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Community pharmacy

Community pharmacy must transform for the future, conference is told

mark koziol chair Pharmacists Defence Association

Source: Royal Pharmaceutical Society

Mark Koziol, chair of the Pharmacists’ Defence Association, says pharmacists need to become ‘population health managers’, with every prescription coming through the door being an opportunity to make an intervention to improve patient outcomes

Community pharmacists face an uncertain future unless they move away from the dispensary and carve out new roles as ‘population health managers’, the chair of the Pharmacists Defence Association (PDA) has said.

Speaking during a debate on the first day of the Royal Pharmaceutical Society’s annual conference in Birmingham, Mark Koziol said the medically-led model of healthcare had become unsustainable, marking a pivotal moment for community pharmacists.

“The old adage about pharmacy being the most accessible healthcare professional is absolutely the right place to find ourselves,” he said.

“I see us as a profession taking an interventionist approach to end up in a place that utilises our accessibility as genuinely being the first point of call for patients, while incrementally re-engineering the way that healthcare works.”

He said community pharmacists were ideally placed to “really get behind the prescription”, move into a population health management role and save the UK healthcare industry millions.

This means regarding every prescription coming through the door as an opportunity to make an intervention to improve patient outcomes, he said.

“As an example,” he explained, “we know full well that patients taking steroid eye drops for long periods are at risk of developing a cataract, so delving into summary care records [SCR] to find out how long a patient has been taking them and then having a discussion with the prescriber about why the steroid is still being prescribed, so the patient does not end up in secondary care is a vital public health role.

“It’s a population-based approach to assessing the prescription not just for its accuracy, not just for its efficacy but getting behind the prescription relying on the SCR to make really valuable interventions.

“We have to manage our luck and make sure we end up in the place we want to be. We must make sure doctors are diagnosing and not wasting time prescribing because that is not where their core skills are. That’s the training of pharmacists who are ending up dispensing when we should actually be prescribing. You don’t need the medicines expert to be assembling the medicines, that’s the job of the pharmacy technician.”

Tess Fenn, president of the Association of Pharmacy Technicians UK, agreed.

“I thoroughly support that the dispensary should be technician-led. We need to use staff to the top of their strengths and ability. Once the prescription has been clinically checked, the rest of the process should be technician-led.”

Although she said the pharmacy technician, within their capability and competence should be able to issue a prescription to the patient as well.

Koziol said he feared the narrative coming out of the Department of Health was promoting the role of pharmacy technicians at the expense of community pharmacists in a misguided bid to save money.

He warned the ongoing dispute over supervision had to be resolved and roles needed to be clearly defined before his vision could become reality.

“It’s a well-rehearsed argument,” he said. “There’s the mechanical side of the process where there is no real value attached to the pharmacist being involved, then there is the clinical/professional aspect where we want the pharmacist to be.

headshot Stephen Messham, president of the British Pharmaceutical Students’ Association

Source: Royal Pharmacetuical Society

Stephen Messham, president of the British Pharmaceutical Students’ Association, said the Royal Pharmaceutical Society should take a leadership role to ensure the professionalism of pharmacy is maintained

Stephen Messham, president of the British Pharmaceutical Students’ Association, who also took part in the debate, called on the Royal Pharmaceutical Society to take a leadership role.

“We need the RPS to bring the industry together and take this forward,” he said.

Sandra Gidley, chair of the RPS’ English Pharmacy Board, said: “Clearly we need to do a lot more to highlight the capability of the pharmacist.”

She added that there was no reason why some of the work carried out as part of the Community Pharmacy Forward View – published jointly by the PSNC, the now disbanded Pharmacy Voice and the RPS English Pharmacy Board last year — should not be taken forward.

“I suggest that we probably need to get on with it. Watch this space.” she concluded.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20203503

Readers' comments (1)

  • Using every prescription as an opportunity to make an intervention to improve patient outcomes.. .. one of the best suggestions we've heard for a long time... and developing the role of the technician in supporting (not threatening) clinical pharmacy roles... now we are talking... but community pharmacy is so far from this ideal scenario. Our large survey of prescription advice giving is representative of inner city pharmacies in England... and shows that only 1/3 who collect a prescription have any interaction with pharmacy staff... ... the current contract plus the arguments over supervision may be inhibitory factors.

    Peter Rivers

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  • headshot Stephen Messham, president of the British Pharmaceutical Students’ Association

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