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Putting people at the centre of care is the only way forward

Anne Child MBE
Anne Child MBE

a person-centered approach is a never-ending process and it is a professional journey I am deeply committed to as a pharmacist.

I recognise it requires a strong commitment by the individual and adoption from leadership. I believe this commitment is vital in a regulatory climate that focuses (rightly so) more and more on person-directed practices as a maker of the standard for quality care. 

Compliance is no longer enough. It is quality outcomes that define us all as care providers. Pharmacists, I believe, can be at the heart of this. For example as pharmacists we can adopt an ethos towards medicines, in whatever setting we work, by being given the time to spend to support individual patients in their understanding of their medicines, the risks/benefits of treatment and the value of their medicines. By adopting a shared decision making processes approach we can achieve this goal.

All of this helps to gives patients, wherever possible, a feeling of enablement and involvement.

As pharmacists we have traditionally been viewed as the healthcare professional involved in the medication process, but in my opinion our true value has not always been seen. We have not been appreciated by others or ourselves, for the great impact we can have at the coalface of care.

Moving forward, pharmacists belong in multidisciplinary teams where we can use all our core skills to include not only medicines optimisation, but holistic support for patients and carers.

This is never more apparent than in support for the frail elderly, especially those being cared for at home or in residential care settings where simple support can make all the difference.

Just as pharmacists are stepping up to work streams in GP services, health and social care settings such as care providers can benefit from our skill set and drive for positive outcomes.

There is much work to be done across care interfaces to include those from training to process, and everything in-between i.e. understanding safe medication pathways, incidents and learning outcomes, to how we manage and optimise medicines.

Just as importantly, there is the human face of pharmacy: how we support positive care planning to include the medicines aspects of advanced care planning and support for individual needs.

Medicines reviews for the elderly frail to include appropriate deprescribing should be considered in the landscape of overall health and wellbeing. Pharmacist who have the skills should be given the time to deliver these supportive reviews.

I spend much of my time now in the care home setting and I never cease to be amazed at the complexity of care in this environment. Pharmacists are in general good communicators, and if ever a setting needed a voice, it is here where we can be advocates for residents, while working closely with the multidisciplinary team to ensure medicines add the value intended by the prescriber.

By working closely with clinical commissioning groups (CCGs), community pharmacists and other healthcare professionals, I have learned that we can influence to deliver projects which improve outcomes linked to key target areas such as falls, nutrition and hydration, chronic obstructive pulmonary disease (COPD) management and reducing avoidable hospital admissions.

All of these can have a positive effect on the health economy as a whole, but the truth is they have a far greater intrinsic value, because they benefit individual people all of whom have a name. In short we can help improve quality of individual lives, and this in turn can help families and carers in the wider circle of care.

These close working relationships between us, patients and carers will define care provision in the future in health and social care settings. Clearly this has been recognized in the NHS Five Year Forward document, and hopefully we pharmacists will be early adopters of its concepts.

Currently I start most working days thinking now about medicines, but always I am bought back to the following: medicines treat diseases and we care and support individuals.

We must as a profession embrace the art of care and not only the science of care, as both aspects must be covered to ensure the best outcomes for our patients.

Anne Child MBE is director of pharmacy and dementia care for Avante Care. She is a pharmacist with special interest in care home medication and dementia care pathways

Follow Anne @aechild1

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