Asking patients using pharmacy services what they need

by Stephanie West, RPS Regional Liaison Pharmacist

In our previous blog, Nicky Gray spoke about the ‘strength and authenticity’ of relationships between stakeholders as central to successful integrated working. The same holds true when engaging the populations we serve. Promoting a positive patient experience of health and social care services, through providing integrated out-of-hospital care for patients, is a central aim for PCNs.

Community pharmacy has firm foundations to build upon. The National Healthwatch Report 2016 found that:

  • Three quarters of people say they would go to a pharmacist, rather than a GP, to get medication for a minor illness.
  • Over half would go to a pharmacist to seek advice for a specific minor illness or injury.
  • A third of people would consider using a pharmacy instead of visiting a GP for general medical advice.’

Community pharmacy was also the healthcare service of choice for ‘traditionally harder to engage groups.’ Significantly, the report found that participants ‘trusted the pharmacist’.

Asking patients

One thing that strikes me is – how are patients being consulted and educated about the increasing clinical services delivered by pharmacists? How is the patient voice being captured?

GP Practices have engaged with patients through Patient Participation Groups for many years, to make sure ‘that their practice puts the patient, and improving health, at the heart of everything it does’ These could be a useful forum to capture patient views on new ways of accessing care from the wider PCN team. If you are part of a group focussing on the role of pharmacists in the practice, please get in touch.

Community pharmacists have to conduct an annual patient survey. This focuses on traditional services and advice-giving and could be developed to raise awareness of different clinical services. 

The Berwick Review called for the NHS to ‘Engage, empower, and hear patients and carers at all times’. NHS Trusts have patient and public engagement strategies, recognising the importance of capturing patient views. There are opportunities to do this, many trusts will have patient representation on their Medicines Safety Committee, but can we engage them more widely as strategies for pharmacy and medicines optimisation are developed across Integrated Care Systems?

Shared decision-making

Liberating the NHS: No decision about me without me  focussed on shared-decision making. How are pharmacists ensuring that patients are fully involved in decisions about their own care and treatment? How is pharmacy linked with local communities, groups and networks? NICE Guidance identifies Shared decision-making as ‘an essential part of evidence-based medicine’ and the NHS Patient Safety Strategy 2019 commits to: ‘Commission shared decision-making (SDM) training for clinical pharmacists moving into PCNs, to work with patients with atrial fibrillation (AF) on anticoagulants’.

Get in touch

Our new System Leadership Resource section on ‘Culture Change’ includes a focus on meaningful engagement with local people. If you have a case study showing how you have improved health outcomes or developed a service through patient engagement, shared-decision making and/or co-production we would like to share your insights so please do contact us.


 


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Bring your whole self to work

By Robbie Turner, RPS Director for Pharmacy and Member Experience

Pharmacy is a very diverse profession, especially in terms of gender and ethnicity.  As your professional body, we want to recognise, celebrate and encourage a variety of voices and experiences across pharmacy to better represent you.

The diversity we see is not necessarily represented at senior and leadership level though. Things could be better, and as an organisation we recognise we could also do more in this space.

That’s why I’m so excited we have launched a new programme of work on inclusion and diversity. 

Pharmacists often work in isolation, and especially in the case of community pharmacy, may often be the only healthcare professional on the premises. It can be hard to bring your authentic self to work when your environment means you don’t feel comfortable expressing who you are.  When we don’t bring our whole selves to work we can suffer – in terms of our wellbeing and our work.

We are about to go out to the profession as a whole to get your views on how inclusion and diversity can be improved and celebrated. There will be opportunities to engage with us on this to make sure that our strategy is truly created hand in hand with you.

We’ll be launching a survey at the end of the month as a starter. It’s incredibly important that as many of you as possible complete it – it’s your chance to be in at the start and ensure you inform what we do, both in the short and longer term.

After that we’ll be creating and celebrating some key events such as Women in Leadership and Black History Month in October.

We’ll be sharing our initial thinking at our annual conference on 17th November. 

I’m convinced this programme is the right way forward for the profession, as is everyone at the RPS. Who you truly are matters. We want you to feel able to bring your whole self to work and experience a sense of belonging. I hope you join us on this journey. 

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.

How my pharmacist helped with my diabetes medicine

by Mike Schofield

Although my type 2 diabetes was diagnosed more than 12 years ago, it is only in the last 15 months that I have been medicated.  Prior to that, I had controlled it through diet and exercise. 

On collecting my first prescription for metformin, the pharmacist went to great pains to explain that I should take one tablet each morning and a second tablet each evening on a regular basis and to contact them immediately if I suffered any ill-effects after taking them. We also discussed dietary factors and the need for regular exercise.

The pharmacist then phoned me the following day, on the third day and after one week, to again check that I was taking the medication as prescribed, not suffering any ill-effects and had no questions about the medication.  One month later, when I collected my next prescription, the pharmacist again checked that I was following the instructions and had not suffered any ill-effects as a result of taking metformin.

For the next 12 months I collected my prescription on a regular basis until at the annual renewal the pharmacist asked that I had a consultation with him.  He then asked if I was taking the metformin as prescribed, not suffering any side effects and was following dietary advice and taking regular exercise.  He also asked me to confirm that my feet were being checked by my diabetic nurse and that I received an annual check for diabetic retinopathy.  I as able to confirm that it was the case with both.

In my opinion I have received excellent service from my local pharmacy and am most impressed at the level of care that I have received.

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.

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.

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

Time to Influence

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

Time to Influence 

Throughout the year, RPS speaks on behalf of its members in Wales at the highest strategic levels. We do this with pride and professionalism to influence the change we want to see in health care. Most importantly, we can help improve patient outcomes through the interventions of pharmacists.   

While the issues vary considerably, one variable remains a constant: influencing change takes time. The recent publication of a National Assembly report into dependency on prescription drugs reminded us of this very fact.   Read more Time to Influence

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