This commentary was written for Pharmacy in Practice (link below)

Scotland’s Chief Medical Officer says pharmacists are ideally placed to have a central role in delivering Realistic Medicine, ensuring the healthcare people receive is of the greatest value to them as individuals, is most in line with their wishes and has the least potential to do them harm.

Dr Catherine Calderwood was speaking at the Pharmacy Management National Forum for Scotland in Dunblane this week, which focused on the role of pharmacy in the new landscape of integrated care. Delegates to the event also discussed examples from across Scotland where pharmacists have been working alongside other professionals and providers to find new ways of delivering care that best meets people’s needs.

Dr Calderwood says pharmacists have been one of the biggest groups of professionals commenting on her annual report that, earlier this year, first showcased the move towards so-called Realistic Medicine. She says their response has been resoundingly positive. In fact, some professionals responded that they had already been practising all the elements of Realistic Medicine in their own community settings and were now pleased that they had her official stamp of approval.

Dr Calderwood spoke on the role of pharmacy in delivering the pillars of Realistic Medicine. For ‘reducing harm and waste’ she gave a personal example:

“I did some local medicines reconciliation, you would be proud of me, in my own father’s drawer in his kitchen. You will all know it, filled with the pharmacy bags with the cross on them. I should tell you that my father was an orthopaedic surgeon when he was working. So we started taking the bags out and I literally piled this stuff up.

“My father was on nine different medications, still diligently going and collecting them and storing them in the drawer and probably he needs three of them. And repeat that in cupboards up and down the country.

“So this is your world,” she told her audience of pharmacists, “of tackling this sort of thing all the time.”

The CMO cited work in NHS Forth Valley to illustrate how pharmacy is delivering another aspect of Realistic Medicine: ‘releasing the creativity of healthcare professionals to be improvers and innovators’.

Dr Calderwood presented interim findings from a programme that has signed up almost every community pharmacy in the region to manage the treatment of urinary tract infections, impetigo and exacerbations of COPD – backed with face to face and online training opportunities.

In the first 22 weeks of the programme, 897 people were seen after coming to the pharmacies with UTIs. Of these pharmacists treated and discharged 682 of them, with only 139 needing onward further referral.

Similar numbers of people with impetigo and exacerbations of their COPD were being treated and completely discharged through community pharmacy. In all, almost 1200 people were seen in first 22 weeks of the programme, which is to be formally evaluated for its potentially to be rolled out to other areas.

“That is innovation,” says Dr Calderwood, “person centred, personalised care and it is freeing up time for the GPs who are very much under pressure on appointments.”

Dr Calderwood told her audience that Prescription for Excellence, makes commitments to the profession that will help make the delivery of Realistic Medicine a reality for all people – helped, not least, by the desire of pharmacists to practice Realistic Medicine as part of multi-disciplinary working:

“Your expertise, your training, your knowledge and the ability to provide care as I have demonstrated is happening in Forth Valley, this is the right time to be doing this.

“We are changing our thoughts, we are moving treatment out into communities, away from hospitals and, in doing that, I would say pharmacists are absolutely ideally placed at the right time to become more involved. And I think we need, as has been the commitment of Prescription for Excellence, to really invest and develop the pharmacy profession.”

First published by Pharmacy in Practice:

https://pharmacyinpractice.scot/2016/08/26/scotlands-pharmacists-ideally-placed-to-practise-realistic-medicine-says-cmo/