The way in which people in Scotland access health care is always changing – and in my opinion, the need for that change has never been greater, nor more urgent. Thankfully, we have an NHS system that is world-leading and has always been responsive in adapting to the needs of the people it serves.
Of course, we cannot ignore that staffing and resources are a limiting factor for the health professions, with far more vacancies than there are qualified doctors, nurses and pharmacists and many nearing retirement age.
However, there is much that can be done to shift the balance of care by ensuring that each member of the healthcare team has the right skills and abilities for their role and that they spend the majority of their time using those skills in direct patient care, supported to do so by technology and effective data analysis.
This has already been happening over the last few decades – it is common for a nurse or a pharmacist rather than your GP to be the one managing your long-term conditions at your local practice, and it is a whole team of healthcare professionals who will look after you on the rare occasion that you are admitted to hospital (now that most NHS services aim to keep people as close to home as possible).
So, how do community pharmacy teams fit into this picture over the next 5-10 years? The Community Pharmacy network is also undergoing workforce pressures and a year on year increasing workload, and now I’m suggesting there’s more to do? The answer starts with effective service design, and we are working with our colleagues in Scottish Government to expand but also streamline existing pharmacy services and invest in skills development.
Part of this investment has included a Scottish Government-funded scheme to support community pharmacists to obtain their independent prescribing qualification and advanced consultation skills, with 64 places fully resourced in this first year of study.
The long-term plan is for pharmacists to be able to use their expertise in medicines and those prescribing skills to manage their patient’s long term conditions and a greater range of acute illnesses. This leaves our GP and hospital teams free to deal with more complex care.
Having a background in community pharmacy myself, I can tell you that there is nothing more frustrating than knowing exactly what the patient standing in front of me needs and not being able to issue prescription, only medicines – having to refer them to a GP or out of hours service so that they can waste hours of everyone’s time and NHS resources, just to get their hands on a piece of paper that lets you hand over the medicine you would have liked to supply them with in the first place!
We already have several community pharmacist prescribers providing services which allow them to deal with common clinical conditions in one visit – the feedback from people accessing these services is overwhelmingly positive, and why wouldn’t it be?
Other local healthcare providers are also supportive of the move and are getting used to directing people straight to the pharmacist where traditionally a GP appointment would have been made. It won’t happen overnight, but with continued funding from Scottish Government for training and resource from Health and Social Care partnerships to run similar pharmacy-led clinics, we will completely change the face of community, or as the NHS describes it, primary care, and do our bit to keep our NHS alive and kicking.
Harry McQuillan is the chief executive of Community Pharmacy Scotland.