2019 Northern Ireland Pharmacy Conference
Moving from Supply to Services
Managing the Risks; Embracing the Opportunities
NIHR rounds up some of the highlights of the 2019 Northern Ireland Pharmacy Conference – in partnership with The Pharmacists’ Defence Association – and provides snapshots of the speakers’ impactful presentations.
At a time when pressure on the NHS is pounding and we’re at risk of floundering morale, it’s crucial that the different spectrums of the pharmacy industry come together and take command of their unique skills for the benefit of patients. Helping to map out a better way forward, the Northern Ireland Pharmacy Conference 2019 – in partnership with The Pharmacists’ Defence Association – recently attracted an array of esteemed delegates and industry sponsors to the Europa Hotel, Belfast for discussion, debate, and learning.
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Speaker One: Professor Michael Scott, Director, The Medicines Optimisation Innovation Centre (MOIC)
Topic: What’s new in medicines optimisation and innovation? Overview of the work of The MOIC to date, and plans for future developments. Where does community pharmacy fit in?
As he took to the stage, Professor Scott immediately alerted the audience to the major challenge of medication errors within the system – 6.5 million errors annually – and the pressure thus inflicted on hospitals, in which 5,000 bed-days are subsequently lost. But he also presented an optimistic vision for the future – and how we can collaboratively work to rectify these stark statistics and make our service better through medicines optimisation.
In line with the ultimate aim of reducing medication harm by 50 per cent by 2023, Professor Scott outlined a number of the key goals under The MOIC framework, such as better adherence with prescribed medicines; improving polypharmacy management; reducing harm for high risk patients and medicines; and increasing knowledge, capacity, and skills in health literacy.
Drawing our attention to the real-world impact of these aspirations, Professor Scott overviewed the work of The MOIC and various projects lining the route of the innovation pipeline which boast evidence-based insights which could be replicated on a wider scale – like the Case Management Project, practice-based pharmacists, and Out-of-Hours Supply.
But particularly noted was the importance of building relationships and knowledge transfer during this process, demonstrated via The MOIC’s work with the European Association of Hospital Pharmacists, and the European Innovation Partnership on Active and Healthy Ageing.
Speaker Two: Mark Koziol, The Pharmacists’ Defence Association
Topic: Integrating pharmaceutical care across all sectors of pharmacy: integration and intelligent commissioning for better patient outcomes. Changing the perceptions of the public: informing the public about the impact of medicines
Mark’s presentation shed light on the fact that although healthcare professionals are undoubtedly working hard, they’re often not working smart – and as a result the industry is increasingly vulnerable to struggle; giving rise to overwhelmed GPs, and too many patients being driven to hospital. For example, prescribing medicines is the most common medical intervention, yet the service isn’t taking medicines seriously enough, leading to them being wasted or containing errors.
Also illustrated was the interaction between the patient and healthcare professional, and how there’s danger of it turning into a consumer-supply relationship if we don’t take action. We thus need to do more to rebuild the dynamics of this relationship and change the public’s thinking of pharmacy.
The power of integration came into play during Mark’s presentation, too, as improvements can be instigated simply by creating a community of practice and connecting with all of the different parts of the system. We can address inequality of service and help reduce it by adopting an increasingly patient-facing approach which will ensure that patients are treated more similarly.
Ultimately, we learned that we all attain responsibility for helping the sector to soar; and it’s our mission to seek changes to the current perception of pharmacy. We must strive to engage the public with a memorable, iconic message about pharmacy in order to reframe their thinking about this clinical relationship, and prove that pharmacists are experts in medicine.
Speaker Three: Cathy Harrison, Acting Chief Pharmaceutical Officer, Department of Health
Topic: Future developments for pharmacy: future healthcare provision via community pharmacies
The Acting Chief Pharmaceutical Officer propelled the medicines optimisation model into the spotlight, and its integral ability to drive forward consistency in patient care.
In particular, from a policy perspective, The MOIC is an important enabler of change; helping to wield research and quality improvements. But through this process it’s also been proven that the sustainability of innovation has to be realistic to find its place in the real-world.
There isn’t one solution to the errors in our system, so The MOIC allows us to cast the net and take time to evaluate different strategies and new models of care which can lead to positive change in pharmacy.
Crafting a plan for the sector’s next steps, Cathy emphasised the necessity of looking at where we are now and the building blocks for an enhanced long-term future. In line with this, co-operation is at the core of the medicines optimisation framework; there’s power in connecting our services and integrating the clinical pharmacy workforce, with pharmacists working together across sectors.
Likewise, we must implement smart networks and invest our assets in collaboration, rather than competition. Benefits will be reaped by way of applying technology that works for both you and your patients, such as electronic transmission prescriptions.
Speaker Four: Dr Terry Maguire, Pharmacy Proprietor
Topic: Transforming community pharmacy: paying attention to public health and self-care agendas
Terry’s enlightenment was steered by his expert knowledge that while transformation from supply to services is a critical course of action, it won’t happen by accident, but by the adoption of a strategic approach. In order to move forward, we need to look at why we’re not currently moving at as fast a pace as we should be. As Terry explained, successful change entails realising that change is needed, in addition to believing that change can be successful.
One of the biggest challenges which we must address are the barriers perceived by pharmacists – including money, relevance, space, and know-how.
We might say that we want a service-led landscape, but it’s not that easy. The aspirations of the diverse types of contractors are all different and we can’t change the system if pharmacy itself isn’t convinced. Services must be developed by pharmacy itself. Furthermore, provision of care can be bolstered by investment into research and development.
Terry’s final message returned us to our original ethos of wanting to help patients which we should never lose sight of – looking after people adds value.
Speaker Five: Eoghan O’Brien, Pharmacy Proprietor
Topic: Innovating the pharmacy offering: an example of innovative pharmacy practice opportunities
Eoghan delved into his working experience and how the lessons gleaned in his job all point towards the significance of patient outcomes in all the projects which we choose to undertake in pharmacy.
The focus of Eoghan’s reflection comprised his Portglenone Diabetes Partnership 2018 which assessed a series of shifting behaviours in patients – homing in on the better control and / or reversal of type 2 diabetes in 10 people willing to make changes in what they eat and drink; their physical activity levels; and how they manage their stress.
The initiative was instrumental in taking into consideration the multifaceted nature of a patient’s being – and how both their mental and physical health provide obstacles in the pathway to improvement.
As such, the individuals were assisted not just with their nutrition, but in concerns regarding their behaviour change – from the reality of it, to the different stages, and what can help. Also reasserted was the importance of promoting patients’ independence; and the project targeted this by helping the individuals achieve sustainable change via healthy food shopping.
Speaker Six: Niall Downey FRCSI, Doctor and Airline Pilot
Topic: Optimising risk reduction – learning from the airline industry. How might airline industry approaches benefit risk reduction in the NHS?
Reflecting on over 25 years of experience as an airline captain and a doctor has allowed Niall to approach the present manifestation of our healthcare system with a unique perspective – and one which may be incredibly advantageous.
His presentation – brimming with modern media demonstrations and real-world examples in which mistakes commonly occur – showcased how our current approach to adverse events, due largely to human error, can be honed by applying proven techniques from the aviation industry.
With the problems usually persisting in the systems, rather than the people, we need to consider implementing a just culture, rather than the blame culture which continues to dominate. By way of this new openness, individuals wouldn’t be as reluctant to hold their hands up when something goes wrong.
If we introduce more mechanisms for preparing and checking for undesirable outcomes – which don’t have to be expensive or comprehensive – we’ll herald a new era of efficiency and confidence.
Speaker Seven: Dr Mark Timoney, Pharmacy Proprietor
Topic: Adding value through transformation: seeing it from the other side
Taking to the stage, Mark allowed the audience to veer down the path of his transition as he reflected on his shift from a background of strategy and policy to adopting a post front of line. Through this changing role, Mark has been able to identify the sector’s barriers first-hand; including high costs, efficiency, and business rules. However, it shouldn’t be this way, he asserted, as our strategies have informed us that integration is our key, and the way forward to making sure that patients have access to tried and tested services.
An exploration of the essential indicators of change occurred; such as reducing health inequality; increasing healthy life-expectancy; reducing preventable deaths; and improving the quality of the healthcare experience.
Having long occupied an authoritative platform, Mark was also perfectly placed to advise as to how we can remould the traditional leadership role to bring greater engagement. As Mark noted, leadership is less about being an expert, but in fact inspiring and motivating others. Our health service representatives need to be courageous to lead that charge.