Diabetes care – get involved!

by Professor Mahendra G. Patel, Diabetes Lead, English Pharmacy Board

Today we’ve published our new policy ‘Using pharmacists to help improve care for people with Type 2 Diabetes’. Aimed at policy makers and service commissioners within the NHS in England, it calls for pharmacists in various care settings to be fully integrated into services for those with Type 2 diabetes. This makes way for increased prevention, earlier detection, and better access to diabetes care tailored to individual needs.  

More than five million people in the UK are expected to have Type 2 diabetes by 2025. This is a national challenge in terms of poor health outcomes, economic burden to the NHS, and ever-widening health inequalities largely driven by factors such as ethnicity and deprivation. Each year within hospitals, there are thousands of patients with diabetes experiencing medication errors that could be avoided.

Significant numbers of people are failing to meet the nationally recommended treatment targets in reducing risk of complications associated with type 2 diabetes. Many are not understanding their condition nor adhering to prescribed treatment. In my opinion, this is a critical time to make more effective use of the extensive clinical skills of the pharmacist.

The NHS Long Term Plan recognises the vital role of pharmacists and their clinical skills in supporting patients to achieve better health outcomes, improving patient safety and reducing medication errors. The recent establishment of new Primary Care Networks and the growing maturity of local Integrated Care Systems, together provide unparalleled opportunities for people to receive better access to their pharmacists, more personalised support, and joined-up care at the right time in the optimal care setting.

In line with new and emerging roles for pharmacists and advancing practice, and at a time when technology is set to command a pivotal role in healthcare, our new policy on diabetes builds on our previous national campaigns.

It translates the latest evidence into practice, focusing on helping people to live longer and lead healthier lives whilst ensuring effective and safe use of medicines. It further highlights the need to support services within and across different care settings, where pharmacists can make significant and meaningful differences in improving health outcomes.

It also shows how pharmacists, who are integrated within a specialist diabetes multidisciplinary team, can provide added value and synergy across care pathways as routine daily practice.

Professor Sir David Haslam, Chair of NICE, one of the many organisations supporting our policy states, ‘Diabetes is a public health emergency’. We will continue to press these recommendations to progress this crucial national work.

Pride: professional is personal

by Gareth Kitson, RPS Professional Development and Engagement Lead

Like everyone, my professional identity is informed by my personal life. Achieving that identity has at times been a struggle and is always a work in progress. It’s something I have learned to take pride in.

As I have progressed through my career, I’ve realised that identifying as a gay man is a bigger part of my identity than I once thought. 

Speaking up

I have had countless conversations with colleagues about what it is like to be a gay man living in London. I’ve spoken about how I have faced prejudice and discrimination because of my sexual identity.  I have highlighted the changes in sexual health provision and how HIV is no longer associated with the falling tombstone of the 1980s. I’ve updated people on how PrEP is transforming the prevention agenda for men who have sex with men.

Being a pharmacist is a huge part of my identity and my sexual identity is too. It often intertwines with other aspects of my personality, including my professional life.  If I feel accepted and safe in my working environment, I’m more creative, better engaged and form stronger working relationships.

Pride

This is why I’m really proud that the RPS is walking in the Pride in London Parade in 2019. 

This is the first time we’ve done something like this.  I’m proud that my professional body recognises both my professional and personal identity. Members of staff and members of RPS will be walking in the Parade on July 6th – if you see us, give us a wave! #wearepharmacy.

Why Pride matters


By Gareth Kitson, RPS Professional Development and Engagement Lead

I had known for a long time that I was gay but had never had to acknowledge it. I never engaged with the LGBT+ community at Uni as I had a ready-made group of friends. I wasn’t confident enough to engage with members of the community as I felt I had to behave in a certain way.  After moving to London I was pushed into the one of the most vibrant and diverse communities in the world and wasn’t ready for the effect it would have on me.

Fitting in

Every aspect of the LGBT+ community had “tribes” or “communities” and I really struggled to find my place.  I also found it really hard to make friends outside of a dating environment.  Most gay men will tell you the same story – insecurity, isolation and the struggle to “fit in”. 

In July 2012 I was out shopping on Oxford Street and accidentally stumbled on the Pride in London Parade.  I felt overwhelmed, curious and confused as to what was happening.  I stopped and watched the entire Parade pass by and spent the rest of the day reflecting on what I had just seen.

Not alone

For the first time, I suddenly felt that I wasn’t alone.  I suddenly realised that there were other people living in the same city as me who identified as a member of the LGBT+ community.  There were opportunities to meet people who may have gone through the same experiences as you, be it coming to terms with your own identity or coming out to your family and friends. 

This one day showed me that people from all backgrounds can stand next to each other and be proud of who they are.  That families can gather and show their children that it is OK for a man to love a man and that some of their friends may have two mummies instead of a mummy and a daddy. 

It was heart-warming, confidence-boosting and empowering when I finally realised that I wasn’t alone.  That I could live my life as I wanted, being true to who I really was, in the city I now called home. That’s why Pride matters.

Members of staff and members of the RPS will be walking in the Parade on 6th July. If you see us, give us a wave #wearepharmacy.

System leadership: how to get involved

By Amandeep Doll, RPS Regional Liaison Pharmacist

The NHS landscape is always changing and it can be difficult to know where to start for pharmacists who want to get involved in their local health and care systems.

You may have recently heard a lot about ‘systems’ in healthcare – but what are they really about? In short, they mean working collaboratively across health and social care boundaries to improve patient and public outcomes.

Current systems

The systems in England which plan, organise and deliver health and care services are called Integrated Care Systems (ICS), Sustainability and Transformation Partnerships (STPs) and Primary Care Networks (PCNs). The NHS Long Term Plan will be delivered through these systems, which will work in collaboration with existing commissioning, secondary care providers and local authorities.

Pharmacists must be part of these structures at leadership level to ensure the future success of the profession at every level of practice. Our impact in systems is maximised when we integrate with the wider health and social care team.

Our challenge

The challenge for pharmacists is to deliver system-wide medicines optimisation, creating a collective sense of responsibility across different areas of pharmacy, organisations and individuals. This has the potential to dramatically improve population health.

To do this, pharmacists must be formally recognised by these systems and a framework established to support pharmacy integration and build a collaborative approach.

But where on earth do you start? If you’re keen to get involved, we can help you explore leadership opportunities within healthcare.

We can help

Our brand new online tool A systems approach to medicines optimisation and pharmacy will help you navigate the opportunities for pharmacy service development and medicines optimisation within local health and care systems.

It identifies six ways you can support effective system leadership and is packed full of practical advice to encourage collaborative working. It also provides checklists of the resources, standards and guidance needed to build knowledge and skills, along with case studies of how pharmacists have improved medicines optimisation and patient care.

A systems approach to medicines optimisation and pharmacy is part of our support for members working to improve medicines optimisation. I really hope that other pharmacists will contribute their experiences and share good practice in this rapidly changing environment. We need to see what works and what doesn’t so we can all learn to lead better.

Why not submit your own leadership case study?

Download our case study template and email it to england@rpharms.com

Related resource: Medicines Optimisation

Salbutamol – landmark asthma treatment

by John Betts, Keeper of the RPS Museum

2019 marks the 50th anniversary of the landmark asthma treatment Salbutamol becoming commercially available in the UK. Salbutamol is still widely used today to relieve symptoms of asthma and COPD such as coughing, wheezing and feeling breathless. It works by relaxing the muscles of the airways into the lungs, making it easier to breathe.

Launched in 1969 with the brand name Ventolin, Salbutamol revolutionised the treatment of bronchial asthma.

It treated bronchospasm far more effectively compared with previous bronchodilators and had fewer side effects.

To understand how much of a breakthrough Salbutamol was in the treatment of asthma, it’s first worth comparing it to the drugs that were used to treat asthma before 1969.

One of the main drugs used for treating asthma in the mid-1960s was isoprenaline. This is a powerful bronchodilator and was used to relieve bronchospasm. However, the side effects include a sudden increased heart rate. Between 1963 and 1968 in the UK there was an increase in deaths among people using isoprenaline to treat asthma. This was attributed to overdose due to both excessive use of the aerosols and the high dosage they dispensed.

In the mid-1960s the mortality rate for asthma sufferers had risen to over 2,000 deaths a year. An effective bronchodilator was desperately needed that did not stimulate the heart or affect blood pressure.

Salbutamol was discovered in 1966 by a research team at Allen and Hanburys (a subsidiary of Glaxo). Salbutamol was the first drug that selectively targeted specific receptors in the lungs, inhibiting the production of proteins needed to produce muscle contractions. It works by relaxing the smooth muscle of the airways, opening them up and so lessening or preventing an asthma attack. Not only was Salbutamol a good bronchodilator, it lasted longer than isoprenaline, and inhalation caused fewer side effects.

In addition to the effectiveness of the drug, the method of administration itself was also revolutionary. The Ventolin inhaler was designed to ensure metered aerosol doses of Salbutamol were inhaled straight into the patient’s lungs.

The drug was an instant success.

The only real deficiency of Salbutamol was its short duration of action; at 4 hours it couldn’t prevent night-time asthma attacks. In response to this the pharmaceutical manufacturer Glaxo aimed to develop a longer acting drug. The result of their research was Salmeterol. Launched in 1990 with the brand name Serevent, it had a 12-hour duration of action.

50 years on Salbutamol is still on the World Health Organization’s List of Essential Medicines; a testament to the major role it continues to play in the treatment of asthma. 

Visit the RPS Museum Mon-Fri 9am-5pm

Improving antibiotic resistance in Ghana

Contributors from Korle-Bu Teaching Hospital in Ghana: Dr Daniel Ankrah, Mark Harrison, Tony Osei, Priscilla Ekpale, Julia Selby, Jennifer Laryea, Asiwome Aggor, Frempomaa Nelson, Helena Owusu, Grace Aboagye and Agnetta Ampomah

The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) educates, trains and supports overseas health workers to tackle the growing challenge of antimicrobial resistance. Partnerships are running in Ghana, Tanzania, Uganda and Zambia, with the support of UK health workers including pharmacists.

Here, the Korle-Bu Teaching Hospital in Ghana – North Middlesex University Hospital NHS Trust (NMUH) partnership to explore their motivations and hopes for their project.

Read more Improving antibiotic resistance in Ghana

Professional Standards – committing to change and improvement

By Suzanne Scott-Thomas, Chair of RPS in Wales

Professional standards are central to improving practice, creating a more responsive service for our patients and increasing efficiencies.

Part two of this blog on the value of professional standards highlights another example of how using the RPS Hospital Pharmacy Standards has helped reshape a service, along with tips on creating change and improvement.

Read more Professional Standards – committing to change and improvement

Improving care with professional standards

by Suzanne Scott-Thomas, Chair of RPS in Wales

As pharmacists, we need to know that the services we provide are effective, safe, and efficient. This way we can make sure patients are getting the care they need and deserve. We also need to know that the services are continuing to meet the requirements of an ever-changing healthcare environment.

Read more Improving care with professional standards

Social prescribing – linking patients with support

by Hemant Patel FRPharms, English Pharmacy Board member

Today is Social Prescribing Day. So, what is social prescribing?

Social prescribing enables GPs, pharmacists, nurses and other primary care professionals to refer people to a range of local, non-clinical services via a link worker.

Social prescribing schemes can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.

Link workers give people time and focus on what matters to the person, and as part of their care, connect people to community groups and agencies for practical and emotional support.  With the recent publication of the NHS Long Term Plan and personalised care being marked as a priority, the NHS has promised to support at least 900,000 people to benefit from social prescribing by 2023. Pharmacists have a role to play here. Read more Social prescribing – linking patients with support

Women in early pharmacy

By Matthew Johnston, RPS Museum

“There is an impression that women are something new in pharmacy, but nothing could be further from the truth.”

These were Jean Kennedy Irvine’s words on her election as the first woman President of the Royal Pharmaceutical Society in 1947.

Medieval monasteries

In her speech, Jean also mentioned the early beginnings of community pharmacy in the medieval monasteries, where residents would grow medicinal plants to treat themselves and local people.

One of the oldest items on display in the RPS Museum is a stone mortar from a Spanish nunnery (AD 410-1500), used for preparing medicines. The Hanbury Collection of the RPS Library also contains a later copy of the ‘Physica’, a work by St Hildegard, Abbess of Bingen. Originally written in the 1100s, it outlines the medicinal properties of various drugs obtained from the natural world. Read more Women in early pharmacy