fit for purpose. A fourth task was about evidence and outcomes, and looking at what pharmaceutical care does for patients, and what the medicines that we use are delivering for patients. Sometimes medicines bring more harm than benefit, so it’s really important that we have the evidence and the outcomes for the medicines that we use. And, lastly, I wanted to increase strategic engagement both internally within government and - particularly for me - externally across the profession, and that is what I’ve been doing across the last two years - which has allowed me to publish Achieving Excellence in Pharmaceutical Care.
JM: You can get the impression that there is potentially a role that pharmacists could play in pretty well every healthcare setting, and that pharmacists could make a positive impact everywhere. So, to achieve the full potential of the profession, do we need more pharmacists, or do we need to take the existing workforce and change the way that they are deployed?
RMP: We need both. We do need a few more pharmacists coming through the system and we are seeing some evidence that that is happening. I have asked NES and the schools of pharmacy to look at what that means for workforce planning. Workforce planning in pharmacy is really difficult because we have a lot of gaps. We can count the number of people in a hospital or in primary care, but we have difficulty counting community pharmacists, which makes it more difficult to plan. But I think we do need more.
At the same time, we do need to redesign what pharmacists are doing - and also what technicians are doing. We need to allow the current workforce to work differently and the pilot in Inverclyde at the moment is a really good pointer to how we might do that, with technicians and pharmacists working in new ways. I think IT will make a big difference and that we haven’t seen its true potential. I keep talking about iPhones and drones, but automation is also taking place, and the evaluation that we have been doing of places where tasks have been automated will tell us to what extent pharmacists’ and technicians’ time is being freed up so that they can be more patient facing.
Chief Pharmaceutical Officer, Dr Rose Marie Parr, in conversation with John Macgill
JM: Your vision is of one pharmacy profession delivering the best pharmaceutical care for people in every healthcare setting and every part of Scotland. The experience of clinicians is often of systems that vary between NHS Boards and where appropriate clinical information about patients is not always accessible by practitioners in the community. What are your priorities in terms of achieving your joined-up, patient-centred vision?
RMP: I think we do have the right vision, but sometimes we do put in our own barriers and silos and the IT is a bit clunky. I think there are things we can do ourselves. Some of the sessional portfolio working I have seen some younger pharmacists doing is really important and is helping break down some of the barriers. But, in terms of patients’ understanding of pharmaceutical care and the value they place on medicines, I think we really need to step that up a gear. I think most people value their community pharmacist. They understand them and we know that most people, even when they are not registered, will go back to the same pharmacy each time and that is interesting.
So, how do we help patients to value what pharmacists can do, and appreciate what medicines can and can’t do for them? Well, we started with a citizens’ panel to talk about what people think of medicines and how they get their information. And it’s quite telling that patients judge what they can see. I think the worst thing that we can say is that you can rate a pharmacy by the quickness
‘WE NEED TO ALLOW THE CURRENT WORKFORCE TO WORK DIFFERENTLY AND THE PILOT IN INVERCLYDE AT THE MOMENT IS A REALLY GOOD POINTER TO HOW WE MIGHT DO THAT, WITH TECHNICIANS AND PHARMACISTS WORKING IN NEW WAYS. I THINK IT WILL MAKE A BIG DIFFERENCE AND THAT WE HAVEN’T SEEN ITS TRUE POTENTIAL.‘
of delivering a prescription; that it’s only about speed. But, patients do not understand what is going on in terms of spending time on their safety: checking they are the right patient, making sure they are getting the right dose at the right time, those questions are going back to the prescriber. A lot of that goes unnoticed and un-valued and, unless we can get patients to understand all this work and value it, we’re going to have a challenge because people won’t know what they’ve lost until they lose it.
We have a group at the moment talking about how we value medicines and we want to build on this group and draw more people in to help us and guide us, and make sure we have the information we need to shape how we improve understanding of what we do.
JM: The strategy makes a series of very clear commitments on behalf of government. What, in return, do you want the profession to do to realise the vision, particularly in the short term, when it might be tempting just to sit back and see how things unfold?
RMP: And we can’t do that. We can’t
let this just sit on a shelf. How we deliver the strategy is as important as what is in it. There are lots of really positive things about Scotland and how we can use the networks, be they directors of pharmacy, across primary care and community pharmacy, with NES and the pharmacy schools and the RPS and the GPhC. Each has a role in informing how we deliver this and what help we need with education and training.
I would ask pharmacists to stick with this strategy even in turbulent times. Stick with the vision around care for patients. I agree with one of my community pharmacy colleagues who said to me ‘I’ve never really thought about anything other than what the patient needs. And if the patient needs it and we supply it for them in a quality way, the rest of it will flow’.
For me it’s about how we can harness the experience, enthusiasm and expertise. Because we are setting a path for the profession for the future, for your career. Change is always with us, but if we really do keep the patient at the centre of this, then we can’t go far wrong. •
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