By Gareth Kitson, Professional Development and Engagement Lead
The way the NHS delivers care to patients is constantly evolving and aiming to meet the changing needs of an aging population and people living with multiple conditions. As a busy pharmacist providing the best possible care to our patients, it can often be difficult to get to the bottom of the changes and truly understand how the changes might affect you in your day to day roles.
A few weeks back, NHS England launched a discussion paper looking at how the NHS should be developed over the next 10 years, the Long Term Plan (LTP). The plan is split into three sections, each examining specific areas which will need to improve, if we are to continue to provide the best possible care to our patients. These areas include:
- Life stages
- Clinical priorities
- Enablers of improvement
Each section will resonate with healthcare professions differently and I’ve highlighted areas in each that might be relevant to our members. However, one of the biggest changes that will affect most pharmacists will be how care is provided to our patients. The traditional method of providing care to patients (the patient moving around different parts of the health system) is a relatively inefficient way of delivering care and one that does not put the patient at the centre of everything we do. A new, proposed method of providing care is through the use of Primary Care Networks.
Primary Care Networks
We’ve already seen improvements in the way that care is provided to our patients and I would expect the NHS LTP to build on this and develop it even further – I’ll talk through some of these proposals and the LTP later on. However, as I previously mentioned the way we are providing care to patients is changing. You may have already seen the development of the Primary Care Home (PCH) model which sees care services being redesigned and delivered around a defined population, with the patient being placed at the centre of care provision and the MDT working around them. You may also have heard about Primary Care Networks. More information about them can be found here. However, how might this new model of care affect pharmacists working with patients on a daily basis?
It’s important to remember that this new way of providing care to patients is a positive step for pharmacists as it will allow us to support patients using the full breadth of our skills and showcase the value we can add to patient care. There have already been some great examples of where pharmacy have become integrated into a primary care home model and have had a lasting impact upon patient care. We’ve seen pharmacists managing long term conditions for their patients, COPD and hypertension, for example. We’ve also seen them change how patients on multiple medications are managed and highlight the importance of polypharmacy to both patients and prescribers. Integration of pharmacy into this new model of care also promotes better collaborative working, improved working relationships and more effective use of resources, which in turn, leads to better care for our patients.
The RPS realises the importance of promoting pharmacists and ensuring they are included in any new model of care. Consequently, we have produced 5 key considerations that we think should be included in the formation of any new primary care network that is designed to support our patients. The key considerations and further information about our work with Primary Care Networks can be found on our website. I’d encourage you to read it and discuss with your colleagues and local leaders to ensure that pharmacy is at the forefront of any changes that are made to how care is provided to your patients.
NHS Long Term Plan
When reading the NHS discussion paper, it can be difficult to picture how you might be affected by these changes. It can also seem quite intimidating to submit your views and give your opinion on how the plan that will be developed over the next few years. As your professional body, the Royal Pharmaceutical Society is developing a response to the discussion paper which aims to represent the views of our members. The finalised plan will be developed and published in good time but what might the future NHS look like and how might this affect you?
The LTP has dedicated the first section of the consultation to different life stages; Early Life, Staying Healthy and Aging Well. Pharmacists are well positioned to support all areas of this section.
Pharmacists from all sectors come into contact with thousands of people every day. Through these contacts, we can promote public health campaigns and work collaboratively with our primary care colleagues to support our patients throughout all life stages. Pharmacists already do a great job in this area; the flu vaccination service being a prime example.
Mental Health is a huge priority for our health service over the next few years and I would expect all pharmacists to soon be playing an even greater part in supporting the public in this area. Mental Health is a topic that crosses all life stages and the RPS have recommended that this should be the one of the top priorities for addressing health inequalities over the next five to ten years.
Furthermore, as the experts in the safe and effective use of medicines, pharmacists will continue to have a key role to play in ensuring patients with long term health issues get the most from their medication and are empowered to make informed decisions about their health and treatments. This role is sure to develop and pharmacists and their teams will be key in ensuring this is a success.
The LTP highlights three main clinical priorities that will be focused upon, over the next five to ten years. These are Cancer, Cardiovascular and Respiratory Health, Mental Health and Learning Disability and Autism. Once again, pharmacists are already doing wonderful work in these areas and our recent Mental Health campaign in England, showcased some of these. One area where pharmacists could play a bigger role in these specific areas could be through supporting disease prevention services (for example, supporting stop smoking services via community pharmacists) or working alongside other healthcare professionals, such as GPs and other doctors, to help reduce the incidence of cardiovascular and respiratory diseases. Many pharmacists already work to help detect atrial fibrillation but this is an area that could be expanded over the next few years, with more pharmacists being used to recognise early signs and symptoms of LTCs. This could also see pharmacists doing more to support the physical health of patients with mental health conditions. This is something that the RPS have recently highlighted as part of our mental health campaign
We all know the exceptional work that members of the NHS workforce do. As the system develops, we need to make sure that the workforce is also developed and supported to be the best they can be. Without a highly trained, compassionate and effective workforce, the NHS will not be able to deliver the best care to patients.
At the recent FIP conference, the report on the global trends in the pharmacy workforce was launched with some interesting findings. I’m sure that everyone has been involved in workforce discussion at some point in their carer and have seen how the workforce greatly impacts upon patient care.
Therefore, as part of this consultation, the RPS have highlighted that the pharmacy workforce needs to be included in any changes made to the NHS. As a workforce, we are expertly placed to use our skills to help deliver services to patients using new and innovative methods. Some pharmacists within our workforce are independent prescribers and are skilled to support patients to manage their long term conditions and to support them with problems they may encounter when taking multiple medicines. The advancement of technology is undeniable and therefore, we also need to pay particular attention to ensuring our workforce is digitally literate and can translate this in to ensuring we support our patients, to the best of our ability.