Community Pharmacies can play a bigger part in health care, writes Harry McQuillan
More should be done to utilise the skills and expertise of Scotland’s community pharmacies to help patients get better results from their medications, and to help ease pressure on the NHS.
Across Scotland, patients receive NHS community pharmacy support to help them manage their prescribed treatment safely and effectively. The Scottish Government and NHS Scotland should build on the existing Chronic Medication Service to further use the community pharmacy network to support the Scottish people with their prescription medicines.
Around four in ten people in Scotland live with a long-term condition. Treatment will usually involve regular medication being prescribed. Repeat medicines account for around three quarters of all prescriptions written by GPs. Despite these predictable events, most patients still attend the pharmacy after ordering their prescriptions from their GP. This usually occurs on a monthly basis. The community pharmacy is then often required to dispense medication while the patient or carer waits for the prescription.
Giving pharmacy teams more involvement in the repeat prescription process will reduce GP workload and allow them to better prepare for patients’ needs when they pick up their medicines. The benefits of a predictable prescription workload will free up valuable pharmacist and GP time to deliver more care.
The Chronic Medication Service has been part of the NHS since 2010 yet we are still short of realising its full potential. Patients can be issued NHS serial prescriptions for up to 48 weeks which can be dispensed at monthly or bimonthly intervals by their regular pharmacy. This would allow pharmacies to focus on the care of their patients and reduce the risk of waste being generated.
Despite serial prescriptions being government policy for many years now there has been little progress on making them the norm. Health Board’s must focus their efforts on promoting this type of prescribing to the public and support local health care professionals to implement the service. It will deliver benefits to all of us accessing and working in primary care.
Some medicines are more likely to cause harm when taken incorrectly. These medicines are known as “high risk”. Community Pharmacies already support patients on such drugs but more can be done. The majority of hospital admissions relating to medicines are caused by a relatively few types of drugs. Building on the success of the current high risk medicine support pharmacies offer, further prescription drugs could be added to improve patient safety.
When medicines are first prescribed, advice and reassurance can help ensure patients have the confidence to get the most out of their medicines and take control of their condition. Since the New Medicine Service was introduced, community pharmacists have recorded over 30,000 interventions supporting patients with new therapies. Community Pharmacy Scotland would like to see the service tailored to where it can best support the needs of the NHS.
For example, with mental health budgets strained, emphasis on people newly prescribed anti-depressants can add a vital layer of support that may not otherwise be possible.
Policy makers must think differently about how care is delivered in the NHS if it is to continue to meet demand. As budgets are constrained and other professions face recruitment challenges, community pharmacy is a natural location for the public to seek professional support and advice. The foundations already exist to allow pharmacy to become the first port of call for the Scottish people’s health needs. This is especially true for those living with long term conditions.
The Scottish Government and Health Boards must work with the pharmacy network to turn current policy into mainstream NHS services. Patients deserve the full NHS pharmacy service they have been promised.
• Harry McQuillan is chief executive ofCommunity Pharmacy Scotland