Pharmacy services

A large focus of the talks was on increased service provision by community pharmacies. In England, as part of the NHS England Primary Care Access and Recovery Plan, a sum of £645 million over two years was allocated to expand services offered by community pharmacy. This has enabled expanded pharmacy oral contraception and blood pressure services and the launch of Pharmacy First, through which community pharmacies can supply prescription-only medicines for seven common conditions. Through these three initiatives it is expected an additional 10 million GP appointments in England will be freed up per year.

Lessons learnt from the UK implementation of Pharmacy First include the difficulty for pharmacists to administer the Pharmacy First service without access to the patient’s GP record and without an integrated digital system for updating the patient’s GP record following a pharmacy consultation. Tahmina Rokib, Clinical Lead for GP Connect Access Record, spoke of how they are developing solutions to these problems by removing the need for double entry of data by pharmacists and to provide automatic updating of GP records after a pharmacy consultation.

Shazia Patel, Community Pharmacy Clinical Lead for Derbyshire Integrated Care Board, highlighted that there were over 160,000 Pharmacy First consultations in the Midlands area in the first six months of the year, with 20 per cent of these consultations delivered by pharmacies in the areas of greatest deprivation.

Aled Roberts, Community Pharmacy Wales, spoke of how Wales has an Independent Prescribing Service where qualified independent prescriber pharmacists can prescribe within their scope of practice for a range of specified conditions. There have been over 12,000 consultations per month from 200 pharmacies across Wales. 93 per cent of the patients who availed of consultations would otherwise have been seen by a GP.

It was useful to hear of UK experiences and challenges with pharmacy services as we embark on a similar journey in Ireland, with the anticipated rollout of a Common Conditions Service.

Technology

Technology, and how it can reduce pharmacy workload, cognitive burden and improve processes, was also a frequent topic of talks.

Nishali Patel, Digital Medicines Clinical Lead for NHS England, presented on the NHS App which patients can use to book GP appointments and view their GP records and electronic prescriptions. Although patients can order their prescriptions via the app, it was interesting to note that there is no tracking of the status of the prescription requests, so patients don’t know if it is ready for collection. Ms Patel reflected that because 45 per cent of phone calls to pharmacies are to ask if a prescription has been received or if it is ready for collection, the NHS are developing prescription status updates within the app so patients will be notified when their prescription is ready for collection, and it is now in pilot phase.

Dan Ah-Thion, Policy Manager with Community Pharmacy England, spoke of the drawbacks of replicating paper prescription processes when moving to electronic prescribing. In England they have had electronic prescriptions for 18 years, but they have been left in a situation where there can only be a maximum of four items per electronic prescription because they designed it based on the old paper prescription format. They will now need to spend up to four years redesigning the system to remove this limitation. Similarly, most pharmacies in England still print the electronic prescriptions to fit in with their workflow. It shows the importance of designing an e-prescribing solution in conjunction with practicing pharmacists and the importance of establishing it as a paperless system from the beginning.

Artificial Intelligence (AI) was mentioned as a means of driving efficiency by both speakers and exhibitors at the event. Natalie Lewis, Associate Dean in Aston University Birmingham, outlined the benefits of using different AI programs but also cautioned that AI uses information from the internet which can be biased or out-of-date, and that AI can hallucinate and generate incorrect information (for example, she displayed an anatomy diagram which showed four kidneys in a patient). She also advised that businesses should have a clear policy on the use of AI and not to enter any patient or business data into AI as it can then be used for data modelling.

Patient Medication Records

Patient Medication Record (PMR) vendors such as Titan PMR have adapted pharmacy workflows to minimise pharmacist involvement in the dispensing process so they can provide more services. Titan displayed how they can use AI to analyse and perform clinical checks on prescriptions, which is cutting edge, if a little concerning. Their PMR can also translate labels into several different languages if needed. They, along with other PMR providers such as Positive Solutions, utilise barcode scanning technology to ensure the accuracy of stock picked.

Training and development

There was a strong focus on Pharmacy Technicians and their changing role in pharmacies at the Pharmacy Show. The NHS Long Term Workforce Plan has a strong focus on increasing the number of Pharmacy Technicians and expanding their role, initially to include certain vaccinations, for example, seasonal flu vaccines. This stronger focus has led to the establishment of multidisciplinary working groups focussing on strategic practice and policy changes.

Another common theme was the emphasis on qualifications. This includes not only multiple levels of pharmacy staff qualifications but also a strong focus on empowering Pharmacy Technicians post-qualification via the Post Registration Pharmacy Technician Career Framework Development. This has led to the availability of courses such as:

Foundation Practice Programme;

Accuracy Checking Technician;

Level 4 Enhanced Practice Programme;

Level 6 Enhanced Clinical Practitioner; and

Leadership Programmes available to both pharmacists and technicians.

Again, continuous learning and upskilling is seen as very important and often programmes come with funding available through the NHS.

Finally, wellbeing of all pharmacy staff, whether pharmacists, technicians or other staff was a recurring theme with many talks looking to provide tips, skills and work practices to support staff in dealing with everyday pharmacy life. The recognition of the need to focus on wellbeing and taking action came through strongly throughout the show.