In the first of a series of 3 articles about NHS Tayside’s ‘Teach and Treat’ model, Lead Pharmacist, Yousaf Ahmad, outlines the background. The second article will focus on the development of the teach and treat model
THE 20:20 vision for health and social care within NHS Scotland sets out clear ambitions that by the year 2020 everyone will be able to live longer, healthier lives at home or in a homely setting.
The aims by the Scottish Government is to deliver a healthcare system which is integrated into the health and social care arena, with a focus on prevention, anticipation and supported self-management. Irrespective of the setting, care should be provided to the highest standard of equality and safety with the person at the centre of all decisions.
This vision and action plan set out by the Scottish Government reaffirms the contribution of pharmacists and the pharmaceutical care they can provide in future healthcare systems. It builds on the direction of travel of our progressive and developing policy landscape for high quality, sustainable health and social care.
This action plan will require the delivery of NHS pharmaceutical care to adapt to new and innovative models to facilitate professional independence of pharmacists, working in collaborative partnerships with other health and social care professionals and also with the third sector to deliver the best possible health outcomes for patients from their medicines.
Prescription for Excellence
From this Scottish Government vision Prescription for Excellence was developed to complement the 20:20 vision route map and quality strategy ambitions.
Prescription for Excellence has been widely accepted as a progressive and ambitious plan to develop the future of pharmacy within NHS Scotland over the next decade, in particular focussing on significant changes in medicines and therapeutics which will require the delivery of innovative models to enable patients to obtain the maximum benefit from the medicines they are prescribed.
Prescription for Excellence puts pharmacists as a critical member of the multidisciplinary team. This concept of delivering person-centred healthcare within all systems of pharmacy is a both new and yet previously well-founded, depending on the care setting the pharmacist works in. This vision within Prescription for Excellence for pharmacists in NHS Scotland can be summed up in a few short sentences:
“All patients, regardless of their age and setting of care, receive high quality pharmaceutical care from clinical pharmacist independent prescribers. This will be delivered through collaborative partnerships with the patient, carer, GP and the other relevant health, social care, third and independent sector professionals so that every patient gets the best possible outcomes from their medicines, and avoiding waste and harm.”
It has been approximately three years since this vision for pharmacists within NHS Scotland was launched, so how do our colleagues at their local bases and at national level aim to deliver such a pivotal and groundbreaking change to the way we practice pharmacy? Clear messages, such as the creation of independent caseloads, theories around GP pharmacists and questions raised about the competencies and skill sets required by pharmacists to deliver on such a massive scale, can ultimately result in either the most innovative pharmacy system in the world, or it can fall flat on its face. Albeit the next five to ten years within NHS Scotland is a pivotal time for pharmacy and the colleagues that work within this system to form a profession which plays a greater role in patient care.
One of the questions and issues that I raise today is: how do we have a trained, competent and well developed pharmacists that actually are recognised as clinicians, yet are capable of delivering on exceptional patient care? Creating a workforce strategy is a mammoth task for all employers whether it is in primary, secondary or third sector. In particular, due to the diverse nature of pharmacy systems creating a single platform is wholly unattainable.
Read the second article in this series here.
Yousaf Ahmad is Lead Pharmacist at NHS Tayside
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Evidence based research on pharmacist interventions in pain management
 Bruhn H, Bond CM, Elliott AM et al. Pharmacist-led management of chronic pain in primary care: results from a randomised controlled exploratory trial. BMJ Open 2013;3 (An exploratory randomised controlled trial- PIPPC Study)
 McDermott ME, Smith BH, Elliott AM et al. The use of medication for chronic pain in primary care, and the potential for intervention by a practice-based pharmacist. Family Practice 2006; 23: 46–52
 UCL- LESS Pain Toolkit; The results of a community pharmacy pilot pain service evaluation (The LESS PAIN toolkit was designed to facilitate well informed semi-structured discussions between community pharmacists and service users with pain related problems
(N.B As a profession we need to start creating more of this evidence based relating to Pharmacist interventions in clinical conditions, so that we can prove the benefits for a pharmacist at managing patient’s clinical care)