PILOT


garth newberry from carryduff Pharmacy. ‘certainly, in terms of our pharmacy, the under-utilisation of the community pharmacy pilot became very clear in the early stages.


‘the stock list was also restricted. despite the fact that the Board highlighted the positive role that community pharmacy played in this pilot, no reason was ever given for why the pilot ended.


‘If you have a pilot that is working successfully, then you don’t terminate it during the evaluation. the evaluation was always ongoing and so they would have known if it was working fine. all the initiative needed was more awareness of its existence.


> meet the requirements of the acah service.


‘Moving forward, in order to fully meet the medicine needs of acah patients, the service would require a small number of pharmacies to hold a small list of injectable medicines including antimicrobials, and for all community pharmacies to be able to dispense routine prescription items required for the care of these patients. a policy change by the department of health would be required to facilitate this.


‘as a pilot, the scheme obviously had a ‘natural end’, but, despite the fact that the pharmacy element certainly proved successful, the service can’t be rolled out until there are policy changes by the doh.’


the pharmacists involved in the scheme are united in their disappointment that pharmacy is no longer involved in the service.


‘there’s no doubt that the service that pharmacy provided was extremely worthwhile,’ said Michael cooper from cooper’s Pharmacy on the andersonstown road in Belfast.


‘not only did it free up valuable resources in secondary care – in that we facilitated people getting out of hospital – but the fact that, in some cases, we provided compliance aids for patients meant that the usual lag time between discharge from secondary and entry into primary domiciliary care was avoided. We did, I believe, act as a bridge between secondary and primary care.


10 - PharMacY In focUS


‘the fact that the doh remunerated pharmacies for providing compliance aids does, I feel, demonstrate the value that the doh places on the service. this was a validation of the valuable role that community pharmacy plays in compliance support, allowing people to live at home for as long as possible.


‘I firmly believe that, as a concept, the inclusion of pharmacy in the service is a great idea. the only thing missing moving forward is the gaps in It technology to fully bridge the gap between primary and secondary care.’


Meanwhile, Shauneen Ward from Woodbourne Pharmacy believes that the pilot showed how pharmacy’s contribution to this pilot could have a significant impact on savings for healthcare.


‘In practical terms this pilot meant prescribers, such as consultants and nurses, utilising the appointed pharmacies closest to the patient’s home to access required medication. logistically, this prevented prescribers having to travel to Musgrave hospital to collect medication and then travel back to the patient’s home.


‘this pilot was reflective of the ‘transforming Your care’ objectives and demonstrated how community pharmacy can integrate into secondary care teams to allow truly focused patient care. the project was hugely successful for the pharmacies that were utilised. the efficiency of community pharmacy was validated,


with required medication dispensed at a much more timely manner with improved cost effectiveness. the time taken to travel back to the hospital to access medication with waiting times of up to three hours is a waste of resources.


‘Utilisation of community pharmacies established frameworks to make savings in this area, combined with the savings in keeping patients out of hospital, could have a significant impact if rolled out.


‘accessing medication from community rather than hospital pharmacy would certainly improve the safety and quality of dispensing. Medication supplied by the pharmacy which already understands the health and social care needs of our patients is crucial to allow continuity of care at such a vulnerable time and puts the needs of the individual and carers first.


‘It’s very disappointing that the pilot has come to an end. the project required a change in practice in secondary care and, although community pharmacy certainly delivered, the service was not utilised as expected. I hope to see further promising projects like this in the future so that primary and secondary care can work together to deliver a safe, resilient and sustainable health and social care system for the future.’


‘the evaluation certainly proved invaluable in identifying issues such as staff awareness of the initiative,’ said


‘there is no doubt that the objective of the scheme was to create a more prompt and convenient supply of medicines to acah nurses for patients and this was achieved. While we personally experienced a slow start – primarily because carryduff didn’t have the uptake because we were further out from the city centre than some of the other pharmacies - it was still easier for the nurses to come to us than to go to Musgrave hospital. the nurses were, however, used to going to the hospital for the prescriptions and it took time for their mindset to change. over time, however, this modus operandi gradually changed.


‘I’m very disappointed that the pilot was initially extended and then pulled. there was good patient care and, in my mind, if a pilot is working well, you don’t ‘pull it’ and then put it back in following the evaluation. In fact, every time you dispensed, you had to fill in a form which you then gave back to the nurse or sent in, so there was constant evaluation.


‘has this pilot been ‘pulled’ because of technical issues? or is it just part of the continual cut or diminishing of services in community pharmacy? It seems that, while many are happy to cut remuneration, they’re reluctant to invest in services that have proved to be cost-effective and, indeed, beneficial for patients.


‘there is a push for services to be much more integrated. this pilot was a great chance for integration. It’s such a pity that it didn’t get the chance to prove its worth fully.’


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