As a future pharmacist I am able to see how pharmacists make a strong contribution to delivering patient care, offering much more than the safe and effective dispensing of prescriptions. I value greatly the part that pharmacists play in promoting health and wellbeing. Pharmacies offer readily available professional advice without the need for an appointment, on self care and the safe use of medicines and, increasingly, services that identify potential health problems (such as health screening) and support healthier lifestyles (such as stopping smoking and lifestyle advice).
Throughout the past few years pharmacists have been moving forward by taking on a series of new job roles and increasing the range of services they make available to their patients. As well as supplying medicines, they are capable of offering confidential medical advice. In addition to this many pharmacies offer services such as:
Hair retention programme
Weight loss programmes
Prescription Collection Service (PCS)
Minor ailments
Drug user services (supervised consumption)
Consultation room (privacy)
Emergency contraception
7 days a week pharmacy
Body Mass Index (BMI) Machine
Cervical Cancer Vaccination Service
Flu Vaccination (Seasonal)
Medicines Check Up
Chlamydia screening and treatment
Repeat Prescription Service
Many community pharmacies now have the facilities and skills to measure blood pressure, offer cholesterol testing and even screen for diabetes which is essential in a health conscious society.
Recent developments in the pharmacy profession have occurred whereby many pharmacists are beginning to undertake an independent prescribing course which allows them to work as autonomous practitioners thereby allowing them to make prescription decisions based on their assessment of the patient's condition and their judgement of the most appropriate medication regime. If this continues in the next six years a majority of community pharmacies will have pharmacists qualified in the field of independent prescribing meaning patients are seen to more efficiently.
In today's society many of us visit the pharmacy quite regular (at least once a year) for health related reasons and it is vital that patients feel that any queries or worries they have can be resolved before they leave the premises of the shop.
Therefore if we look at the current strengths and the arrangements put in place we can see how current standards are maintained but also what's more is that we can look at how they can possibly be improved just to go that one step further to ensure efficiency all around is achieved.
Observing the current strengths it is clear that at the moment there is a high volume of easily accessible health professionals within vast communities throughout the country that are fully competent and capable of offering their professional services.
Health professionals are there not only to give out medicines but are also fully capable of making sure health and wellbeing is maintained, so people are able to take better care of themselves.
Furthermore majority of health professionals are there to help prevent illness and provide appropriate treatment for those with short or long term illnesses. In addition people also have access to over the counter medication to allow them to obtain certain medication without the requirement of a prescription thus allowing quick and easy access to a range of medicines to help with their problems until they can be seen by a GP if need do so for alternative treatment.
A report also showed that community pharmacies were easily accessible where 96% of the population (including even those living in deprived areas) are able to access a pharmacy within 20 minutes by the means of public transport or walking and 99% by car.
There has also be an increase in the figures of the accessibility to a pharmacy within the more deprived areas suggesting more pharmacies are opening up within or nearby the vicinity of these deprived areas where access was previously limited.
Many pharmacies remain open for rather long periods of time throughout the day to allow patients to come at a time more suited for them, also majority of pharmacies recently have been approved to open for at least 100 hours per week, every week of the year.
Research also shows that in 2006 more than 750 million items were dispensed and the number is increasing by 5% per year. Therefore more and more people are receiving their prescribed medicines promptly, safely and efficiently.
Another strength pharmacies have to offer is the benefit of being able to provide a less formal environment for those who feel less comfortable visiting their GP or some may find it more convenient to speak to the pharmacist rather than booking an appointment to see their GP. People may prefer walking into a pharmacy just because they are able to receive on the spot professional help and advice which is almost impossible when visiting a GP.
Therefore if we take into consideration of how the current system is structured we can then suggest what needs to be improved or changed within the pharmacy sector, which we may see come to develop in the near possible future of pharmacy. Observing how the profession and practice of pharmacy will change in the years to come and seeing how I myself will be involved in this change to come, I believe many things which current pharmacists are practising will change drastically however not so much that the need for pharmacists also becomes drastically decreased or obsolete.
There are many areas in pharmacy where pharmacists can actually help their patients that one step further such as:
Promoting better access to pharmacists' expertise on medicines, so pharmacists and their team can ensure the safe and effective use of medicines within individuals;
Increase the medicines that are available to purchase over the counter (OTC) to treat certain conditions that pharmacists can be involved in;
More pharmacies that are involved in the treatment of minor ailments (such as heartburn/indigestion, diarrhoea, hayfever, coughs, colds and aches and pains) on the NHS;
Increase awareness of services such as NHS LifeCheck a service which assess your lifestyle and improve your future health using simple questions to assess you;
Give timely and opportunistic advice on how individuals could make positive adjustments to their life such as eating a well balanced diet, exercising more frequently and ensuring they manage their weight accordingly;
Pharmacists could also offer more health related services helping and giving support to those trying to quit smoking, or offering vaccinations against the flu or any other pandemics. Furthermore, as the number of sexually transmitted infections is increasing pharmacists can offer sexual health services based on safe sex and giving patients the opportunity to ask any questions, in addition to this they can also offer services such as chlamydia screening and access to contraception, including emergency hormonal contraception (EHC);
Providing support to those who may need it more such as people starting new medication for a long term condition (coronary heart disease or asthma) to ensure they are fully competent in taking their medication on time but also to help improve their quality of life, health and wellbeing;
Pharmacists through their many years studying also have a great deal of knowledge on the clinical side of pharmacy but rarely get a chance to use it within community pharmacy. Therefore services such as blood testing and interpretation of results for cholesterol levels, and helping to deliver screening programmes within national and local guidelines following UK National Screening Committee (UK NSC) would be a possible step forward;
Patient care could also be improved through pharmacists developing their own skills such as specialising in a particular field of expertises of their interest or undergoing a supplementary or independent prescribing course allowing them to prescribe certain medicines;
Pharmacists play a crucial role in guaranteeing the safe practise of medicines and it is vital that they are fully competent in what they do, as they along with GPs can ensure medicines are appropriately prescribed and used within individual(s). The safe use of medicines is highly important as it can help to reduce the number hospital admissions seen, also this can be achieved by resolving common problems such as poor use of medicines or managing possible side effects due to medication. Pharmacists can further ensure that support is provided as patients transfer between hospital and the community.
Local 'health community clinical pharmacy teams' can make a significant contribution in this respect.
There have been significant developments coming to alight within the IT sector of pharmacy in order to improve efficiency and safe use of medicines where services such as Electronic Prescription Service (EPS) are being trailed to see their effectiveness. EPS allows medications and other prescribed therapies to be managed electronically at every stage, from prescribing to supply and administration. EPS will therefore help to reduce the chances of prescribing and administration errors thus leading to an increase in patient safety.
EPS is believed to offer significant benefits to all prescribers, dispensers and patients as it aims to improve patient safety by decreasing the amount of incomplete or illegible prescriptions. Also EPS will reduce the number of times patients will need to visit their GP to collect repeat prescriptions making it easier and more convenient for patients to get their medication.
Therefore EPS is a possible change that we as pharmacists may see come into practice in the near future if trials prove successful where majority of paper prescriptions will be replaced with electronic ones leaving pharmacists or dispensers to merely dispense against them.
Medicine use review is another aspect which could be further developed and possibly seen as a high priority in the future. Medicine use reviews (also known as MURs) are one on one consultations between the pharmacist and patient and used to help identify any problems the patient may be experience whilst taking their medication (such as any side effects being experienced upon starting medication, or difficulty in swallowing or remembering to take medication). From providing such a service as MURs pharmacists can ensure that medicines are taken as directed but also they can consult the prescriber and recommend a change if they feel it will be more beneficial for the patient in doing so.
MURs do play a key role in patient compliance as the service is vital to bring into light and address any issues which the patient but also the pharmacist feels, and doing so can may the appropriate adjustment(s) required.
Therefore in the future to come pharmacy will change towards the better in that we may be required to carry out MURs on a more routinely basis to ensure patient safety is always maintained to its highest level.
Repeating dispensing has been growing significantly over the years and it is not estimated that about 70% of prescriptions issued annually are repeats therefore if we take this into the context of what will it mean for the up and coming future then possible we will see:
Better management of patients' medicines as pharmacists will be more aware of regular medications being taken, thus able to flag up any interactions earlier then usually. Also pharmacists will be able to ensure the effective and efficient use of medication
Patients will less frequently visit their GP as the pharmacy will be more involved in the retrieval of their prescription depending on the choice of the patient if they agree with this service. This would mean pharmacists would mean more work for the pharmacist but also would increase the number of patients staying loyal to one particular pharmacy
More efficient communication between the GP practices and the pharmacies, as pharmacists will need to report back to prescribers if problems do arise, thus showing that the pharmacy is providing appropriate services to their patients
A decline in the amount of medicines wasted which is achieved through pharmacies carrying out regular checks on whether certain medicines are required by patients and if not they can be stopped.
Another issue we face in pharmacy is the urgent need for medicines but the incapability to offer it to them because many people work and therefore can only visit the pharmacy in the late evenings which presents a problem as majority of the pharmacies begin to close.
Also another particular problem that occurs nearly everyday in pharmacy is where the patient runs out of his/her medication and needs an emergency supply as either the script is not ready or someone has forgotten to request it from the GP.
Therefore if we improve the way in which our services are run we could possibly see less issues and more satisfied customers. Particular improvements which could be developed and put into action are:
Methods which enable the ordering of prescriptions electronically
Using automated telephone requests using a code (under trial in some GPs)
Campaigns based on making people aware to check their stock levels and request repeats if required
Furthermore as the emergency supply of medicines is becoming quite frequent within pharmacies due to patients not receiving their medication(s) on time, pharmacists are left to decide whether it is vital that the patient have their medication immediately. Usually pharmacists can supply enough medicine to last 5 days which should be enough for either the patient or pharmacist to obtain a prescription from the GP.
However sometimes even a 5 day supply can sometimes not be enough therefore a current debate being considered is to whether or not to extend this to a 28 day supply.
The future of pharmacy is becoming more and more challenging as time moves on, there is an increasing demand that pharmacies should expand and improve the range of clinical services (i.e. support on safe use of medicines, monitoring) they offer, especially services for those individuals with long term conditions.
Many pharmacies are now even beginning to offer vascular risk assessments; this service is can be highly useful as it could have a significant role in reducing disease or even early death.
To summarise I believe that the practice of pharmacy over the next 6 years will change drastically and some of the main changes that we will see are:
Many if not all pharmacies ensuring they offer all the vital services to ensure healthy living which may include services such as raising more awareness of safe sex through offering sexual health advice and access to emergency hormonal contraception. Also offering chlamydia screening and treatment and help and support to those who need it
An increase in repeat dispensing and MURs being carried out in more pharmacies to meet the patients' requirements
Extra support to those with long term conditions, and ensuring they are on medication best suited for their lifestyle and side effects if any are appropriately managed
Check up facilities for people with long term conditions (i.e. asthma, CHD, blood pressure, diabetes)
More pharmacies will have a GP on site to ensure the patient can, if required, speak to both the doctor and the pharmacist if he/she requires a second opinion
Overtime there has been an increase in demand from society for more flexibility around appointment times and days. Community pharmacies have the ability and resources to accommodate these increasingly demanding needs from individuals in society and I believe that many more pharmacies will be required to open for 100 hours a week to meet these demands
To conclude, in the near future community pharmacies will have a large presence in the UK which will mean patient's needs are better met. In being said I do think that we're going to see many more customers who are a lot more informed about pharmaceuticals. Nowadays people are doing a lot more research into medicines and reading more on the Internet, which is not always the most reliable source of information. To keep up, pharmacists will need to know a lot more, about more subjects, such as natural products and supplements, because our customers will be more informed and will be expecting us to be aswell.
