PHARMACISTS are ideally placed to have a central role in delivering Realistic Medicine, ensuring the healthcare people receive is of the greatest value to them as individuals, is most in line with their wishes and has the least potential to do them harm, Scotland’s Chief Medical Officer (CMO), Dr Catherine Calderwood ,told delegates at the Pharmacy Management National Forum for Scotland in Dunblane.
Pharmacists were one of the largest groups of professionals to have commented on her annual report, published earlier this year, which first showcased the move towards so-called Realistic Medicine. Their response, she said, had been resoundingly positive.
Dr Calderwood spoke on the role of pharmacy in delivering the pillars of Realistic Medicine. For ‘reducing harm and waste’ she gave a personal example:
“I did some local medicines reconciliation, you would be proud of me, in my own father’s drawer in his kitchen. You will all know it, filled with the pharmacy bags with the cross on them. I should tell you that my father was an orthopaedic surgeon when he was working. So we started taking the bags out and I literally piled this stuff up.
“My father was on nine different medications, still diligently going and collecting them and storing them in the drawer and probably he needs three of them. And repeat that in cupboards up and down the country.
“So this is your world,” she told her audience of pharmacists, “of tackling this sort of thing all the time.”
The CMO cited work in NHS Forth Valley to illustrate how pharmacy is delivering another aspect of Realistic Medicine: ‘releasing the creativity of healthcare professionals to be improvers and innovators’.
Dr Calderwood presented interim findings from a programme that has signed up almost every community pharmacy in the region to manage the treatment of urinary tract infections, impetigo and exacerbations of COPD — backed with face-to-face and online training opportunities.
In the first 22 weeks of the programme, 897 people were seen after going to the pharmacies with UTIs. Of these, pharmacists treated and discharged 682 of them, with only 139 needing onward referral.
Similar numbers of people with impetigo and exacerbations of COPD were treated and completely discharged through community pharmacy. In all, almost 1,200 people were seen in first 22 weeks of the programme, which is to be formally evaluated for its potential to be rolled out to other areas.
“That is innovation,” says Dr Calderwood, “person-centred, personalised care and it is freeing up time for the GPs who are very much under pressure on appointments.”
Dr Calderwood told her audience that Prescription for Excellence, made commitments to the profession that would help make the delivery of Realistic Medicine a reality for all people — helped, not least, by the desire of pharmacists to practice Realistic Medicine as part of multi-disciplinary working:
“Your expertise, your training, your knowledge and the ability to provide care as I have demonstrated is happening in Forth Valley, this is the right time to be doing this.
“We are changing our thoughts, we are moving treatment out into communities, away from hospitals and, in doing that, I would say pharmacists are absolutely ideally placed at the right time to become more involved. And I think we need, as has been the commitment of Prescription for Excellence, to really invest and develop the pharmacy profession.”