Diabetes: the team approach

By Philip Newland-Jones and Anna Hodgkinson, Consultant Pharmacists in Diabetes

People with diabetes need the support of a full multidisciplinary team more than ever, and utilising pharmacists trained in diabetes care are an essential part of this vision.

Statistics from Diabetes UK show that one person is diagnosed with Type 2 diabetes every three minutes in England and Wales, and 500 people with diabetes die prematurely every week.  It is estimated that the NHS currently spends 10% or £10 billion of its annual budget on diabetes and its complications.

We know that over 65 year olds with Type 2 diabetes have on average six to seven other health concerns, often needing multiple medicines. Both the Long Term Plan and the NHS Interim People Plan recognise the value and impact pharmacists can have to improve outcomes for people living with long term conditions, including diabetes. This paper outlines a clear vision for pharmacy and the need for the NHS to utilise pharmacists alongside other healthcare professionals across all care settings to improve the care of people with Type 2 diabetes.

In the past, pharmacists have held a more traditional but key role in the management of diabetes, including being an integral part of improving medicines safety and supporting medicines optimisation. Over the past few years, recognising the skills and positive impact on care pharmacists can have both with individuals and at a population health level, we have seen a change in mindset. Increased numbers of pharmacists are now working in diabetes and Consultant Pharmacist posts have been developed. Although this is a start, as highly trained and skilled professionals, we know we can do more whether this is at a GP practice, care home, a community pharmacy, hospital, or Integrated Care System level.

The direction of travel for pharmacy in the management of Type 2 diabetes is clear. We have a huge role to play alongside our healthcare professional colleagues in improving outcomes for people with Type 2 diabetes, after all supporting people with diabetes needs the full multidisciplinary team more than ever.

We are excited for the opportunities that the RPS policy document, The Long Term Plan and NHS Interim People Plan will bring for pharmacy and we look forward to working with the profession over the coming days, months and years to promote and support the role of pharmacists within all care settings to improve outcomes for people living with Type 2 diabetes.

It is important to note that pharmacists cannot do this alone, we need the right environment for development, the support and mentoring from colleagues with experience in diabetes care such as practice nurses, diabetes specialist nurses, GP’s, specialist dietitians, podiatrists.  The only way we are going to be able to effectively tackle diabetes across all care sectors is to ensure this seamless teamworking and collaboration is encouraged and cultivated.

We’ve got two things to ask of you:

  • If you are a pharmacist, and you are interested in supporting people with diabetes then please ensure you have thought over what competencies you need to develop using the UKCPA Integrated Career and Competency Framework for pharmacists in Diabetes
  • If you are a healthcare professional working in diabetes in any sector of the NHS, think if your team would benefit from the support of a pharmacist, and if you work with a pharmacist embrace and support their development to ensure they are the best they can be for your team and your patients.

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

From community pharmacist to Medical Science Liaison

Sinead Monaghan, Medical Science Liaison, Sanofi

I graduated with a master’s degree in pharmacy from Queen’s University Belfast.I undertook my pre-registration year in a community pharmacy chain in Northern Ireland. I was employed as a pharmacist manager with the same company post pre-registration year. I spent a further four years as a community pharmacist.

I thoroughly enjoyed this role, especially being a pharmacist tutor. This very much sparked my interest in training others. I had always been curious about alternative pharmacist roles, but felt my knowledge of career paths was limited.

Read more From community pharmacist to Medical Science Liaison

How Sarah became a Medical Science Liaison

Dr. Sarah Anne Goffin, Medical Science Liaison at Sanofi

I come from a family of healthcare professionals and have always been passionate about science, so pharmacy seemed to be a perfect fit for me. 

I undertook my undergraduate at the University of East Anglia between 2006 and 2010 and completed my pre-registration year in 2011. As I worked part-time as a counter assistant in community during my degree I wanted to take the opportunity to increase my experience in hospital pharmacy. 

Read more How Sarah became a Medical Science Liaison

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

I am what I am! LGBT History Month

By Mike Beaman, FRPharmS, retired pharmacist

I am writing this blog in support of the Royal Pharmaceutical Society’s response to LGBT History Month.  Although not a gay activist I have, nevertheless, been generally open about my lifestyle since coming to terms with being a gay man back in the early 1970s.

I was born in 1947 so I was 19 and a university undergraduate when the legislation decriminalising homosexuality became law in 1967. I was already a young adult and therefore having an intimate relationship with another man before that time would have been a criminal act and would also have resulted in my being sent down from university and unable to eventually register as a pharmacist. Read more I am what I am! LGBT History Month

Primary care networks: getting started

by Stephanie West, RPS Regional Liaison Pharmacist

One of the things that excites me as a Regional Liaison Pharmacist for RPS is seeing examples of how local primary care professionals are coming together to discuss good patient care, provided by the right practitioner, close to home. So it was fantastic to see clear recognition of the key roles pharmacists play  Read more Primary care networks: getting started

Biosimilars: a great opportunity for pharmacists in England

by Jonathan Campbell, RPS Regional Liaison Pharmacist

Biosimilars have huge benefits for patients and the NHS and offer opportunities for pharmacists too.

The NHS Long Term Plan sets out how “the NHS will move to a new service model in which patients get more options, better support, and properly joined-up care at the right time in the optimal care setting”.

These new models of integrated care will need organisations and their staff to work together across the traditional boundaries of community, general practice and hospital – adopting a system leadership approach to improving population health that puts the patient at its heart. Read more Biosimilars: a great opportunity for pharmacists in England