How the Pharmacy 2020 project is lighting the way for pharmacy's future
In this first article of a series leading to a consultation that will seek members' views on where pharmacy might be by 2020, Carl Rees interviews the President about his vision
Carl Rees: Can you give a brief overview of Pharmacy 2020 as a project and a reminder of why it is important for the profession?
The President: There are a huge number of changes taking place in pharmacy, with practice transforming all the time. The Society’s Council recognises this and, in 2004, we identified the need to refocus on what pharmacy does, and highlight the social benefits it brings as a profession. The Pharmacy 2020 initiative is a strategy for the whole profession. It resulted from the Council’s desire to see pharmacy consolidate its position within the health care arena while paving the way for the generations of pharmacists to come.
The whole purpose of Pharmacy 2020 is about pharmacists taking charge of our own destiny, not leaving it to the hands of others. But we need to do this in such a way that we have the support of the other health care professions. There is no doubt that professional boundaries are gradually breaking down but, as pharmacists, we must find ways to work with other health care professionals as respected equals in what is a highly competitive health care industry. We want to use Pharmacy 2020 to secure a more mainstream role for pharmacy, especially in clinical areas, and elevate our members’ professional status.
We also need to take into account the political, financial and demographic changes that pharmacists face so that we fully understand the profession’s own challenges and aspirations. After all, Pharmacy 2020 is a consultation initiative. It is about bringing out what people feel about the future. It is important that each member feels that he or she has a stake in the future of pharmacy during the discussions that will take place as part of Pharmacy 2020.
What has happened in the past year?
At the British Pharmaceutical Conference we announced the launch of the Pharmacy 2020 steering group. I am the chairman. The group comprises members from across the British Isles and meets quarterly, enabling us to look at the future of pharmacy in a broader way. In some ways our working has been disrupted by the announcement of the White Paper and the Carter Working Party and that work took priority over everything else.
However, the group is focused, first towards building awareness of the need for a strategy and, secondly, building awareness about a number of key factors that will influence pharmacy in the period leading up to 2020, such as Society changes, Government changes and things like that. So we have now established an enthusiastic Pharmacy 2020 steering group and we are busy preparing for consultation. It is an exciting time for pharmacy.
You mentioned the White Paper. Some might say that Pharmacy 2020 is merely a gimmick, and that the Society should be concentrating its efforts on its future role as a professional pharmacy body. How would you respond to this?
I think most people who understand long-term planning will appreciate that it is vitally important to plan for the future even when short-term contingencies require your immediate attention. The whole of the health care scene is changing due to various external factors like government policy changes, technology, changes in diagnostics and so on.
We now have an ideal opportunity to reposition pharmacy as a clinical profession but also to ensure that our contribution to drug discovery and manufacture is strengthened. The genomic revolution will mean pharmacists have a greater opportunity to play an important role in the development of drugs which are discovered, developed and manufactured in Britain.
Looking at pharmacy practice in hospital and community pharmacy, everybody agrees there is a revolution going on. The new community pharmacy contract in England and Wales has already provided a taster for the kind of change that will occur, so we need to prepare the profession to take advantage of the flux in the health care system. The idea behind Pharmacy 2020 is, therefore, to reposition pharmacy and underline its clinical importance as a profession.
You touched on the new contract. The Practice Research Trust published a report recently that suggested the new contract had failed to spark innovation in pharmacy. Why might that be?
Innovation requires innovative people and adequate support from the Government and from the professional bodies. In some ways it is similar to when Christopher Columbus wanted to go and discover new lands. His king would not authorise it so he had to go and ask another king for help — and look at the rewards of that discovery.
We face a similar pioneering position today.
If we have the vision, the courage and the strength to commit ourselves to travel then we have got the ability to carve out a niche for pharmacy in the health care arena. But the difference is it will be a central role because at present we are playing on the periphery.
On what grounds would you argue that we are playing on the periphery?
Well, periphery in the sense that a lot of mainstream health care is not delivered through pharmacies. A lot of public health initiatives, for example, are delivered through GPs and nurses, when access to those two professions is fairly limited compared with pharmacy. So what I want through Pharmacy 2020 is a logical analysis that will give us our rightful place where we can make a meaningful contribution that has real impact on patient care.
I recently heard an example in East London where for years a GP practice had failed to achieve its flu vaccination targets. But in the first year, a pharmacy concentrating on people with chronic diseases like diabetes was able to achieve these targets. The public trust in pharmacists and the ready access to pharmacies can help make it happen.
Has the Society considered mapping other successful professions?
Yes, but with Pharmacy 2020 we are not focusing on what other professions are doing. We are looking at what the public wants, what the Government expects and what the ambitions of the profession are. When we have done that successfully we will see how we, in terms of ambitions and abilities, compare with other professions. That is why working in partnership synergistically with others is going to be important. The outcome will be more universal and desirable.
The National Director for Primary Care David Colin-Thomé recently said that pharmacists “should kick the door down and make themselves indispensable” to commissioners. If you are a practising pharmacist busy with your day-to-day job, how do you find the time and the energy to do this and take on more work?
I understand what David Colin-Thomé is saying and there are already pharmacists around the country who are kicking the doors down, which is why we are already having considerable impact in the health care system. It is no secret that getting money from primary care trusts is difficult but, despite that, innovation is taking place.
I would like to see more PCT money being diverted to pharmacy but we have to be careful we do not antagonise people. We can only move forward with the imagination and determination of well motivated pharmacists. I think pharmacists are not short of ideas, they are short of commissioners.
So how can pharmacists get closer to commissioners?
We have to shout about our current skills but at the same time, get seriously engaged in developing new skills to make sure we are fit for the future. The two things go hand in hand. We must also recognise that there are areas where we have not done so well. For example, the growing drugs budget is a serious problem for all PCTs yet community pharmacy currently plays no role in helping PCTs to better manage their drug budgets.
If our help was available, I am pretty sure we would soon become invaluable to PCTs. The other two areas I think we can make a significant impact on quickly are obesity and diabetes. These are two chronic diseases where pharmacists can make a huge impact on long-term patient care.
Hemant Patel: we must avoid wasting our opportunities
We must also avoid wasting our opportunities. For example, this year there is over £90m available for medicines use reviews yet I am convinced this money will not be used — a wasted opportunity that we need to change. It is about developing confidence in individuals to provide new services and enabling the Society to help this process. Pharmacy 2020 is the starting point.
The All-Party Pharmacy Group recently published its report into the future of pharmacy and one of the findings shows that, although there are many good examples of pharmacy innovation in progress, the potential of pharmacists as health care providers is not being realised quickly or consistently enough. Is the Society to blame for this and how will Pharmacy 2020 help address this issue?
In the past decade the Society has become overbalanced on the regulatory side and so the professional support it was expected to provide was not there to the same degree. I recognise this and it is another reason why Pharmacy 2020 has been developed.
But it is also worth remembering that the Society is sometimes in a difficult position. Busy pharmacists are interested in solving their “here and now” problems. They may say, “I have a pile of prescriptions to do and you are asking me to do MURs. How do I do it?”. And they want an instant answer to that. But the Society’s job is also to plan for the future — in this case 13 years ahead — to ensure the long-term objectives of the profession are taken into account.
With Pharmacy 2020 we are trying to focus on both the long- and short-term. Working through the national pharmacy boards we want to provide relevant support at the time of need which is tailored to the individual sectors of the profession. Previous initiatives, like Pharmacy in a New Age, taught us that this is very important indeed.
What practical support can the Society provide via Pharmacy 2020 to busy members who are keen to develop themselves but do not know where to start?
There are three steps and the Society has an important role to play in each. First, it is making the members aware and getting them involved in change via Pharmacy 2020. Hopefully, pharmacists will engage and we will get people interested enough to make the necessary changes themselves.
Secondly, we will highlight examples of excellence, be a forum for swapping ideas and good practice and create genuine hope. This will lead to the desire and motivation to look at different ways for pharmacists to develop their skills.
Finally, the Society needs to support its members when the necessary actions to create change are clearly mapped out. We need to provide guidance to help them do it, tools to help them do it and practical telephone advice when people come across any obstacles.
Pharmacy 2020 is about looking at areas afresh and saying we will use our skills and databases to help the Government and the public. I want pharmacists to start looking at the changes taking place around them within the pharmacy environment in terms of what PCTs are doing, what technology is offering, and the opportunities of robotics and diagnostics.
As individuals, pharmacists need to accept responsibility for change and join the Society in understanding the nature and speed of change. They also need to be hopeful and optimistic because positive results can only ensue from a positive approach. We must also be future-focused while understanding our history and culture.
Will Pharmacy 2020 continue even if the Society does become a body akin to a royal college”?
Absolutely, categorically, yes. I am absolutely delighted the Society is splitting because it will enable pharmacists to reclaim their Society and to improve the range of services they provide. The journey may be difficult but overall the direction of travel is the right one for the health service, the Government and the profession of pharmacy. Eventually, I believe, it will be the right one for each and every member of the Society.
At the present time a substantial amount of valuable resources are being dedicated to regulation and, in my view, an inadequate resource is being invested to develop professional support. Without the two roles we will be able to concentrate on each role separately, independently but very much appreciating the interdependence of each organisation.
It is important to remember that Pharmacy 2020 will constantly feed into the strategic planning of the Society. The boards have taken a deep interest in Pharmacy 2020 and I am delighted about this, they will help us identify good practice going forward.
To some, a plan that looks 13 years ahead may be seen to be too far-reaching. In fact many of the people to whom you are directing the consultation will have retired by then. Why should they get involved?
In the past six months I have been touched by the sentiments expressed by retired members and fellows of the Society who have shown a tremendous interest in Pharmacy 2020. They feel grateful to previous generations, who laid a solid foundation for them to practise, and believe that their duty is to ensure they play a role in laying an equally strong foundation for future generations of pharmacists.
And at the other end, the British Pharmaceutical Students’ Association is saying “count us in”. So to get feedback from the new entrants as well as the experienced and wise members of the Society has been extremely encouraging. I am getting excellent vibes about Pharmacy 2020 from the whole profession.
In terms of the actual consultation, how is the Society consulting its members? What are the ways in which pharmacists can have their say and when is the deadline for their views?
On 6 October 2007, the Society will publish the Pharmacy 2020 consultation document in The Pharmaceutical Journal and on the Society's website, where it will remain for 12 weeks, concluding on 21 December. We will be encouraging members to get involved as much as possible and we will also be training our continuing professional development facilitators to help offer support and advice on Pharmacy 2020 throughout the consultation period.
The Pharmacy 2020 steering group will then meet in January 2008 to consider all of the consultation responses. These will be used to generate an initial Pharmacy 2020 vision document in February 2008, which will be submitted to members for further consultation in spring 2008. So you can see we are involving members every step of the way.
Once the members have given their feedback on this document we will be ready to start work on the full Pharmacy 2020 programme.
Citation: The Pharmaceutical Journal URI: 10004657
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