The Scottish Government's Prescription for Excellence strategy has the potential to change pharmacy forever.
Prescription for Excellence (PfE), the Scottish Government’s vision for the future of pharmacy, offers us some fresh motivation to think innovatively about how we deliver healthcare in challenging times, with people living longer and complexity of care increasing. The framework, developed to complement the Scottish Government’s 2020 vision and the ambitions of the healthcare quality strategy, has widely been heralded as the most radical Government pharmacy policy document for a generation.
Our organisations, the Health and Social Care Alliance Scotland (the ALLIANCE) and the Royal Pharmaceutical Society (RPS) have welcomed the publication of the action plan, which, whilst ambitious, will place person-centred healthcare at the core of pharmacy provision across Scotland.
PfE proposes a number of steps that will support people living with long term conditions to get the best outcomes from their medicines and enable them to live well in the community.
The 10 year vision outlines plans to:
- Build on the introduction of the Chronic Medication Service for people with ongoing pharmaceutical care needs.
- Introduce registration with a ‘named pharmacist’ for greater consistency and continuity of care throughout a person’s healthcare journey.
- Support greater levels of information sharing between pharmacists delivering NHS services and other health and social care professionals.
- Encourage better adherence to medicines and self-management through improved access to pharmaceutical care.
- Increase the number of pharmacist independent prescribers ; pharmacists who can work, in partnership with their health and social care colleagues and people living with long term conditions, to monitor, and review treatment regularly.
The vision places great emphasis on the expertise of pharmacists in the safe and effective use of medicines, and their potential contribution and integration into health and social care teams. Building capacity for pharmacists to develop closer relationships with people who access pharmacy services is a welcome development. Many pharmacists across Scotland have built longstanding positive relationships with the people they serve, but the framework recognises that greater efforts are now required to encourage continuity of care, particularly in relation to supporting management of long term conditions. The vision is not without its challenges, and there is much work to be done by everyone, over the next few years, to bring the ambitions of the document to fruition.
It is crucially important that the public are aware of pharmacists’ expertise and scope of practice if they are to engage with the ideas being explored. A recent survey which sought ALLIANCE members’ views on the PfE vision and action plan identified a clear need to raise awareness of the role of pharmacists and the future direction of travel for the role. The survey also highlighted a strong desire for disabled people, people living with long term conditions, unpaid carers, and representatives of third sector organisations to have opportunities to inform the PfE programme’s development and provide real-time feedback on its implementation.
Building on this activity, the ALLIANCE agreed a programme of work with the Scottish Government to address the issues raised. To ensure that future pharmaceutical care provision is built around people who access support and services, a consultation forum of targeted ALLIANCE members will explore proposals contained within the vision and action plan in the context of lived experience. This forum will provide people living with long term conditions, and unpaid carers, a strong voice on the road to new models of pharmaceutical care by feeding in to the Scottish Government’s Prescription for Excellence programme.
The RPS leads and develops the pharmacy profession for the benefit of the public and people accessing pharmacy services. Engaging with the public is an important work stream within RPS, and the organisation will attend the ALLIANCE’s consultation forum, to hear the views and lived experiences of the forum members. The ALLIANCE will also contribute to the awareness-raising agenda through the publication of an accessible and user-friendly outline of the case for change put forward by the Scottish Government, to make sure that people have a clearer idea of how pharmacists can contribute to their health and wellbeing. The publication will highlight current exemplary pharmacy practice to build on, and opportunities for future developments.
The work of our organisations will support the Scottish Government’s commitment to achieve the best possible outcomes for people who access support and services. Furthermore, it will ensure that people are recognised as equal partners and are given sufficient information to enable them to make informed decisions about their care. Our prescription for the future is one of radical change – these developments offer us an important juncture on the route to that.
Written jointly with Ian Welsh, Chief Executive, the ALLIANCE