Context and policy

Medicines are at the centre of much of modern healthcare; however, there is a growing body of evidence that highlights the cost to society of sub-optimal medicines usage, including wastage, medicines not being taken as intended and avoidable adverse drug reactions. It is now well recognised that more could be done to optimise the benefit that patients gain from medicines, while ensuring the NHS gets appropriate value for the money spent. The 2010 white paper Equity and excellence: liberating the NHS,1 sets out the need for pharmacy professionals to contribute to the optimisation of medicines by working more closely with patients and taking a greater level of direct clinical responsibility for decisions about prescribed medicines and patient care, while encouraging greater patient involvement in those decisions.

Medicines optimisation2 is different from medicines management, in that it places patients at the centre of their healthcare, taking a holistic approach built on partnerships between clinical professionals and the patients they care for. The treatment of complex conditions is shifting more and more from hospital to primary care, reinforcing the importance of medicines optimisation across all pharmacy sectors.

The last decade has seen the development and implementation of advanced services in community pharmacy, such as the medicines use review (MUR) service and the new medicine service (NMS). Both services aim to improve adherence and help patients to maximise the benefits of their medicines,3 shifting the focus of community pharmacy practice away from simply the supply of medicines. Building on these services, community pharmacists have the opportunity to extend their role in medicines optimisation by spending more time with patients, not just in the pharmacy, but in GP practices, care homes and in patients’ own homes. Medicines optimisation principles are based on the clinical pharmacy, pharmaceutical care and medicines review work that is routinely undertaken by pharmacy professionals in hospital and primary care.

Alongside medicines optimisation, pharmacy professionals can play a key role in supporting the Government’s vision for improving public health, as set out in the 2010 white paper Healthy lives, healthy people.4 Public health interventions focus on supporting people to stay healthy, protecting them from threats to their health, by making healthier choices, and reducing health inequalities.

All patient-facing pharmacy professionals have a role in delivering healthy living messages and, in line with the ‘making every contact count’ initiative, have plenty of opportunities to talk to patients and members of the public about improving their health and wellbeing.

Community pharmacy is a valuable and trusted public health resource, with the potential to be used even more effectively to improve health and wellbeing. The Healthy Living Pharmacy initiative is highlighting the difference that community pharmacies can make to the health of local communities.5

In addition to the health policies outlined above, it is important to note the recent system developments to education and training within the NHS. The Education outcomes framework,6 published in March 2013, directly links education and learning to improvements in patient outcomes. Its key aim is to ensure that the health workforce has the right skills, behaviours and training, to support the delivery of excellent healthcare and health improvement. It is within this framework that this learning and development programme in consultation skills for pharmacy is set.

  1. Department of Health. Equity and excellence: liberating the NHS. London: Department of Health; 2010 www.gov.uk/government/publications/liberating-the-nhs-white-paper
  2. Royal Pharmaceutical Society. Medicines optimisation: helping patients to make the most of medicines. Good practice guidance for healthcare professionals in England (May 2013). London: RPS; 2013. www.rpharms.com/promoting-pharmacy-pdfs/helping-patients-make-the-most-of-their-medicines.pdf
  3. Department of Health. Impact assessment on the introduction of the new medicine service. London: Department of Health; 2011 www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_130234
  4. HM Government. Healthy lives healthy people: our strategy for public health in England. London: HMSO; 2010 www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england
  5. Brown D, Portlock J, Rutter P, Nazar Z. From community pharmacy to healthy living pharmacy: Positive early experiences from Portsmouth, England. Research in Social and Administrative Pharmacy 2014; 10 (1): 72-87. www.sciencedirect.com/science/article/pii/S1551741113000855
  6. Department of Health. Education outcomes framework. London: Department of Health; 2013. www.gov.uk/government/publications/education-outcomes-framework-for-healthcare-workforce

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