Outside the comfort zone – getting involved in politics as an RPS member

by Elin Gwyn MRPharmS, Palliative Care Pharmacist, Betsi Cadwalladr Health Board

The latest meeting of the Welsh Assembly’s Cross Party Group on Hospice and Palliative Care was recently held at on Friday 23rd November. Royal Pharmaceutical Society in Wales asked me to attend the meeting on its behalf. With RPS having just recently launched its policy on palliative and end of life care, its engagement and membership of this group is very timely.

The purpose of cross party groups is to bring together groups and organizations with expertise in a particular policy area with Assembly members who are interested in the same area. The cross party groups don’t have power, but they are used to raise Assembly members’ awareness of issues related to the field so that they can scrutinise and challenge the government and the NHS more effectively.

Read more Outside the comfort zone – getting involved in politics as an RPS member

A good life to the very end…

Chief Pharmacist and Clinical Director of Pharmacy and Medicines management for Cardiff and Vale University Health Board
Darell Baker, Chief Pharmacist and Clinical Director of Pharmacy and Medicines management for Cardiff and Vale University Health Board

by Darrell Baker FFRPS, Chief Pharmacist and Clinical Director of Pharmacy and Medicines management for Cardiff and Vale University Health Board

A good life to the very end…

For human beings, life is meaningful because it is a story, and in stories endings matter
(Atul Gawande)

Quality palliative and end of life care is important and medicines can have a key role to play in facilitating that quality of care for many of our patients. On behalf of the Chief Pharmacists in NHS Wales, I am pleased to have supported the development of the RPS Wales policy document and to endorse its key recommendations.

 

Focusing on the individual

Understanding what quality end of life care looks (and feels) like for an individual is an important starting point. Pharmacy staff need to work as integrated members of the multi-professional team around the patient, with access to clinical information about the patient. This way, we are able to respect their wishes and support effective implementation of treatment and symptom management plans, regardless of location.

Read more A good life to the very end…

Palliative and End of Life Care – getting it right first time

Sudhir Sehrawat, Community Pharmacist and RPS Welsh Pharmacy Board member
Sudhir Sehrawat, Community Pharmacist and RPS Welsh Pharmacy Board member

by Sudhir Sehrawat, Community Pharmacist and RPS Welsh Pharmacy Board member.

 

Getting it right – first time.

 

In every day working life we strive to get things right so we achieve the results that people need. It saves time, avoids duplication of effort and you get the result you want. Yet, as a community pharmacist, I see palliative care as an area where we sometimes don’t get things right first time due to the complexity of the systems and processes involved.

 

What happens when we get it wrong

 

In a real life scenario I was presented with a prescription by a patient’s relative for end of life medication on a Saturday morning. The medication prescribed was not on the Health Board Palliative Care Formulary and the family had spent most of the previous day travelling to various community pharmacies to get the prescription dispensed. I contacted the out-of-hours GP explaining the situation and the relative was asked to attend the out-of-hours service for a new prescription. They returned after lunch with a new prescription, however, the hand written prescription did not meet the controlled drugs regulations. I contacted the out-of-hours service again and the family member was asked to pick up a new prescription and return to the pharmacy. The controlled drug was supplied in part due to limited stock held but was enough to last until Monday evening. I explained we could order the remaining stock and deliver it when it arrived. After work on Monday evening I visited the patient’s address with the remaining medication only to discover the patient had sadly, already passed away on Saturday evening.

When a patient is at end of life members of the family and friends need to be with their loved ones, not chasing supplies of medication.

There’s lots to consider within this one real life scenario.

  • Why was a non-formulary palliative care medication prescribed?
  • Why was the alternative controlled drug prescription not written correctly?
  • Where were the communication channels to let the community pharmacy know the patient had passed away?

This single case is typical and highlights multiple opportunities to improve care at the end of life.

 

Getting it right in future

 

I welcome the upcoming policy on palliative and end of life care by the Royal Pharmaceutical Society in Wales. This leading policy will address the issues we healthcare professionals face and importantly, allows patients high quality coordinated care. Patients and carers have the right to be treated with dignity and respect. The policy outlines key areas to ensure patient empowerment through timely access to medication, providing the right support through shared health care plans and offering education and training to the workforce.

If we work on an All Wales approach and implement the key recommendations of the policy, we have the opportunity to drive quality improvements as well as reduce demands on our health and social care services. I’m fully behind the policy as I hope many of you reading this blog will be. Lets get it right – first time.

 

RPS new Palliative and End of Life Care policy for Wales will be published at the end of November, and launched at the RPS Medicines Safety Conference in Cardiff on November 22. 

Palliative Care & The Pharmacy Team – what do we have to offer?

by Elizabeth Lewis, Palliative Care Pharmacist

What do we pharmacists have to offer?

I have just retired, having had a very rewarding career as a palliative care pharmacist. I firmly believe pharmacy has a key role to play in supporting patients and their families, as well as other professions, in the delivery of palliative care services in both community and secondary care. Currently we are an under used resource but have the potential to offer much more to existing services.

Community Pharmacists are ideally placed to advise on the safe and effective use of medicines. The local pharmacist is a readily accessible source of information and advice for both the patient and those supporting them. With improved communication with fellow professionals in both the community and secondary care services they would be better placed to ensure the supply of essential medication and support. This in turn would help community services in supporting patients who wish to die at home.

In secondary care the inclusion of an advanced specialist pharmacist in the palliative care multidisciplinary team is beneficial in providing advice on all aspects of medicines management from the suitability and availability of drugs and the prescribing options to the use of drugs in renal and hepatic failure. Non specialist pharmacists also have a role in ensuring symptom control is optimised, appropriate and effective.

For pharmacists to reach their full potential in the field of palliative care they need access to education and, where appropriate, the opportunity to gain experience in working with palliative care patients.

The scope of palliative care includes many non-cancer diagnoses and, with an ageing population, there are more patients requiring palliative care input than ever before. Pharmacy needs to rise to the challenge. We have made a start in Wales and have formed the All Wales Palliative Care Pharmacist Group, for pharmacists with a particular interest in palliative care.

*The group undertakes projects on a national basis such as the Just in Case Box scheme and the development of the syringe driver chart and also acts as a support group for its members.

We need to build on these foundations to ensure pharmacy provides great care for palliative care patients and continues to develop expertise in palliative care medicines use across the whole range of pharmacist roles

Elizabeth Lewis is a major contributor of expertise to our new Palliative and End of Life Care policy for Wales, which will be published at the end of November and launched at the RPS Medicines Safety Conference  in Cardiff on November 22.

A revolution for health and social care in Wales?

by Ross Gregory, Head of External Relations, Royal Pharmaceutical Society in Wales

Ross Gregory, Head of External Relations, RPS Wales
Ross Gregory, Head of External Relations, RPS Wales

If you haven’t already heard of the Parliamentary Review of Health and Social Care in Wales, there is little doubt you soon will. Published early in the New Year and anticipated as one of the most important independent advisory reports for the NHS Wales in nearly two decades, the report makes a case for change for radically transforming the Welsh model of health and social care to make it fit and sustainable for the future.

I would recommend you take a look at the report. At less than 40 pages long, it’s far from an onerous or difficult read and you may find it provides a certain ‘feel good factor’. You may even find it provides a ray of hope that the challenges facing us in the delivery of health and social care services are being thoroughly addressed. Beyond the glow of enthusiasm and optimism however, a number of critical questions remain; Will the report have the potential to drive a revolution from within our system and significantly transform services? What will a new system look and feel like? What will this mean for pharmacy services and the future of pharmacy profession in Wales?

Read more A revolution for health and social care in Wales?

Why get involved in Quality Improvement?

Fiona Jones, Welsh Pharmacy Board Picture by Nick Treharne

Author: Fiona Jones, Welsh Pharmacy Board
Picture by Nick Treharne

Why get involved in Quality Improvement? I’m sure everyone asks these question.
Do I have time?
How much work is involved?
Will it make a difference?

Like you, I too thought I didn’t have any time, or maybe the skills to start making a difference, I may have felt that it’s easier to keep doing what I’ve always done. However back in 2012 I undertook the RPS Leadership course and from then on I haven’t looked back. Read more Why get involved in Quality Improvement?

Collaboration across organisations sets standards for Welsh pharmaceutical care

Daniel 150Following on from the successes of previous years, the 5th Annual Wales Medicines Safety Conference was quite the event drawing in delegates from a diverse range of health professions, including the professional bodies for nursing, physiotherapy, general practitioners and pharmacists. Read more Collaboration across organisations sets standards for Welsh pharmaceutical care

Welsh NHS Confederation Conference

 By Paul Gimson, Director for Wales

Earlier this month I was lucky enough to be representing pharmacists and the Royal Pharmaceutical Society at the conference of the Welsh NHS Confederation  . The Confederation is the body that brings together the organisations that make up the NHS.

First up was the CEO, Helen Birtwhistle.  A few weeks ago, Helen reinforced the message that the NHS will fail  if it continues to do the same thing with less money, to the National Assembly for Wales.  She repeated this again at the conference but this time in front of the Minister for Health and Social Services, Lesley Griffiths, along with a clear message to all politicians that their support will be needed when the difficult decisions have to be made.  It was easy to see the subtext. Read more Welsh NHS Confederation Conference