Medicines are the most frequently accessed healthcare intervention in today’s NHS and there continues to be new innovative molecules launched that treat diseases which previously could only be improved by surgery, if they could be improved at all.
This is particularly relevant in the field of oncology and in the treatment of viral diseases such as hepatitis C and human immunodeficiency virus (HIV).
Where the challenge arises is whether the way we deliver access to these treatments has kept pace with the treatments themselves.
It is understandable that when new and innovative medicines are launched, they are typically supplied through our hospital network and out patient clinics.
This certainly allows the patient and the medicine to be monitored to ensure potential adverse reactions are minimised and maximum benefit is derived from the prescribed pharmacotherapy, i.e. the taking of your medicines as was intended.
As this treatment continues and becomes a longer-term solution, we need to find a way that allows people to be treated nearer to or at home.
This is in keeping with current Scottish Government health policy and I would argue more importantly, the wishes of our population. I often hear instances where people have had to travel considerable distances to hospital clinics to receive a repeat of their medication, which for some can be a significant disruption to their daily or working life.
An alternative that is used is a homecare delivery service that utilises a courier company to take the medicines to someone’s home within a time window.
This requires someone to be present to receive delivery as these medicines should not be left with anyone other than the intended recipient. This again can disrupt someone’s working life.
A potential solution to this is to allow treatment support and access to these medications through the patient’s community pharmacy. This would allow the pharmacist, practising at the centre of our communities, to have the complete picture of the medicines their patient is receiving and provide any necessary interventions.
An agreed protocol could then be developed to ensure any concerns that the pharmacist and their team within the pharmacy have are relayed back to the hospital setting for consideration and review. This process should free time within our hospital settings, allowing more initial treatment appointments and reducing waiting times.
A similar issue can occur when patients are due to be discharged from a hospital setting following an admission for treatment. This can be delayed if their medicines are not ready to take with them.
This can have knock on effects with patient transport availability and associated long waits at a time when patients and families would rather be returning to their own home.
By harnessing technology and transmitting the relevant information to the patient’s usual community pharmacy, this medication could be ready to collect as the patient returns home.
Almost all my colleagues within the community setting provide a delivery service and therefore if the medicines could not be collected in this scenario, the discharge communication would indicate when the patient would be returning home and their medicines would be with them that day.
Many of the building blocks to implement such changes are already in place. Scotland, uniquely in the world I believe, has patient registration with pharmacies and this allows identification of where the patient has chosen to receive their pharmaceutical care from.
The technology to transmit electronic messages has been existed for decades now – what needs to happen is to have these systems joined up and allow the seamless transfer of necessary information between healthcare professionals so that they can deliver safe and effective care to the high standard they aspire to.
Such changes will also require the support of the entire health and social care team, both in acute hospital settings and in community primary care.
The pleasing thing is that there appears to be a groundswell of opinion that wants to see this change happen and ensure that modern medicines and technologies are fully utilised in a manner that collectively benefits people most.
Harry McQuillan is chief executive of Community Pharmacy Scotland.