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Global agreement reached for the future of hospital pharmacy

Located where France, Switzerland and Germany meet, Basel is symbolically ideal as a location for pharmacists from 98 countries to meet. Their goal: to agree globally on a vision for the future of hospital pharmacy practice. This was achieved by developing and voting on a set of consensus statements that will inform the work of the International Pharmaceutical Federation’s hospital pharmacy section for several years.

Conference attendees were assigned to one of six working groups, each dedicated to a different topic:

  • Procurement of medicines
  • Prescribing of medicines
  • Preparation and distribution of
  • medicines
  • Administration of medicines
  • Monitoring of medication therapy
  • Human resources and training in hospital pharmacy

Each group was asked to debate between seven and 15 consensus statements on its topic, and 16 general statements that were given to all groups. Each group consisted of representatives from a diverse selection of countries. For example, the administration of medicines group included representatives from over 20 countries, including the UK, United States, Ghana, China, Iran, Australia, Israel and Uruguay.

After five hours of debate, the session facilitators met to collate each group’s findings and produce a revised list of 74 consensus statements — 13 general and 61 specific to the working groups.

Voting

The following morning, a poll was conducted for each statement to determine whether it was internationally endorsed. One representative
from each attending country was given voting rights and asked, for each statement, whether they: strongly agreed; agreed; disagreed; or strongly disagreed.
All statements were internationally supported (a majority of voters agreed or
strongly agreed), although most statements will be of greatest use to developing countries. By comparison, the UK has many initiatives described in the statements already in place. However, some statements may have an impact on UK hospital pharmacy practice. These include:

Statement 5: Health authorities should ensure that each hospital pharmacy is supervised by pharmacists who have completed specialised training in hospital pharmacy

In some European countries (eg, Spain),pharmacists are not allowed to work in hospital pharmacies unless they have completed a qualification in hospital pharmacy practice. “In the UK, we support specialism within hospital practice but do not have a ‘generic hospital pharmacy’ qualification as an entry level requirement,” said Carwen Wynne-Howells, chief pharmaceutical adviser for Wales. “Chief pharmacists at hospitals in the UK have developed the necessary competencies for doing their job and can refer to the Knowledge and Skills Framework as a means of assuring this. The UK would have difficulty implementing this statement as it is currently worded.”

Statement 18: Procurement of pharmaceuticals is a complex process requiring pharmacist control and technically competent staff.

“The key role the pharmacist plays in the procurement of medicines is reflected in this statement,” said Richard Cattell, president of the Guild of Healthcare Pharmacists and head of pharmacy at the Dudley Group of Hospitals NHS Trust. “The Guild thoroughly supports this statement and we have recently been successful in helping pharmacists to persuade their NHS trusts that this is the case.”

Statement 30: Hospital pharmacists should be an integral part of each patient ward round to assist with therapeutic decision-making and advise on clinical pharmacy and patient safety issues.

Some hospital pharmacists in the UK take part in medical ward rounds, but they do not attend every ward round. Jean Curtis, professional secretary for the Guild and UK voting representative, commented: “Attending ward rounds provides one way in which pharmacists can improve patient care. For high risk patients, we advocate pharmacist participation on ward rounds, whereas for low risk patients, other methods may be more cost effective to ensure these patients’ pharmaceutical needs are met.”
Mr Cattell added: “We encourage any and all activities which improve pharmaceutical care in a cost effective manner.”

All consensus statements will be finalised by the conference steering committee before their publication. They will be accessible on the American Journal of Health-System Pharmacists website (www.ajhp.org) from early 2009.

The International Pharmaceutical Federation’s global conference on the future of hospital pharmacy was held in Basel, Switzerland, on 30–31 August 2008. Gareth Malson is acting editor of Hospital Pharmacist.

Citation: Hospital Pharmacist URI: 10033556

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