PrOFeSSOr angeLa TIMOney IS DIrecTOr OF PharMacy FOr nhS LOThIan. In nOVeMBer, She WILL chaIr The PharMacy ManageMenT naTIOnaL FOruM FOr ScOTLanD, LOOKIng BacK aT The cOVID-19 PanDeMIc SO Far, anD aSKIng WhaT IT MeanS FOr The FuTure. SP aSKeD PrOFeSSOr TIMOney FOr her reFLecTIOnS On hOW The PrOFeSSIOn In ScOTLanD haS cOPeD SO Far.
‘We are runnIng MaraThOn aFTer MaraThOn’
2
020 has been a bit of a rollercoaster year but, when I think about the year so far, I like to think about things that didn’t happen. Medicines, for example, did not become a crisis area like personal protection equipment. The hospital service did not fall over. community pharmacies, despite significant additional stress, remained open and functional and I think we need to celebrate that.
Some of that was because of our preparations for european union exit. In nhS Lothian we had been reviewing our medicines supply and distribution systems and processes – and strengthened them – which put us in a better position. So much of that work was across the four home countries where the rules of engagement around fair shares, the use of the Barnett Formula for allocation of supply in terms of shortage, were already established. Other parts of the nhS didn’t have that kind of opportunity to prepare, so we were better able to cope with medicines supply challenges. I don’t think that was necessarily true in terms of workforce, medicines governance or clinical and therapeutic work, but the ability to get medicines supply issues addressed very effectively helped patients and the nhS.
6 - ScOTTISh PharMacIST
I have to mention care homes. undoubtedly there are lessons for all of us to learn about the care homes fiasco. I think that, for many of us, we were aware that this is a frail, vulnerable population where pharmaceutical care needed to be strengthened. This client group would have been in hospital ten to fifteen years ago getting clinical pharmacy input, but many have not been getting clinical input despite the complexity of their care needs and dependency on rapid assessment and intervention. cOVID shone a spotlight on this and I think that we must not now miss any opportunity to improve it.
I am so grateful to my wonderful pharmacy team. everybody just stepped up, and I know that’s not just true of pharmacy. It was inspiring and I think that we coped.
Someone said at the beginning it was not a sprint, it was a marathon. The issue now is that what we are seeing is not a marathon. This is a series of marathons, which makes it really important that we concentrate on staff wellbeing and sustainability, mainly because this is challenging – it’s still challenging every day – and we simply don’t know how long this race is.
community pharmacy has done incredibly well and has been very well received both by patients and the public. People recognise that the service managed to stay open and continue to provide for patients.
My clinical staff at ward level are really essential members their teams and are relied upon for their clinical knowledge and expertise, but I do have some concerns around how clinical guidance in initial phases of cOVID was developed. It became quite uni-professional. Doctors provided all the guidance, whereas we know that guidance needs to be multidisciplinary and multi- professional – particularly around medicines. I feel that pharmacy was sometimes considered at too late a stage. I think that lessons have been learnt, not just for pharmacy, but for
others. There is an inevitability that, because everybody had to act quickly, people probably just spoke to those colleagues they saw around them. But, in order for guidance and pathways to be robust, there has to be a strong multi-disciplinary element, bringing in nursing and physio colleagues and other allied healthcare professionals as well.
For more than a year I have also been chair of the Scottish Intercollegiate guidelines network (SIgn). I have to say that I really enjoy working with SIgn and would like to encourage my pharmacy colleagues to put themselves forward for positions not usually part of a pharmacist career pathway. It challenges your thinking and develops your skills, not just for the role, but hopefully for pharmacy too as this enables us to have a
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