It’s not business, it’s personal!

by Nicola Gray, RPS Regional Liaison Pharmacist

I have no doubt that the success of forthcoming integration across systems and sectors is going to be determined by the strength of personal relationships between stakeholders. Human beings crave connection with others above all else and the strength and authenticity of these connections will influence partnership working.

Making connections

These connections cannot be formed ‘on demand’. Sometimes people meet and immediately recognise a ‘soul mate’, personal or professional, but this is rare. And even then, we have to hope that the first flush of exhilaration for a strong new connection settles into something enduring and mutually enriching.

Developing relationships

I was recently a guest of Greater Manchester LPC at the NPA Conference in Manchester, and a thread about relationships became apparent across a number of presentations. Ed Waller from NHSE highlighted the importance of developing relationships and collaborative networks to enable community pharmacy to play its optimum role in PCNs. Simon Dukes from PSNC reflected on why partnerships fail, including lack of trust, stalemate, and the perceived power of one party over the other.

Later, Rose Marie Parr, Chief Pharmacist in the Scottish Government, countered that good relationships are built upon a shared vision, effective leadership and trust. Russell Goodway from Community Pharmacy Wales spoke of delivering a shared ambition through a willing partnership, and our own Paul Bennett spoke of unprecedented co-operation among representative bodies through aligning on the major issues facing pharmacists

Focus on what’s real

I think it is time to reflect on the strongest connections and most enduring, authentic relationships that each pharmacist has made – without exploiting them but focusing on mutual benefit. An obvious source of many enduring connections for pharmacy is with patients. How can pharmacists really tune into those connections to find out what is most relevant and valuable to their local population? Is that not the foundation on which our ‘offer’ to the local health system must be based? How, can we then share this common vision and facilitate strategic change at local level?   NHSE is sending a strong message through PSNC that a ‘tsunami’ of separate pharmacy approaches to PCNs will not be welcomed. What is needed is a coordinated effort from contractors within each locality.

Make use of support

We should also reflect on wider support from the pharmacy system that we can draw upon. From connections with colleagues in local hospitals, and our ‘academic hubs’ in our Schools of Pharmacy. Reminding us who we are, where we have been, and where we are going – not least with what we have to offer to the health system of our understanding of new medicines and new science. For those who already have strong and enduring relationships with multidisciplinary partners in primary care and beyond, try to anticipate the turbulence that they must also be experiencing and consider how you can help them to achieve shared objectives for your community.

So let’s take stock now of our best and most enduring connections, and pool our knowledge to make maximum impact when the time is right.

Our new resource on system leadership helps point the way. It includes case studies from pharmacists working in different levels of the system and links to tools, standards and guides to develop the leadership qualities required to work collaboratively across boundaries within your local health and care systems.

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.

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

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

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

Biosimilar adalimumab is a test of shared decision making in the NHS

Co-written by the National Rheumatoid Arthritis Society, National Ankylosing Spondylitis Society, RNIB, Birdshot Uveitis Society, Psoriasis Association and Crohn’s & Colitis UK

The entry of new biosimilars and the creation of an NHS ‘local market of treatment options’ will see significant numbers of patients switched from the originator product, Humira, to one of four biosimilar alternatives this year.

Adalimumab is one of several biological drugs used in the treatment of autoimmune inflammatory diseases, including rheumatoid arthritis, ankylosing spondylitis, psoriasis, psoriatic arthritis, non-infectious posterior uveitis, Crohn’s and colitis.

While some patients will take this in their stride, for others the change will be met with feelings of apprehension. Read more Biosimilar adalimumab is a test of shared decision making in the NHS

Making a difference to mental health patients

By Caroline Dada, Lead Pharmacist for Community Services, Gender Identity & Medication Safety Officer

Mental health treatment has been transformed in the last 20 years leading to a significant reduction in the number of inpatient beds. The treatment of mental health is unrecognisable from the asylums of old, thank goodness!

This transformation has led to a major shift in care provision, with many patients with mental health problems being seen by the GP with limited specialist input. GPs have raised concerns about this change, reporting a need for increased knowledge and competence and improved co-operation between primary and secondary care. Patients are also concerned, with 22% reporting they needed more specialist input1. Read more Making a difference to mental health patients

Putting antimicrobial stewardship in a global context

By Diane Ashiru-Oredope, Global AMR lead, Commonwealth Pharmacists Association

The independent Review on Antimicrobial Resistance estimated that at least 700,000 deaths each year globally are attributable to drug resistance infections such as bacterial infections, malaria and HIV/AIDS. Unless action is taken, it is thought the burden of deaths from AMR could balloon to 10 million lives each year by 2050 and cost the global economy up to $100 trillion US Dollars.

To help address this, the Department of Health, through the Fleming Fund, has just launched the new Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) scheme. This pioneering pharmacy-led initiative will send up to 12 volunteer teams of NHS pharmacists and specialist nurses to Ghana, Tanzania, Uganda and Zambia to work with local health workers to jointly tackle AMR. The scheme is now open for applications.

CwPAMS will help improve the detection and monitoring of resistant infections at the hospital level, take measures to reduce infection and put in place steps to use antibiotics effectively – all of which will help to keep antibiotics working better for longer whilst helping to stop the emergence of superbugs. The scheme is being led by The Tropical Health Education Trust and the Commonwealth Pharmacists’ Association (CPA) and is looking for multi-disciplinary approaches that involve pharmacy.

How will CwPAMS build capacity in AMS?

The CwPAMS programme will apply skills and knowledge from UK pharmacists to support capacity building for AMS in partner institutions. One important aspect of this is improving monitoring of antimicrobial consumption.

Robust monitoring mechanisms are required to help make informed decisions on where to focus efforts to reduce unnecessary use of antimicrobials, and assess the impact initiatives are having. Whilst monitoring both antimicrobial consumption is included in all national action plans on AMR, the capacity to implement this in most low and middle income countries is low. Enhancing monitoring capacity for AMS can also support building wider systems capacity and enable more effective stock control.

How will the CwPAMS scheme benefit pharmacists in the NHS?

There are important benefits for NHS pharmacists not to overlook when considering whether to apply, including:

  • opportunities to develop frugal yet innovative solutions to share with the UK 11/9/2018
  • improved leadership capacity
  • increased job satisfaction
  • improved understanding of digital technology in health
  • greater understanding and experience of working with limited resources and appreciation of the cost of resources within the NHS
  • opportunities for professional development.

How can you get involved and what support is available?

CPA are encouraging pharmacists to apply for this new and exciting opportunity. We recognise applying for grants can seem daunting to those not well immersed in doing so; the RPS are able to offer a range of valuable support in preparing applications. Contact the RPS Research Support Service or email research@rpharms.com.

CPA & THET will also be providing training for those who are awarded grants. To find out more visit the CPA website which includes access to the grant call documents. The grant call closes on 4 January. You can also email the CPA team directly via amr@commonwealthpharmacy.org.