The following interview is published in the new edition of Scottish Pharmacist magazine, available on line at http://bit.ly/2h8R6AM

The pharmacy profession is involved throughout the chain of decision making processes around every new medicine considered for use in NHS Scotland. Scottish Pharmacist asked the Chairman of the Scottish Medicines Consortium, Professor Jonathan Fox, to explain the profession’s input at the different stages.

JM: What role do pharmacists play, working alongside other professionals, in the SMC process (up to and including SMC publishing its advice)?

JF: Pharmacists are vital to our work. Since the inception of SMC in 2001, pharmacists have been central to the work of SMC and are very actively involved in both the New Drugs Committee (NDC) and SMC.

We have 13 pharmacists on the core SMC staff, who are involved in all SMC activities, including the critical appraisal of the submissions, horizon scanning and the PACE process. The head of the SMC staff team, Anne Lee, is a pharmacist. We currently have eleven pharmacist members sitting on NDC / SMC and SMC’s most recent past chair, Professor Angela Timoney, is a pharmacist. We have also had a pharmacist chair of NDC, Dr Jan Jones, who is now one of our Principal Pharmacists, and of course there are our vice chairs, Gail Caldwell and Caroline Hind. Across the whole range of our work, from submission assessment to senior decision making, pharmacists play an essential role – SMC couldn’t function without them.

JM: How is community pharmacy represented on SMC and in its decision-making processes?

JF: We currently have two senior pharmacists with community pharmacy responsibilities who are full members of SMC and are also vice chairs for the Committee chairs, myself and Dr Alan Macdonald. They are Gail Caldwell, Director of Pharmacy at NHS Forth Valley and Caroline Hind, Deputy Director of Pharmacy and Medicines Management at NHS Grampian. Both Gail and Caroline have health board responsibilities for the operational management and development of Primary Care Pharmacy Services, including community pharmacy services, so they provide valuable expertise to SMC, ensuring that decisions are made with full understanding of key community pharmacy issues.

We also have several NDC and SMC members who have primary care roles in health boards and a large pool of clinical experts who advise on our submissions including pharmacists working in a primary care setting.

JM: What do you see as the role of area drug and therapeutic committees and formulary pharmacists at board level in taking forward the advice of the SMC?

JF: SMC was set up as a consortium of the Area and Drug Therapeutic Committees (ADTCs) across Scotland – to create efficiencies and avoid duplication by taking a ‘once for Scotland’ approach in the assessment of all new medicines. This has been very effective and allows ADTCs to concentrate on other medicines governance activities focusing on the safe and effective use of all medicines, not just new ones.

All ADTCs have well established processes in place to review the advice from SMC, which is issued to them confidentially on the first Friday of each month, four weeks before it is published on the SMC website.

Health board pharmacists play a pivotal role in these processes, as a key part of the multidisciplinary team who support the implementation of SMC advice within a local context. This may be in relation to the development of shared care arrangements, guidelines or local pathways of care. Pharmacists across the range of clinical settings work closely with other healthcare professionals to ensure their patients have early access to clinically and cost-effective new medicines.