Please note this piece is a spoof and does not represent the views off the Chief Pharmacist – in fact I have made it all up!
So tell me, what is your personal driver here?
Well, when I qualified I was told that the doctor would diagnose and the pharmacist would prescribe. I believed this and after 30 years we are not that much closer. A lost generation. I want to lead the profession to a different place.
A different place – what do you mean by that?
Well pharmacists must take a leading role in healthcare provision and not always a subservient one.
Crikey – that is a bold statement.
Not really – pharmacists have always been there as the doctors ‘wingman’ checking prescriptions and offering advice, promoting safety and being patient’s advocates. Always a tricky role but there will always be a need for this valuable role. Pharmacists have always diagnosed and treated illnesses and it is this role that I want to see expanded. In my opinion half of the patients that see a Doctor could be adequately – perhaps better managed by a pharmacist and we should strive towards this goal.
So you have great aspirations for community pharmacists?
Absolutely, I have helped the NHSCB develop the transformation scheme, but not only community pharmacists. Have you seen the new breed of consultant pharmacists and independent prescribers. I want members of the public to see more of these. In every hospital, in every GP practice and in community pharmacy. They are a constant source of pride for the profession and I would like to encourage this, but I have to help to create opportunities.
In every GP practice?
Why not? There are some great examples around. I am always surprised that so few GPs have taken that route. Most pharmacists are very structured and logical. Give them a problem and they will solve it. If you want to be organised within an inch of your life and achieve maximum QoF points – employ a pharmacist.
You mentioned a the transformation scheme – what is that?
I have heard people complain that community pharmacy was slow to change, but why should they change their model of service delivery without guaranteed income – so the transformation scheme supports the change, but the community pharmacists have to be embrace change.
Tell me why you have pushed medicines optimisation to the limit?
Medicines management went too far, caused too much aggravation for the government and restricted the tools of our trade. The Ministers tell me that we need to boost the economy and support our industry and make the UK a good place for investment. Our skill is in how we use medicines, not how we block access to them. I also see medicines as part of the glue or framework of integration, but they have often been the cause of division. In someways it was a success and in some our downfall.
So this is the basis of medicines optimisation
Absolutely not. The NHS has fundamentally changed. The focus is on achieving better outcomes through service redesign and greater effectiveness. The currency has changed – its no longer £ prescribing budget spend – it is £ commissioning spend. And we need to really bring people into the conversation and improve their experience with medicines. Different currency – different solutions. We must focus on quality and outcomes and by doing so the costs will come down long term. Remember the austerity program is here for 10 years so simple cost-saving is just too short term and the quick savings can damage quality.
So is it an evolution?
No it is a revolution. New NHS, new problems, different currency, different solution. Out with the old and in with the new. CCGs should employ medicines optimisation specialists. They can contract budget management solutions through practices if they need to. We must set challenging targets then give the medicines optimisation specialists space to grow and implement change.
So where do things like NMS and MUR fit?
There are very important things, but they can dangle in the wind a little. Medicines optimisation specialists should link medicines reconciliation in both primary and secondary care to NMS and link medication review to MUR and this will give the services a common language and a common understanding.
And your job now?
Well we are still working that through, but I am still the Chief Pharmacist and I will always provide leadership and direction to the profession.
Thank you, I feel that there are other areas that I would like to explore with you.