Supported Self-Care
Whether we like it or not, pharmacists are usually last in line when it comes to healthcare.
I can hear the pharmacy twitterati and facebook posters reaching for their re-tweet or like buttons already, but hear me out. Last in line is where we might want to be.
Healthcare is an expensive business and the costs are just going to escalate over the coming years and decades, with an ageing population coping with an ever increasing number of long term conditions. The NHS produce reference costs for most elements of care:
A+E attendance = £138
Out-patients appointment = £117
Unscheduled admissions £1609
Excess Day Bed £308
Cost per GP appointment 11 mins) = £46 which equates to £234 per hour patient facing costs
Cost per hour Community Pharmacist = £51 (£64 per hour for patient related activities)
Source http://www.pssru.ac.uk/project-pages/unit-costs/2015/#sections
All these elements of care are expensive so we need to make sure we make the best use of resources. The question is, what’s the best way to do that?
Sara Riggare
The graphic above was produced by Sara Riggare who is a Swedish Engineer with Parkinson’s Disease. She produced the graphic to illustrate the fact that healthcare is not primarily in the hospital, GP practice or Community Pharmacy, but in the patients home. Sara receives one hour of consultation time with her specialist each year and she’s on her own for the other 8765 hours. This blew me away when I saw and read this and it was real light-bulb moment for Medacy.
As I mentioned above, pharmacists tend to be, quite literally, last in line when it comes to healthcare. If a patient is in hospital, they will undergo tests to diagnose, care to make them better and when they are strong enough they are discharged. Very often the last aspect of care in hospital is the supply of discharge medication quite often by a ward pharmacist or pharmacy technician. In primary care, a patient will go to their GP, be diagnosed or reviewed and a prescription produced. In both instances, before the patient goes into their 8765 hours (or equivalent) where they are in-charge of their own health, the pharmacist is the last healthcare-professional they will see.
Pharmacists are ideally placed to make sure patients understand their condition and their treatment and how to support themselves during the own blue-dot time. They see them every month or two to supply their medication and this should be an opportunity to review how things are going. Ideally. notes should be made on the patients clinical notes to update the GP on progress and allow them (or other prescriber,) to tweet their prescription, some might say, optimise their medication so all parties, the patient, prescriber and wider NHS get best return on their investment in medication.
Lack or full access to medical notes with read/write privileges prevents this from happening at present and if community pharmacists are to realise their full potential, this needs to happen ASAP. Sara Riggare beautifully illustrated the opportunity for community pharmacists in clinical support, it’s up to the community pharmacy sector to reaslise it.
This article was first posted on Linkedin in 2017
