Tomorrow's already here
By Mike Smith
I ended 2018 attending a European Pharmacists Forum (EPF) meeting in Monaco. I can’t quite believe that next year will be the 20th anniversary of this group, which is sponsored by Ornella Barra, co-chief operating officer for Walgreens Boots Alliance. It was my privilege to have been the inaugural president back in 1999.
The members represent all of the countries in which we trade, so it covers most of mainland Europe. The last two meetings focussed on developments that will play a major role in the profession’s future.
Our previous meeting in October looked at a well advanced, although new, pharmacogenomics-based service from the Netherlands. Through a simple swab test the patient’s DNA profile can be determined in a specialist laboratory, and then shared with a doctor and a pharmacist to help determine which treatment is the most appropriate and cost-effective for various conditions.
The profile gives clear information on the likelihood of efficacy and the possibility of side effects of various molecules (and isomers). This is a real step forward in the treatment of a wide range of conditions (for example, depression and arthritis) since it increases the likelihood of finding the right treatment for an individual, where genetic factors can be important. This innovative service should find a place in the portfolio of services offered in community pharmacy. I suggest you read up about this to ensure that you are at the forefront of supplying medicines based on this kind of profiling service. It’s closer than you think.
That last meeting of the year was very much focussed on healthcare innovation (HI). It was interesting to hear about the International Federation’s (FIP) vision for the future of community pharmacy. I was particularly interested in how they see the pharmacist’s role in the initial triage of patients. FIP’s interest started in Switzerland some time ago, and it may be particularly relevant in the UK because of the acute shortage of GPs. Here in Devon we have patients waiting up to two weeks for an appointment. In some areas, surgeries have closed or are operating on locums.
The NHS, to say nothing of our patients, desperately want pharmacists to pick up some of this work and help to fill the very real gap, that is widening year-on-year. As our colleagues in Switzerland have shown, community pharmacists are more than capable of triaging patients, and this would lead to a significant reduction in GP appointments.
Some pharmacists may need additional training, but this represents a tremendous opportunity for pharmacists – and so much more so for independent prescribers. I don’t think I’m overstating it to suggest this could lead to a transformation in the provision of primary care – and it could be community pharmacists who deliver this quite logical change.
All we need now is a fully thought out, implementable plan. But this is an opportunity I believe we must take with both hands. There’s a win in here for patients and the NHS alike.
Our HI session also included discussions on the inevitable impact digital technology will have on our sector, wherever you are in Europe. The use of e-prescriptions and e-patient records mean that the old paper-based trails are disappearing. Such changes clearly carry significant risk – just think about the vulnerability of repeat prescription business – but if we can genuinely transform our community based offer in local healthcare hubs, offering a wide range of services that can be accessed by patients and medical professionals alike, then there is an opportunity here too for the profession that recognises, and is well placed, to maintain to the face-to-face direct approach that so many of our patients will continue to look for.
There is of course an elephant in the room. We will struggle to adopt any of these changes without funding – and there seems to be little progress on that front, at least in public.
My very best wishes for a successful 2019. I would also combine that with the final thought that, as the last couple of trips across the channel have reminded me, please be open to and prepared for change.