Achieving excellence in pharmaceutical care: a strategy for Scotland

6. Summary of commitments and actions

Commitment 1:

Increasing access to community pharmacy as the first port of call for managing self‑limiting illnesses and supporting self-management of stable long term conditions, in-hours and out-of-hours.

Actions:

Independent prescribing & advanced clinical skills	We will target resources to expand the number of community pharmacists undertaking independent prescribing and advanced clinical skills training. This includes exploring how resources to cover back-fill for the residential training and period of learning in practice can be provided in order to build clinical capacity to deliver an extended MAS and enhanced CMS.
Minor Ailment Service	We will use the evaluation of the Inverclyde extended MAS pilot to inform any future enhancements to the national Minor Ailment Service.
Chronic Medication Service	We will further develop the Chronic Medication Service to incorporate a more formalised role for community pharmacists in managing people with long term conditions by building in medication review, prescribing, monitoring and dose titration. We will enhance the Pharmacy Care Record in order to record and share outcome data to improve health outcomes and benefit person-centred care.
Serial prescribing & dispensing	We will encourage HSCP to maximise the use of serial prescribing and dispensing to benefit people, utilise community pharmacy more effectively and ease the workload on GPs. We will support engagement between GP practices and community pharmacies and provide enablers to embed serial prescribing and dispensing into normal working practice.
Public Health Service	We will work at a national level to expand the public health role in community pharmacy with evidence-based interventions that add value. We will direct NHS Boards and HSCPs to consider opportunities to utilise community pharmacy to help meet local needs.

Commitment 2:

Integrating pharmacists with advanced clinical skills and pharmacy technicians in GP practices to improve pharmaceutical care and contribute to the multidisciplinary team.

Actions:

GP Practice based pharmacy

We will deliver the commitment to ensure every GP practice in Scotland has access to a pharmacist with advanced clinical skills.

Commitment 3:

Creating the conditions to transform hospital pharmacy services to deliver world leading pharmaceutical care.

Actions:

Transformation requirements	We will commission work to transform the delivery of hospital pharmaceutical services and pharmaceutical care during weekdays and at weekends.
Discharge process	We will commission work to explore ways to improve all pharmacy-related aspects of the hospital discharge process utilising integrated models of pharmaceutical care.
Modern Outpatient Programme	We will work with the Modern Outpatient Programme to ensure a strategic alignment of the pharmaceutical contribution to its work.
Quality improvement & performance measures	We will commission the development of a series of quality improvement tools and performance measures to support the transformation of hospital pharmacy services across Scotland.

Commitment 4:

Providing the focus, resources and tools to support the safer use of medicines.

Actions:

Medicines reconcilation	We will work with SPSP: Medicine to continue to strengthen arrangements for medicines reconciliation at the interfaces of care across Scotland and ensure national guidance and local delivery are aligned. This may involve developing new recommendations for future practice.
Data measurement & monitoring	We will commission Healthcare Improvement Scotland ( HIS) to work with National Services Scotland ( NSS) and NHS Boards to strengthen the available data on harm and establish measuring and monitoring parameters for medicines safety more broadly to consider past, present and predictable future harm.
Quality improvement in community pharmacy	We will make quality improvement an integral element of community pharmacy funding arrangements in a similar way to GPs and introduce a programme of continuous improvement.
Pharmacy role awareness	We will commission work to raise awareness of the role of pharmacists and pharmacy services. We will work with others to facilitate the co-production of tools and interventions that can be used to help support shared decision making around the use of medicines.

Commitment 5:

Improving the pharmaceutical care of residents in care homes and people being cared for in their own homes.

Actions:

Improvement approaches

We will work with Chief Officers of Integrated Joint Boards to identify national approaches to improve NHS pharmaceutical care for residents in care homes and people being cared for in their own homes.

Commitment 6:

Enhancing access to pharmaceutical care in remote and rural communities.

Actions:

Availability of technology to support R&R	We will work with the TEC Programme and NHS 24 to ensure the availability of technology enabled care solutions to support remote and rural communities.
Recruitment & retention	We will commission NES to work with remote and rural NHS Boards to explore mechanisms to attract more pharmacists and pharmacy technicians to work in remote and rural communities and ensure any associated education and training needs are flexibly met. We will test a pharmacy longitudinal clerkship.

Commitment 7:

Building the clinical capability and capacity of the pharmacy workforce.

Actions:

Workforce planning	We will work in collaboration with NES and other key stakeholders to understand and address future pharmacy workforce requirements in order to inform the national workforce plan and the educational needs of the profession.
Postgraduate career framework	We will introduce a Postgraduate Career Framework for pharmacy in Scotland which will include a consultant pharmacist role.
Pharmacy technician development	We will commission NES to develop a work programme with the Further Education Colleges in Scotland in line with the General Pharmaceutical Council's regulatory requirements to consider the future education and training requirements for pharmacy technicians.

Commitment 8:

Optimising the use of digital information, data and
technologies for improved service delivery.

Actions:

HEPMA	We will work with NHS Boards to ensure that HEPMA is the uniform standard in hospitals across Scotland. We will ensure that pharmacy contributes fully to the multidisciplinary transformation of care that will be delivered through HEPMA.
ePharmacy support for primary care prescribers	We will extend ePharmacy support to all key prescribers in primary care. We will commission the ePharmacy Programme to scope and test an incremental move to paperless prescribing across primary care.
Health information access	We will consider how the pharmacy profession can safely access and share appropriate health information in light of the guidance contained in the future Scottish Code of Practice.
Automation	We will explore further options to increase the use of automation in areas where medicines are used in order to release pharmacist and pharmacy technician time to provide pharmaceutical care.
Future hospital requirements	We will commission the Integrated Digital Safer Medicines Programme to scope future requirements for hospital pharmacy transformation and medicines management. We will actively contribute to the development and implementation of the Scottish Government Digital Health and Care Strategy to ensure pharmacy's needs are covered.
Technology enabled care solutions	We will ensure the availability of technology enabled care solutions to support the delivery of pharmaceutical care.
Clinical decision support tools	We will ask the Digital Decision Support Programme to define a roadmap for pharmacy decision support tools that will deliver highest impact in achieving personalised care, shared decision-making and the other priorities outlined in this strategy.

Commitment 9:

Planning for sustainable pharmaceutical care across Scotland.

Actions:

Planning	We will develop and implement a new planning framework to help NHS Boards better characterise the pharmaceutical care needs of their local populations.
Contracting & funding arrangements	We will develop and implement a new contracting framework for community pharmacy NHS pharmaceutical care services, underpinned by a new funding arrangement and a Performer's List for Pharmacy.

"Our focus is on achieving excellence in NHS pharmaceutical care provision to ensure safe, effective and person-centred care."