These commentaries by John Macgill represent his opinions only and not those of any Ettrickburn client.

Focusing the Vision: Dr Rose Marie Parr on the new strategy for Scottish pharmacy

All the things that could go wrong - looking ahead to the SNP conference

Ask Once, Get Help Fast? Pharmacy and Mental Health

Automation and Delegation in Pharmacy: Understanding the Moving Parts

Pharmacy First in Forth Valley One Year On

Initiatives Highlight Potential of Community Pharmacy

Trying to concentrate on the day job

Health and the Local Elections – a strange silence

The Pharmacist Will See You Now – The Growth of GP Pharmacy

Montgomery’s Review – Dr Brian Montgomery answers questions on access to new medicines in Scotland

An afternoon with SMC

Pharmacists at SMC

SMC – are drug firms voting with their feet?

Radical Surgery on the Horizon for Scotland’s NHS

The Future’s Bright – in General Practice

Community Pharmacy in a Changing Environment

Disclosing payments to doctors – has Sir Malcolm done the pharma industry a favour?

Health and Care in the First Minister’s Programme for Government

CMO: Scotland’s pharmacists “absolutely ideally placed” to practice Realistic Medicine

Profile: Maree Todd – MSP and Pharmacist

Scottish Parliament Health Committee Work Programme

Scotland’s new NHS – a Summer of Speculation

Scotland’s New Health Committee

Two million voices in Scotland – is integration the big opportunity to listen?

Medicines – levelling the playing field

Key appointment raises the bar for health & social care partnerships

What did our new MSPs do before?

SMC says no then NICE says yes – three times

SNP promises single formulary and a review of Scotland’s NHS

More Generous than the CDF – but less transparent

Comparison of Funds: New Medicines v Cancer Drugs

Bonfire of the Boards? SNP signals NHS Review

A tribute to five retiring MSPs

New Medicines Review - Health Committee sends findings to Government

Medicines New & Old in the Scottish Cancer Strategy

Great Ambitions, Slow Progress – New Models of Care in Scotland

Scottish Minsters Demand Up-Front Medicine Price Negotiation

Opportunity and Disappointment: MSPs Investigate New Medicines Access

Scottish NHS Strategy calls for 'Realistic Medicine'

The Scottish Model of Value for Medicines: Taking Everything into Consideration

When SMC Says No: An Access to Medicines Lottery

Reviewing the Review: Access to New Medicines in Scotland

A day of psephology and kidology

Insulting the Lifesavers

Worthy of Mention – Health and Science in the Honours List

News Silence from North of the Border

A Christmas PPRS Present from Pharma

Thursday, November 09, 2017: Focusing the Vision: Dr Rose Marie Parr on the new strategy for Scottish pharmacy

This interview with the Chief Pharmaceutical Officer is published in this month's edition of Scottish Pharmacist magazine. You can read the on-line edition at http://bit.ly/2ApZodw

In August, the Scottish Government published Achieving Excellence in Pharmaceutical Care, a strategy for both pharmacy services and pharmacy professionals, setting a direction that seeks to embed the profession as equals in delivering healthcare. Scotland's Chief Pharmaceutical Officer, Dr Rose Marie Parr, says the strategy is the latest in a series from government going back to before The Right Medicine in 2002 and, most recently, Prescription for Excellence in 2013. John Macgill asked Dr Parr what progress she felt had been made in the four years since. 

RMP: I think Achieving Excellence in Pharmaceutical Care builds on Prescription for Excellence and we want to keep its vision. And the vision for me, in all the strategies so far for Scotland, has been around best pharmaceutical care. 

It has been a short time from 2013 to 2017 but so much has changed within the health service in that time. We had new strategies such as Realistic Medicine and Realising Realistic Medicine and a National Clinical Strategy and we have seen health and social care integration, which has made a real difference. When I came to the Chief Pharmacist's job I said I wanted to refresh Prescription for Excellence, not to change its vision but to give it a focus that takes on board the changes to policy within government in Scotland, builds on the good practice that we have already and makes it all more accessible for people. We need to keep the vision and the ambition but we need to get the job done as well. So, I've used those two years I have been in post to speak to people across Scotland. I have had a lot of feedback that has let me see what we need to keep doing and what we need to do well. 

I first came to this role with five big tasks I wanted to fulfil. Refreshing Prescription for Excellence was one. The second was to work on aspects of how we embed pharmaceutical care within our practice across all the settings - and Achieving Excellence, I think, talks to that. Another thing I wanted to address was education and training: not just for pharmacists, but also for pharmacy technicians. We have started that conversation and it's going to be challenging, but we are now looking at five-year undergraduate courses for pharmacists coming through with more experiential learning and more clinical experience. Meanwhile, we absolutely know that we need to change the technicians' training because it's no longer fit for purpose. A fourth task was about evidence and outcomes, and looking at what pharmaceutical care does for patients and what the medicines that we use are delivering for patients. Sometimes medicines bring more harm than benefit, so it's really important that we have the evidence and the outcomes for the medicines that we use. And, lastly, I wanted to increase strategic engagement both internally within government and, particularly for me, externally across the profession and that is what I've been doing across the last two years - which has allowed me to publish Achieving Excellence in Pharmaceutical Care. 

JM: You can get the impression that there is potentially a role that pharmacists could play in pretty well every healthcare setting, and that pharmacists could make a positive impact everywhere. So, to achieve the full potential of the profession, do we need more pharmacists or to take the existing workforce and change the way that they are deployed? 

RMP: We need both. We do need a few more pharmacists coming through the system and we are seeing some evidence that that is happening. I have asked NES and the schools of pharmacy to look at what that means for workforce planning. Workforce planning in pharmacy is really difficult because we have a lot of gaps. We can count the number of people in a hospital or in primary care, but we have difficulty counting community pharmacists, which makes it more difficult to plan. But I think we do need more. 

At the same time, we do need to redesign what pharmacists are doing - and technicians too. We need to allow the current workforce to work differently and the pilot in Inverclyde at the moment is a really good pointer to how we might do that, with technicians and pharmacists working in new ways. I think IT will make a big difference and that we haven't seen its true potential. I keep talking about iPhones and drones but automation is also taking place, and the evaluation that we have doing of places where tasks have been automated will tell us the extent that pharmacists' and technicians' time is being freed up so they can be more patient-facing. 

JM: Your vision is of one pharmacy profession delivering the best pharmaceutical care for people in every healthcare setting and every part of Scotland. The experience of clinicians is often of systems that vary between NHS Boards and where appropriate clinical information about patients is not always accessible by practitioners in the community. What are your priorities in terms of achieving your joined up, patient-centred vision? 

RMP: I think we do have the right vision but sometimes we do put in our own barriers and silos and the IT is a bit clunky. I think there are things we can do ourselves. Some of the sessional portfolio working I have seen some younger pharmacists doing is really important and is helping break down some of the barriers. But, in terms of patients' understanding of pharmaceutical care and the value they place on medicines, I think we really need to step that up a gear. I think most people value their community pharmacist. They understand them and we know that most people, even when they are not registered, will go back to the same pharmacy each time and that is interesting. 

So, how do we help patients to value what pharmacists can do, and appreciate what medicines can and can't do for them? We started with a citizens' panel to talk about what people think of medicines and how they get their information. And it's quite telling that patients judge what they can see. I think the worst thing that we can say is that you can rate a pharmacy by the quickness of delivering a prescription, that it's only about speed. But, patients do not understand what is going on in terms of spending time on their safety: checking they are the right patient, making sure they are getting the right dose at the right time, that questions are going back to the prescriber. A lot of that goes unnoticed and un-valued and, unless we can get patients to understand all this work and value it, we're going to have a challenge because people won't know what they've lost until they lose it.

We have a group at the moment talking about how we value medicines and we want to build on this group and draw more people in to help us and guide us and make sure we have the information we need to shape how we improve understanding of what we do. 

JM: The strategy makes a series of very clear commitments on behalf of government. What, in return, do you want the profession to do to realise the vision, particularly in the short term, when it might be tempting just to sit back and see how things unfold? 

RMP: And we can't do that. We can't let this just sit on a shelf. How we deliver the strategy is as important as what is in it. There are lots of really positive things about Scotland and how we can use the networks, be they directors of pharmacy, across primary care and community pharmacy, with NES and the pharmacy schools and the RPS and the GPhC. Each has a role in informing how we deliver this and what help we need with education and training. 

I would ask you to stick with this strategy even in turbulent times. Stick with the vision around care for patients. I agree with one of my community pharmacy colleagues who said to me 'I've never really thought about anything other than what the patient needs. And if the patient needs it and we supply it for them in a quality way, the rest of it will flow'. 

And for me it's how we can harness the experience, enthusiasm and expertise. Because we are setting a path for your profession for the future, for your career. Change is always with us but if we really do keep the patient at the centre of this, then we can't go far wrong.