Polypharmacy – even the word has a negative connotation

Nina Barnett

Professor Nina Barnett, Consultant Pharmacist for Older People, Medicines Use and Safety Team, NHS Specialist Pharmacy Service

As clinicians we think of polypharmacy as patients being prescribed too many medicines, some of which are at best redundant and at worst cause patient harm. It is easy for us to take a clinician-centred, negative view of the prescribing of multiple medicines because of our awareness of the risks associated with polypharmacy, but I want challenge this thinking and reframe our view of polypharmacy, so we think about it from a patient perspective.

Read more Polypharmacy – even the word has a negative connotation

Explaining the new cannabis bill

charles blogBy Charles Willis, Head of Public Affairs for RPS

You may have noticed over the past few weeks that the Liberal Democrats are returning to an issue close to many of their hearts; reforming the drug laws. This week in Parliament, Norman Lamb brought a 10 minute rule bill seeking to legalise and regulate cannabis in the UK. But how did we get here?

Going into the 2015 General Election, Nick Clegg committed the Party to decriminalisation for possession of drugs for personal use, and Norman Lamb made drug reform part of his Party leadership bid. However, the key precursor to this Bill was set at the recent Lib Dem Spring Conference, where the members debated a motion that would for the first time commit the Party to full legalisation and regulation.

Read more Explaining the new cannabis bill

How much is polypharmacy a necessary evil?


By Dr Martin Duerden, a GP in North Wales and Clinical Senior Lecturer at Bangor University

A few years ago, I and some GP colleagues – Tony Avery from Nottingham University, and Rupert Payne from Cambridge University – were asked to do a review of polypharmacy by the King’s Fund. Polypharmacy had always been looked on disparagingly through my training in medicine and my subsequent work as a GP. It was clear from our review that this high minded perspective of polypharmacy was no longer valid.

Polypharmacy has become common place and the stark evidence is that we now have three times more people taking ten-or-more drugs than was the case in the late 1990s. The reasons for this are complex; many more people take preventative drugs for things like high blood pressure and lipid-lowering; we have a plethora of guidelines urging us to use treatments; and there are an increasing number of drugs available. Perhaps the biggest issue now and in the future is the shear number of people in middle age who are getting older and frailer and carrying many diseases into old age – the so-called ‘multimorbidity challenge’.

Read more How much is polypharmacy a necessary evil?

Reducing inappropriate prescribing of psychotropic medicines in the learning disability population

Steve Buckley 2Steve Buckley, Senior Clinical Pharmacist, Older Adult Services, Greater Manchester West Mental Health NHS Foundation Trust

In July of last year, I started a new post with Greater Manchester West Mental Health Foundation NHS Trust. The post is part funded by Trafford Clinical Commissioning Group. At around this time, NHS England launched a ‘Call to action’ regarding the inappropriate use of psychotropic medicines for challenging behaviour in people with learning disabilities. So – this instantly became my first project for the CCG.

Read more Reducing inappropriate prescribing of psychotropic medicines in the learning disability population

AMR and the importance of finding new ways to prevent and treat infections

jaynelawrenceBy Professor Jayne Lawrence, Chief Scientist for the Royal Pharmaceutical Society

Jim O’Neill, chair of the UK Government’s Review on Antimicrobial Resistance, has today called for vaccines and alternative approaches to be used more widely in healthcare and agriculture as an alternative to antibiotics in the fight against drug-resistant “superbugs”.

There has been much in the media recently about our currently available antibiotics becoming less effective, the fact that we must all be more responsible with their use, and the urgent need to develop new ones. However, even with increased investment, there is no guarantee that we will be able to discover new antibiotics to solve this crisis we find ourselves in. Hence the need to develop alternative ways to prevent and treat infections.

Read more AMR and the importance of finding new ways to prevent and treat infections

Adopting a person centred approach to dementia care

AnneChildBy Anne Child, a pharmacist who is Director of Pharmacy and Dementia Care Medicines and Prescribing Centre Associate at NICE

Adopting a person centred approach to dementia care is a never-ending process and it is a professional journey I am deeply committed to as a pharmacist.

It requires a strong commitment from health professionals as individuals, and within the wider teams in which we work. It also requires commitment from the top down within organisations, both in health and social care. Individuals and their families, striving to live well with dementia, need this from us as a matter of urgency.

Read more Adopting a person centred approach to dementia care

Defining the role for pharmacy within person-centred care for vulnerable groups

Claire Anderson copy[1]By Claire Anderson, Vice Chair of the English Pharmacy Board for the Royal Pharmaceutical Society.

The health and strength of a society can be measured by how well it cares for its most vulnerable members, older people, those with mental health conditions, those with learning disabilities and children and young people. There remain large inequalities in the care, including pharmaceutical care, of these groups.

The NHS Five Year Forward View calls for greater integration of health and social care services and for care to be delivered closer to people’s homes. Pharmacists, working in the heart of the community, are ideally placed to work with other members of the multidisciplinary team to care for vulnerable people at home and in care homes.

Read more Defining the role for pharmacy within person-centred care for vulnerable groups

Online privileges mean online responsibilities…especially for professionals!

johnathanlaird150Why social media benefits outweigh the risks for pharmacists by Johnathan Laird

The dissemination of information nowadays is rapid. ‘Just Google it!’ has become a popular refrain. Health information and the privacy issues surrounding it have meant that searching for advice online is now second nature for most tech savvy patients.

I started my blogging adventure about a year ago. Little did I know back then that my blog site would attract any readers at all never mind the 36,000 hits it has received. I’m staggered at the power of the Internet and the ability of individuals like me to share information/opinions quite easily to wide and diverse audiences. It’s quite remarkable that every time I tweet I do so now to over 10,000 people.

Read more Online privileges mean online responsibilities…especially for professionals!

How can pharmacists and GPs work better together?


Howard Duff, Director for England, Royal Pharmaceutical Society

The English Pharmacy Board of the RPS and National Association of Primary Care want to create a debate about how community pharmacy and general practice can work better together in the interest of patients. The RPS will be ensuring that royal colleges and patients have a say in this, but I also really want to hear the views of pharmacists. No doubt the organisations representing owners and contractors will be involved but what about the voice of those who actually do the work? Read more How can pharmacists and GPs work better together?

How can community pharmacy and general practice work better together?


By Howard Duff, Director for England, Royal Pharmaceutical Society

Both professions operate under nationally arranged contracts which seem to be looking to achieve two different outcomes. There are many good reasons why pharmacy has benefited from this national approach and we believe that some things must remain nationally organised. However the NHS is different place today than it was when the Community Pharmacy Contractual Framework was introduced many years ago.

The Five Year Forward View (FYFV) presents both the case for change and a blueprint for its trajectory. It signposts the way forward and as a profession we must “go with the flow” and not “swim against the tide”. By that I mean that the FYFV describes ways that changes will be supported to happen in the NHS. These are locally driven and they are expected to be initiated and taken forward by local leaders. We need those local leaders in pharmacy to step up and make this change happen in a way that includes the role of pharmacists. I believe that this will both improve patient care and also help to make the NHS more efficient. If we are not alert to the local change agenda then I fear that pharmacy will be left behind.

The mechanisms for change that can include community pharmacy are the multispeciality community providers, primary and acute care systems and better care for patients in care homes. These have been well documented in the press and they provide plenty of scope for community pharmacy involvement. Ah yes but it’s hard, I can hear people saying, we tried to get involved but this was an issue or that was too problematic. Or we were described in the vanguard bid but it’s proving hard to get through the co-commissioning issues to get the service off the ground. I understand all of these things and I must praise those who have managed to overcome the barriers and put community pharmacy onto the FYFV map.

This is not right though is it? Neither is it good enough. We are the third largest healthcare profession, we manage over £8 billion worth of NHS investment in medicines and yet it seems unbelievably difficult for us to help out the struggling NHS and help provide excellent patient care. The RPS English Pharmacy Board wants to facilitate making the inclusion of pharmacist-led care through community pharmacy easier. We want to promote it to other professions, patients and importantly commissioners. We need your help and support to do this – so respond to our consultation and tell us how you think patient care can be improved.

You can take part in our consultation through the RPS website. Read the ‘improving patient care through better general practice and community pharmacy integration’ consultation document and respond with your comments using the consultation form.

Howard Duff, Director for England, The Royal Pharmaceutical Society.

Follow: @HowardDuff