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

ANNEX A

Remit and Terms of Reference

The Scottish Government is to undertake a review of the pharmaceutical care of patients in the community.

The review will focus on the needs of patients and the NHS; current arrangements for providing NHS Pharmaceutical Services across Scotland; their fitness for purpose; and sustainability into the future.

It will report key findings and conclusions and, in particular, will make recommendations on any changes that might be required to optimise the role of pharmaceutical care in the community to achieving the sustainable, high quality healthcare we are committed to through:

• the enhancement of the pharmacist's clinical role, and
• joint working between community and hospital based pharmacists, GPs and other healthcare clinicians and community services.

Terms of reference

In delivering NHS pharmaceutical care services in the community that are sustainable, of the highest quality, efficient and fit for the future a new and innovative approach is required in the form of a modern framework for NHS Pharmaceutical Care Services in Scotland to ensure:

1. A step shift away from a service regarded as "dispensing of prescriptions" to one where its main focus is providing NHS pharmaceutical care and an increased emphasis on providing direct care to patients;

2. Pharmaceutical care services are provided appropriately to reflect local need in the context of national priorities;

3. Pharmacists can contribute to improving patient care through delivering direct personalised pharmaceutical care services that are effective and efficient in partnership with other health and care professionals resulting in optimal therapy from care and medicines;

4. The specific pharmaceutical care service needs of residents in care homes and how best these should be met - an important part of the review will be to help inform service specification in this area and how best to achieve service delivery through clinical pharmacists;

5. Education, training and continued professional development remains relevant to providing modern NHS services;

6. Planning, designing and arrangements for the provision of NHS pharmaceutical care are fit for purpose to target national priorities, as well as focus service provision on the needs of patients and local populations;

7. Effective structures and processes are in place to deliver pharmaceutical care and direct care that best meet the needs of all the people and communities of Scotland and facilitates the professionalism of pharmacists;

8. The effective use of technology to improve efficiency, dispensing accuracy, communication and decision making, medicines adherence support, and hence to improve the quality of the service to patients.

9. Integrated working between primary care and hospital pharmacists and other clinicians.

10. The best possible use is made of available resources - particularly in relation to the efficiency of pharmaceutical care services and the pharmacists' contribution to efficient, safe and cost effective medicines use.

Process

In view of this, and building on the strengths of existing provision, the review will consider and take evidence on:

• How NHS pharmaceutical care can best contribute to the ambitions set out in the Healthcare Quality Strategy for Scotland (May 2010) - that is care that is person-centred, safe and effective to every patient every time - and the six high-level quality outcomes agreed by the Quality Alliance Board:
  • People have the best start in life and are enabled to live longer healthier lives;
  • People are supported to live well at home or in the community;
  • Everyone has a positive experience of healthcare;
  • All staff feel supported and engaged;
  • Healthcare is safe for every person, every time; and
  • Best possible use is made of available resources.
• the structures, processes, education and training that support the pharmaceutical care of patients in the community - including the planning, designing, and contracting arrangements - with the aim of using that capacity and capability to deliver further improvements in pharmaceutical care in our communities in the coming years.

Evidence will be gathered from a wide variety of stakeholders in Scotland from within the NHS, patient groups, the pharmaceutical and medical professions and their regulatory bodies, contractor representatives, educational bodies, and those working in social care and voluntary organisations.

The review will also take into consideration other forms of evidence, including research from within the UK and from abroad, as may be appropriate to supplement the evidence gathering process.

Output

The evidence gathered will be used to develop a report to be submitted to the Scottish Government's Chief Pharmaceutical Officer setting out key findings and conclusions, and to make recommendations on the future shape of NHS pharmaceutical care of patients in the community in Scotland.

Timescales

The main thrust of the review will commence early 2012 culminating in a final report by the Autumn 2012. Key milestones as currently planned include: