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The Darzi experience

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Liz Butterfield

Source: MAG / Pharmaceutical Journal

Liz Butterfield, clinical lead for medicines optimisation at Kent Surrey Sussex Academic Health Science Network, says she has gained fresh insight and understanding as a result of being a Darzi sponsor

Between April 2018 and April 2019, Kent Surrey Sussex Academic Health Science Network (KSS AHSN) sponsored the Darzi Fellowship project titled: “Leadership role in delivery of KSS AHSN polypharmacy project — improving cross-sector medicines safety, deprescribing support and managing change.”  

We decided to sponsor this particular project because supporting medicines optimisation is a key element of KSS AHSN’s remit, and ties in perfectly with the whole systems approach to patient-centred care, crossing all sectors of the health and care system. This includes hospital, general practice, mental health and community pharmacy.

Community matron and dementia expert, Sam Lungu Matikinye chose our project. While not a pharmacist, she had seen first-hand the issues that patients on multiple medications encounter, but found it difficult to affect change as an individual operating in a complex system. Her passion and insight into the problems we were trying to overcome brought a fresh perspective to the initiative.

The project aimed to reduce levels of problematic polypharmacy and Sam was tasked with leading its rollout. This involved creation of a year-long, multi-professional, system-wide deprescribing network. 

Discussing the project and her own experiences made everyone she spoke to realise they had to do something to address the issue of polypharmacy.

The deprescribing network, chaired by a clinical lead GP, involved organisations from across the system.

The programme was a huge win for all involved, creating the space and time for multiple agencies to come together and think about what they could do to improve patient care for those on multiple medicines, and how the system can learn together going forward. Insights gained from this pilot will be used to develop new, local models for addressing deprescribing, extending its life beyond the 12-months of the Darzi Fellowship.

If we get it right we’ll be able to reduce patient admission and readmission rates and make a positive impact on mental health, patients’ lives, and social care.

Although the AHSN had planned to have a Darzi Fellow, the rest of the system hadn’t, so we were mindful of not disrupting existing work or delivery plans. However, medical directors and mental health and GP leads have welcomed the deprescribing network project, and it has encouraged positive discussions across healthcare sectors.

One of the benefits of the fellowship, for both fellows and sponsors, is the access to system leaders who are open to giving their time and sharing insights with someone on a clinical leadership programme. They are genuinely interested in hearing about Darzi and want to support new ways of thinking. We were able to strengthen connections with leaders across the health and social care system to engage in improvements benefiting everyone.

My experience as a sponsor has been incredibly positive, and exceeded my expectations in terms of the wider interest generated by this work.

Darzi Fellows are self-motivated individuals, but there is a definite role for sponsors to play, and I’ve done a lot of work helping Sam to identify who she should be talking to.

I’ve also learned a lot through networking with other sponsors and finding out more about their work, and partly through the links with London South Bank University.

Two areas which stand out for me are learning more about co-production with patients, and understanding how the concept of Failure Demand affects the NHS.

I’ve been a pharmacist for many years, and can genuinely say that I’ve gained fresh insight and understanding as a result of being a Darzi sponsor.

Equally I have seen how much Sam, and the other Darzi 2018 Fellows, have gained from being part of the process.

Whether you are an established leader, or a pharmacist looking to develop your leadership skills, I would wholeheartedly encourage you to get involved with the Darzi Fellowship should you have the opportunity.

Following her success with the Darzi Fellowship, Sam has recently taken a leadership role as Quality Improvement Lead – Adult Mental Health NHS England and NHS Improvement – South East (Kent, Surrey, Sussex)

Box: The Darzi Fellowship Programme

The Darzi Fellowship Programme is a fantastic opportunity to undertake change work with the support of peers and experts in the field of complex change, systems leadership, effective teams, improvement, and new models of care from the UK and Internationally.

The programme is run by the Health Systems Innovation Lab at London South Bank University. It is part-time for one year and is accredited as a PGCert Leadership in Health (Darzi).

The programme is designed for clinicians with a few years’ experience looking to progress into system leadership.

More information about the impact the Fellowship programme can be found here.

How to apply?

There are still a few places left for the London Darzi 2019 fellowship programme. To apply visit NHS Jobs and use the keyword ‘Darzi’ in your search.

To register your interest for future Darzi programmes, as a fellow or as a sponsor, please get in touch with the LSBU team via or 020 7815 8359.

About the author:

Liz Butterfield is clinical lead medicines optimisation for Kent Surry Sussex Academic Health Science Network. She is also a board member of the Royal Pharmaceutical Society and president of the Primary Care Pharmacy Association.

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