400 years of the Pharmacopoeia Londinensis

 By Karen Horn, RPS Librarian

December 2018 sees the 400-year anniversary of the Pharmacopoeia Londinensis (second issue).  We are lucky enough to have a copy in the RPS Library’s early printed collection.  Produced by the Royal College of Physicians, it was the first authoritative, standard pharmacopoeia for the whole of England – Scotland and Ireland later producing their own.

It lists all the drugs authorised for use by the Physicians. These include the stomach lining of hens, used as an astringent, and opium.  Preparations of opium are still in use today.

Signs and symbols

The title page of this Pharmacopoeia is fascinating.  Rich with symbols of power, the Tetragrammaton, Hebrew for God, appears on a cloud from which a hand reaches out to hold the coat of arms of James VI of Scotland/I England.

The College of Physicians’ own coat of arms is situated alongside four important figures who influenced the development of medicine: Galen, Avicenna, Hippocrates and Mesue. The presence of all these images is no coincidence: they emphasise the authority of the College of Physicians.

As interesting as the Pharmacopoeia Londinensis is in its own right, there’s something about our volume which makes it all the more exciting.

 

Sir William Paddy and ‘Principis Ferdinandi’


Discovered in Brussels in 1955, our copy contains handwritten notes contemporary to the period in which it was published.  The majority of these are headed ℞ for ‘Recipe’ or prescription.  Further notes in French include instructions for the dispensing of certain medicines and their uses.

It also includes the name of William Paddy in a handwritten inscription at the foot of the title page.  Sir William Paddy was born in 1554 and was President of the College of Physicians in 1618.  As a Fellow, he is likely to have been involved with its production.  He was also physician to James I.

Paddy is not the only prominent name in the inscription. Whilst the ink has faded in some places, the name ‘Principis Ferdinandi’ is also legible alongside it.  So, who was ‘Principis Ferdinandi’?  The most obvious candidate would seem to be  Ferdinand II, Holy Roman Emperor (1578-1637), although Ferdinand of Bavaria (1577-1650) might also be a contender.  To complicate matters further, a third individual seems to be mentioned, but much of his name is now illegible.  The inscription tells us that our copy of the Pharmacopoeia Londinensis was presented as a gift … but by whom, to whom?

We may never know for certain whose hand wrote the notes and inscription. We will certainly never know all the secrets this volume holds of its journey from London to Brussels and back again.

If you can shed any light on the mystery surrounding our copy of the Pharmacopoeia Londinensis, we would love to hear from you. If you would like to book an appointment to see this and other pharmacopoeias in our early printed collection, please email library@rpharms.com.

 

Rpharms.com – why so different?

We’ve been listening to your feedback about rpharms.com. You told us you love the content on the site, but it can be hard to find. You also told us some of the best bits of RPS membership are hidden and it’s not always clear what we do for pharmacy.

So, say “hello” to our new website – designed by…you!

The new site will give you a clear view about what we do and how we do it

Recognition. Development. Publications.

We’ve moved the good stuff to the top so it’s easier to find and navigate – you’ll find a consistent theme across the site, and all our communications.

  • We drive recognition of pharmacy through our campaigns to secure the future for the profession. We make sure your voice is heard across Government and in the media
  • Our publications, from the Pharmaceutical Journal, BNF, MEP and Pharmacy guides, help you provide safe and effective medicine use for your patients
  • We support your development at all stages of your career, from students, pre-reg’s, newly qualified and more experienced pharmacists, our development programmes match your career goals.

I’m really proud of what the team at RPS has achieved with the new site. We believe it’s clear and easier to use. Of course we will be updating and changing as we get feedback from you. We’ve also got further improvements planned to make the website experience even better. Let me know if you love the site, if you hate it, or if you have any suggestions about improvements @nealcpatel

Follow Chris’s revalidation tips

I’m Chris John from the Royal Pharmaceutical Society (RPS) – welcome to my blog. As Head of Workforce Development I look at the standards, guidance, and policies that will develop our profession. Having been involved in the RPS approach to supporting its members with revalidation I decided to write a blog about my own journey with staying on the register.  Each month I will cover different aspects of a new additional way us pharmacists have to keep our knowledge and skills up-to-date – the peer discussion.  The what, who, where and how. I hope you find my blog to be informative as well as an enjoyable read – do let me know.

Who will Chris choose for his peer discussion?

Chris’s peer discussion blog

 

Who will Chris choose for his peer discussion?

As the season of good will is fast approaching, I am hoping I can persuade someone to act as my peer for my peer discussion as part of revalidation (I will resort to offering bribery in the form of mince pies etc. if necessary).

Previously I wrote in this blog about my own journey with staying on the register of pharmacists and how I would be approaching the peer discussion – one of the new ways us pharmacists have to keep up-to-date.  Last time it was the ‘what’, now I’m considering the ‘who’. Read more Who will Chris choose for his peer discussion?

Have you had your flu vaccine yet?

By Paul Bennett , RPS CEO

I recently had my seasonal flu vaccination – have you had yours?

This is something I do every year. Not only to protect myself, but also my family, my colleagues and people I come into contact with who may be vulnerable. It’s a very sensible precaution because influenza can have a devastating impact if it takes hold. While we often think of flu as something little more than a bad cold, it has a legacy of tragedy behind it. Read more Have you had your flu vaccine yet?

My career journey at Roche

By Ciara O’Brien, Medical Manager at Roche

 

There are many parallels that can be drawn between sectors of Pharmacy because as Pharmacy professionals, we all must adhere to the same standards of conduct. For me, this has meant seeking out and building on the core concepts in my day job – wherever that has been – to develop transferable skills that allow me to confidently bring the value of a pharmacist to any role. In particular, the quality, safety and regulation of medicines speaks to the Pharmacist role of medicines expert and the provision of optimised pharmaceutical based care with the patient at the centre.

I began my career with my GPhC registration from a community pre-reg and no idea what roles were available to me in the Pharmaceutical Industry but a desire to work there. I used job sites online and this lead to my first role at Roche as a Drug Safety Associate. I was able to demonstrate the core competencies and skills I had gained on the MPharm degree and from community practice in the interview. Having the pharmacy qualification meant I could transfer skills from clinical checks of prescriptions to medical review of adverse event cases. Read more My career journey at Roche

Chris’s Peer Discussion Blog

As I get older I think I’m becoming more last minute.com. I recently zapped my CPD records to the General Pharmaceutical Council – just in time for 31 October deadline.  Perhaps I should be more compare the supermarket.com?  Now I have revalidated for 2018 my mygphc.org account has re-set to what I need to do in the next 12 months. There are new things to think about.

I work at the Royal Pharmaceutical Society (RPS) as Head of Workforce Development looking at the standards, guidance, and policies that will develop our profession. Having been involved in the RPS approach to supporting its members with revalidation I thought I should write a blog about my own journey with staying on the register.  Each month I will cover different aspects of a new additional way us pharmacists have to keep our knowledge and skills up-to-date – the peer discussion.  The what, who, where and how. Read more Chris’s Peer Discussion Blog

My day with the English Pharmacy Board

by Sarah Browbank, Hospital Pharmacist and an RPS Ambassador

I’ve been fortunate enough to become an RPS Ambassador recently.  To do my best in my new role, I asked to attend the English Pharmacy Board meeting last week as an observer.  I feel it is important to understand how the RPS works.  Prior to taking on the Ambassador role, I felt I had some idea of what went on but really wanted to get under the skin and truly understand the activity and influence of the RPS.  I can only tell you how inspired, motivated and impressed I am by the work of the RPS and the committed staff that support our profession!   Read more My day with the English Pharmacy Board

FIP – like hosting the pharmacy Olympics

I spent the first week of September in a surprisingly sunny Glasgow, at the 2018 FIP World Congress of Pharmacy and Pharmaceutical Sciences. This was the 78th FIP event and the first time it had been held in the UK for nearly 40 years. We had the privilege and huge challenge of hosting it – and let no one underestimate the size of this challenge! A global gathering of pharmacists and we were responsible for the venue, the catering, much of the programme, the formal opening ceremony and the big events. It’s like hosting the Olympics except for pharmacy! It took considerable effort from our great events team and many other colleagues to plan and deliver this.

The ‘myth’ concerns the view sometimes expressed that such events are irrelevant to the majority of the profession and are only for a select few – the ‘pharmacy elite’ from academia, science, research and pharmacy politics. If you’d asked me previously what FIP was all about, I may have told you rather dismissively and from an uninformed position, that it was not really relevant to us in the UK, out of reach to the ‘typical’ pharmacist and out of touch with the younger generation. What a huge misconception that proved to be!

Glasgow 2018 really did dispel that myth for me. Many community pharmacists and their representative organisations were in attendance actively participating in the event, as well as people from hospital practice and chief pharmacists from all across the globe, including our own from here in the UK. Read more FIP – like hosting the pharmacy Olympics

Our take on the NHS Long Term Plan

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:

  1. Life stages
  2. Clinical priorities
  3. 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?

Life Stages

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.

Clinical Priorities

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  

Workforce

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.