Review of NHS Pharmaceutical Care of Patients in the Community in Scotland

Delivering the Future

73. During the review we heard much about the inappropriateness and unsustainability of the traditional model of community pharmacy, described by many as a supply function in a commercial environment with increasing volumes of prescriptions, and pressures on time and resources. At the same time, all involved stressed the progress that had already been made in Scotland in moving towards a new model with pharmacists playing a key role in the healthcare system in optimising the use of and outcomes from medicines, supporting self care, and promoting health. The frustrations were largely about the speed of progress towards that model of pharmaceutical care with a particular desire to progress to full implementation of CMS. This review has sought to identify where and how that progress can be made, but with flexibility built in to recognise future uncertainties. A fundamental part of delivering the future will be for the NHS to establish a new relationship which emphasises the role and status of the individual pharmacist, the partnership with patients and other professionals, and the consequent implications for the pharmacy bodies which provide the environment and support for the delivery of the clinical services required.

74. We see key elements for the continued future direction being -

• a focus on professionalism and professional identity
• ownership by the pharmacy profession of its own value with a key clinical role to play in the NHS
• demonstration of the impact of that clinical contribution on patient outcomes and resource use
• a resulting changed perception by the public and fellow professionals
• heightening the profile and autonomy of the individual pharmacist while retaining the value of the pharmacy
• solidifying the relationship between patient and pharmacist and the wider team
• pharmacy owners supporting and empowering the individual pharmacists and not imposing inappropriate restraints or targets
• developing and using the skills of the whole pharmacy team
• development of therapeutic partnerships with patients, GPs and other professionals
• using the pharmacy as a community asset and a focus for information, support, referral and signposting
• promoting patient centred, safe and effective services as part of the wider primary and social care team
• proactive planning and co-operation at national and local level
• matching the reward system to the clinical services provided
• ensuring a safe and cost effective supply of medicines
• aligning the information systems to underpin integrated care
• using technology to improve service delivery and secure efficiencies
• designing education and training to meet the future professional and service needs