The virtual event was arranged by Health Education and Improvement Wales and introduced by the Executive Medical Director, Pushpinder Mangat, to engage pharmacy stakeholders in shaping plans for a National Strategy for Consultant Pharmacists. In order to improve the health of the population in Wales, it is anticipated that the strategy will be a vehicle through which to increase the number of consultant pharmacist posts and ‘consultant-ready’ pharmacists.
The event, facilitated by Ruth Alcolado, HEIW Clinical Lead, Leadership and Talent Management focused stakeholders in conversations around how the strategic case for consultant pharmacists in Wales should be made, as well as giving consideration to the different delivery models for posts and how to adequately ‘succession plan’ for the next generation of consultant pharmacists.
These were delivered by Ruth Millar, Principal Research Pharmacist, Western Trust Northern Ireland and Chief Pharmaceutical Officer for Wales, Andrew Evans. Government transformation funding in Northern Ireland delivered the initial two consultant pharmacist posts in outreach clinics for older people in care homes. The resulting improvements in care, reduced medicines expenditure for older people and the reproducibility of the model was compelling and resulted in nationwide recurrent
funding for five posts. Evidence that consultant pharmacists, with junior pharmacy teams working to their leadership, delivered even more benefits appears to offer support to the potential vision for Wales shared by Andrew Evans as illustrated in the figure below.
Chief Pharmaceutical Officer's Vision for Consultant Pharmacists in Wales
There was broad agreement around the need for a Strategy in Wales and this was welcomed across all sectors of pharmacy. A strategic approach must identify where there is an opportunity to make a real difference to service and patient care, at Health Board or National levels.
Development of consultant pharmacist posts led by national strategic priorities, creates the opportunity for the NHS to pool resources to invest in national, regional and local leadership. Consultant posts must reflect the integrated nature of the NHS in Wales, working seamlessly within health boards and independent contractor services (i.e. pharmacies and GP practices), leading whole system service redesign, providing vision and support to the workforce around them.
At a health board level, a more proactive focus on the value of medicines was favoured with a vision for more consultant pharmacists becoming more accountable for balancing costs and realising benefits across the interfaces of health and social care, removing barriers for effective and more holistic medicines management.
There were different perspectives on consultant posts being generalist clinical leaders in medicines use, versus specialist roles embedded within clinical teams. This needs further exploration with non-pharmacy stakeholders as well as understanding the significance, or not, of consultant pharmacists having a ‘caseload’. Business cases should highlight the value in pharmacist roles across the ‘four pillars of practice’, for example valuing the ability of post holders to influence and engage, for example at Board level, as much as mastery of individual clinical practice.
There needs to be a clear, achievable pathway to consultant practice for those in the workforce that would like to pursue this. Opportunities for mentorship, training, educating and researching outside of the usual place of work, network and profession will be needed. Consultant practice needs to become more ‘normalised’ amongst the profession with a greater understanding developed about what mastery looks like across the multi-sector pharmacy workforce.
The consultant pharmacist strategy must not be written in isolation and should be considered alongside the needs of the rest of the pharmacy team.
Summarising the outcomes to close the event, it was clear that similar themes had run through the workshop discussions and that these will help to drive forward a phase of steering group meetings and further discussions, including wider engagement with non-pharmacy professionals.
Target Strategy Launch date January 2022