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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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palliative careAugust 26 2015

Community pharmacies could and should have an increased role in palliative care, particularly in supporting care homes, the Royal Pharmaceutical Society in Scotland has proposed.

In its response to the Scottish Parliament’s consultation on palliative care, the RPSiS says: “There should be alignment of one GP practice, one community pharmacy and one care home to improve pharmaceutical care in care homes, which are increasingly required to deliver palliative care.”

In addition, it recommends:

  • “read and write access to health records should be available with the patient’s consent to all those involved in their care to ensure continuity of care, patient safety and timely access to medicines”
  • “multidisciplinary education and training is required for prescribers to ensure they are familiar with Home Office requirements for controlled drug prescriptions to avoid unnecessary delays in patients accessing their medicines”
  • “new models of care need to be explored to allow community pharmacists to work to the top of their licence, as part of the multidisciplinary healthcare team to provide a more holistic package of care.”

RPSiS has published its response to the consultation which forms part of the Scottish Parliament’s Health and Sport Committee ‘We need to talk about Palliative Care’ inquiry. The inquiry’s remit has included looking at how to overcome barriers to palliative care, the timing of conversations about palliative care with patients, and when and where health professionals should be involved.

The RPSiS submission points out that many hospices now rely on dedicated pharmacist input. The establishment of the Community Pharmacists Palliative Care Network (CPPCN) “has greatly improved access to palliative care medicines and pharmacists’ expertise over extended hours,” it says.

“These pharmacies ensure stocks of the agreed palliative care specialist medicines are available in the community at any time. Most of these pharmacies are open late in the evenings and at weekends with pharmacists available for emergency call out when the need arises.”

Areas where the services could be improved include having better communication between health professionals and across health care settings. There is also a lack of concise and up-to-date palliative care resources and information both for patients and health professionals, as well as “a lack of knowledge regarding the prescription and supply of palliative care medicines.”

Flagged up in the report is an MSc study at the University of Strathclyde which has studied community pharmacy delivery of pharmaceutical care to palliative care patients. “It looked in particular at the issue of prescribing errors in controlled drugs which can cause delays in access to treatment. It found that one in eight prescriptions submitted for dispensing in community pharmacies contained an error.

“Although clinical intervention was frequently required the majority of errors were due to non-compliance with Home Office regulations. Current legislation combined with no access to patient records means that despite the pharmacist’s clinical expertise they are unable to dispense safely without contacting the prescriber for adjustments or clarification of intent.”

Having the ability to access to patient health records “is one of the most important areas which must be addressed,” says the RPSiS. “Communication between secondary and primary care needs to be greatly improved and between community pharmacy and other health care sectors.

“Community pharmacy is the patient facing end point in primary care where timely access to palliative care medicines can be critical to patient care and to both prevention and relief of suffering.”

The Health and Sport Committee will start taking oral evidence in September. It has not indicated when it will publish its final recommendations.

Links:

RPSiS statement              

RPSiS submission            

Scottish Parliament ‘We need to talk about Palliative Care’ inquiry                

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