Prescription for Excellence - the future of pharmaceutical care: vision and plan

Foreword

Professor Bill Scott, Chief Pharmaceutical Officer

This Vision and Action Plan, Prescription for Excellence, complements the Scottish Government's 2020 Vision Route Map and Quality Strategy Ambitions. It plays to the strengths of pharmacists as experts in the therapeutic use of medicines and their potential contribution and integration into health and social care teams.

Over the next decade and beyond, advances in health care will continue to accelerate. In particular significant changes will occur in medicine and therapeutics which will require new and innovative models of care to enable patients to obtain the maximum benefit. The patient is a critical member of the health and social care team and requires to be given enough information to enable them to make informed decisions about their care. This is key to delivering person-centred healthcare.

Pharmaceutical care is a key component of safe and effective healthcare. It involves a model of pharmacy practice which requires pharmacists to work in partnership with patients and other health and social care professionals to obtain optimal outcomes with medicines and eliminate adverse events whenever possible. Patients regardless of their setting should receive high quality pharmaceutical care. This is particularly important for patients with complex health issues including multimorbidities and those in care homes.

Dispensing doctors play an essential role in the dispensing and supply of medicines to patients in rural communities. Going forward pharmaceutical care provision should complement and support dispensing doctors' services and their patients.

These aspirations have resulted in our Vision that all pharmacists providing NHS pharmaceutical care will be NHS accredited clinical pharmacist independent prescribers working in collaborative partnerships with medical practitioners who will continue to have overall responsibility for diagnosis. An essential role of the clinical pharmacist working within the team will be to initially assess the patient for potential issues to help inform the choice of medication. In addition they will be responsible for the continual monitoring of the effects and side effects of the medicines and making adjustments to dose and therapeutic agent within agreed parameters.

The NHS continues to face increasing workplace pressures. The inclusion of the NHS accredited clinical pharmacists into the primary care team is intended to increase the clinical capacity and assist in addressing the increasing demands in primary care as our population ages and the complexity of their care increases.

Critical to collaborative working is education and training in a multi-disciplinary context at both undergraduate and postgraduate level. Work is already underway in this area between NHS Education Scotland (NES) and the Scottish Schools of Medicine and Schools of Pharmacy at undergraduate level. This will set the agenda for future collegiate and collaborative working between the medical and pharmacy professions in Scotland.

Finally I want to turn to professionalism. Professionalism can be defined by a set of values, behaviours and relationships. It encompasses aspects such as commitment, integrity, honesty, a sense of service, accountability, independent judgement and individual responsibility and is underpinned by a culture of continuous improvement. It is therefore fundamentally important that pharmacists, regardless of employer or environment, are able to make professional decisions for their patients at all times. New and innovative models to facilitate the professional independence of pharmacists will be explored as a priority in this Action Plan.

In order to deliver this Vision and Action Plan, I will establish a governance structure within the Scottish Government Health and Social Care Directorates to provide a detailed work plan and establish implementation groups with representatives from all the key stakeholders. This will involve cooperative working with the NHS, the pharmacy and medical professions, patients, the public and the regulatory bodies.