Medical exemption fines: could they be better spent?

by RPS England Board Chair Sandra Gidley

The Government have announced plans to strengthen checks at pharmacies for entitlement to free prescriptions in England.  Whilst we all want to see fraud stopped, I have to ask – is really the right approach?

Only patients in England can be judged to have committed prescription fraud because prescriptions are free in Scotland, Wales and Northern Ireland.

Many patients who fall foul of the medical exemption fine have simply forgotten to renew it. They only need to do this every five years, so it’s a diary date that is easy to miss. We shouldn’t label people with a serious long term condition who have forgotten to renew their medical exemption certificate as fraudsters because they have made a genuine mistake. Read more Medical exemption fines: could they be better spent?

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

Supporting System Leadership

by Amandeep Doll, RPS Regional Liaison Pharmacist

I’m one of four Regional Liaison Pharmacists at the RPS, working on system leadership for pharmacy and medicines optimisation in England, delivering national strategy at a local/regional level.

We know there is a need to bridge the gap between the strategic and operational levels of healthcare and mobilise the profession to get involved with system leadership to improve health outcomes for patients. It’s vital to ensure that medicines optimisation and pharmacy services are considered core criteria when planning and implementing healthcare services.  Read more Supporting System Leadership

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.

 

How pharmacists can support older people with mental health issues: a personal view

By Dr Amanda Thompsell, Chair of the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists

Having met with members of the Royal Pharmaceutical Society to talk about their mental health campaign it made me reflect on the many ways that pharmacists support older people with mental health issues.

Not only do pharmacists give helpful advice around reducing unnecessary medications, on side effects and potential drug interactions and ways to improve adherence, but pharmacists help in so many other ways that can go unnoticed. Read more How pharmacists can support older people with mental health issues: a personal view

Improving mental and physical health – parkrun

By Chrissie Wellington, Global Head of Health and Wellbeing, parkrun

We all know that exercise is one way to improve physical and mental health, but it can be very hard to get started and motivate yourself to continue exercising.

I work for a brilliant organisation called parkrun which provides a fantastic way for anyone to improve their physical and mental health in a fun and supportive environment.

As a non-profit organisation, parkrun organises free 5k runs which take place every Saturday at 9am (9:30am in Scotland and Northern Ireland). There are currently over 770 parkrun events across the UK with approximately 140,000 weekly participants supported by around 14,000 volunteers.  Read more Improving mental and physical health – parkrun

How our Foundation program can help you

By Morenike Adeleke MRPharmS

Being a Foundation pharmacist has enabled me to continuously develop my practice, take into account what I’m doing well and what I can do differently or better. Finishing off the RITA1 stage of the Programme was a time of great reflection on my practice for the last year. I have always thought about my practice, but this brought back memories of some very difficult situations I have found
myself in.

The Peer Assessment tools were very helpful in terms of boosting my confidence in my daily practice; it is sometimes difficult to ask for feedback, as some colleagues may feel uncomfortable giving criticism to pharmacists directly. It was helpful in making me see the areas in which I need to grow; but it was also nice to read some very complimentary comments from my colleagues who may not otherwise have the opportunity to say those things to me.

The workplace- based assessments were initially a bit daunting, but my trainer was lovely and made me see for myself the areas in which I’m performing well. Sometimes with reflection, we focus on the things we need to improve on and forget to congratulate ourselves on the areas in which we are exceeding. Having another pharmacist there to see how I was working was actually quite refreshing and I felt comfortable enough to ask her some questions.The study days have opened my eyes to a number of areas of pharmacy that are important to my daily practice, that are not always obvious. For example, mental health was discussed at our last study day and we talked about how we can support our patients who may have mental health conditions, in a way that does not discriminate against thembut treats them just like any other patient. It’s also nice to meet some new pharmacists and catch up with some colleagues who I haven’t seen for a while! The reflective accounts and uploading all of my certificates so far made me realise how far I have come as a pharmacist. For me, that’s the great thing about the Foundation Programme.

Being able to look back on how far I have come and how I’ve grown as a pharmacist through the programme is fantastic and I’m excited because I have so much further to go.

The Hanbury Botanical Garden: a pharmacist’s holiday destination in 1906

By Karen Horn, RPS Librarian

The Hanbury Botanical Garden is situated on the La Mortola promontory overlooking the Mediterranean. A glance at TripAdvisor  tells us that it is ‘spectacular,’ ‘a real gem,’ and ‘a beautiful, calm place with stunning views.’

What we are not told, though, is the garden’s connection to the Hanbury family and pharmacy.

Thomas, Daniel and the making of a garden

Daniel Hanbury was an enthusiastic traveller, taking every opportunity to further his research on materia medica. It was he who brought La Mortola to the attention of his brother, Thomas.  In March 1867, Thomas, a merchant in Shanghai, visited the area and found the ruined Palazzo Orengo with its neglected grounds and olive groves. Read more The Hanbury Botanical Garden: a pharmacist’s holiday destination in 1906

The Hanbury Memorial Medal – open to scientists of all nations

By Karen Horn, RPS Librarian

Daniel Hanbury, renowned British pharmacologist and botanist, died of typhoid fever on 24 March 1875.  He was 49 years old.  He is buried in Wandsworth, in the Society of Friends’ burial ground.

Shortly after Daniel Hanbury’s death, his friends and colleagues resolved to honour a life dedicated to science by awarding a medal in his memory –  for ‘high excellence in the prosecution or promotion of original research in the Natural History and Chemistry of Drugs.’ Read more The Hanbury Memorial Medal – open to scientists of all nations

It’s time to make the most of pharmacy in mental health

By Sandra Gidley, Chair of RPS England

People with a serious mental illness die 15-20 years earlier than on average.

They are three times as likely to lose all their teeth.

More than 16 million people in England are diagnosed with a long-term physical health condition, and more than five million of them will experience a mental health problem.

These are just some of the shocking figures that underline just how much further we have to go on the issue of mental health and the reason I was delighted to join with members, patient groups and the other health professions to mark the launch of the Royal Pharmaceutical Society’s new campaign on mental health in Parliament last week. Read more It’s time to make the most of pharmacy in mental health