Pharmacists right at the heart of new model of health care

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A new way of training clinical pharmacists is underway in Northumberland as part of widespread work to improve the integration of health and care services between hospital, in the community and in patients’ own homes.

As part of the Northumberland ‘vanguard’ programme, a new way of training and developing the future workforce puts clinical pharmacists right at the heart of the new model of care.

In August, Northumberland welcomed a cohort of newly qualified pharmacists who, for the first time, are working as part of GP practice-based teams from the outset of their careers. This is allowing the recruits to follow an entire patient journey from initial interaction with their GP, any community-based care, right the way through to any hospital admissions and discharge arrangements.

The aim is to expose clinical pharmacists to ‘whole system working’, helping to develop a positive mind-set that fosters collaborative working, pre-empts any issues around medication and, ultimately, makes the experience of care as seamless as possible for patients.

Dr Alistair Blair said: “GP practices are changing with patient care being delivered by a range of professional experts and pharmacists are an important addition to our team. Everyone has been impressed by their enthusiasm, knowledge, hunger to develop and commitment to the highest quality patient care. They have, in a short space of time, become highly valued members of the primary health care team.”

Dr Wasim Baqir, lead clinical pharmacist for the vanguard programme in Northumberland said: “What we’re seeing in Northumberland is a brand new way of working and of teaching new pharmacists entering the profession about how care is changing in the NHS.

“By embedding a pharmacist within GP practice teams it immediately switches the emphasis on what has historically been a hospital focussed education programme – it gets new pharmacists thinking about the whole pathway of care and medication issues that may be encountered by patients at any step along the way.”

The new cohort of pharmacists in Northumberland are paired with hospital-based pharmacists and both rotate into GP practices as part of their training programme, allowing them to gain clinical skills in a hospital environment whilst GP practices benefit from the skills and input of a dedicated pharmacy service.

The newly qualified pharmacists are working closely with six GP practices across Northumberland and are linking in with district nursing staff and social care workers, to proactively identify vulnerable patients who are at risk of hospital admission to keep them safe and well at home.

This includes visiting care home residents to ensure they are taking the most effective combinations of medication and that they stop taking medicines they no longer need or want. This vital pharmacist input is helping to improve understanding of medication, involving care home residents and their families in decisions about their care and, crucially, helping to reduce the amount of unnecessary medication being prescribed.

Alastair Green is one of the new trainee pharmacists working at Guidepost Medical Group in Choppington. Alastair studied at the University of Sunderland and is one of the first pharmacists in the country to train in this way. He said: “It is really exciting to be at the forefront of something so new and innovative in the NHS. To feel like you are making such a positive difference by being proactive in reviewing patients and helping to avoid any problems that might arise with medication in future.”

“The people we’re looking after in care homes are often very frail and may have been taking a large number of medicines over a number of years. Without regular reviews they may end up taking medicines that they no longer need and it’s really important these patients have regular oversight and review so we can keep them supported and well in their own environments. It is lovely being able to get to know patients and to have such support from GPs, community pharmacists and care home staff.”

In 2015, NHS England announced Northumberland as one of only eight areas across the country chosen to take a national lead on transforming care for patients as part of the national vision for the future of the NHS.

Since then Northumbria Healthcare NHS Foundation Trust and NHS Northumberland Clinical Commissioning Group (CCG) have been working with local GPs, Northumberland County Council and wider health and care partners, including mental health and the ambulance service, to truly transform the way care is delivered.

Future-proofing the NHS workforce by transforming the way future pharmacists are trained and how they work together with other professionals, forms a fundamental part of the vision for Northumberland.

Dr Wasim Baqir added: “We are building a future system and workforce that will be sustainable in the years ahead and one that is geared up to help us meet the growing demands of our aging population. This is more pertinent than ever here in Northumberland as we have a higher number of elderly people than any other part of the country. The steps we are taking now will help us be in a better position to meet future demand and keep people looked after at home and outside of hospital.”

Building on successful work over many years to integrate health and social care in one of the most rural counties in England, the NHS in Northumberland is now well ahead in delivering a fully joined up primary and acute care system and working towards a single integrated accountable care organisation from April 2017.

This will be a first for the NHS and will bring together all the different parts of the NHS in Northumberland who are responsible for commissioning and providing health and care services - crucially, it will include the local authority. The aim is to better co-ordinate care, make sure patient and carer experiences are as seamless as possible and support people to stay healthy and well. To do this in Northumberland, all partners will be working towards a set of shared quality objectives focussed on keeping people healthy and well.

For more information visit www.northumberland.nhs.uk.