Home' Australian Pharmacist : Australian Pharmacist November 2015 Contents Australian Pharmacist November 2015 I ©Pharmaceutical Society of Australia Ltd.
We need a different kind of health service. An integrated, multi-disciplinary
care organisation which delivers improved quality of life, improved
dying, improved preventive care, improved aged care, improved patient
flow and improved systems which embrace new technologies, is needed
according to the speakers at the recent UK Royal Pharmaceutical Society
The challenges of our Australian health
system, our limited funding and ageing
population closely mirror those of the
UK and are driving these suggestions of
imperative change as soon as possible.
As Dr Keith Ridge, England's Chief
Pharmaceutical Officer said: 'The journey
to optimal medicines use has just
The cost of acute care in the UK is five
times greater than for the combined
cost of primary care, which includes all
general practice, pharmacy, dentistry,
allied health, mental health and
community service costs.1 The cost of
acute care is rising 4% annually and so a
key priority of the NHS is to shift patients
from acute care to primary care.
Dr Martin McShane from NHS England
said: 'Every admission to hospital for a
long term condition is a failure.'
In the UK, 4% of over 65 year olds, are
in care homes. That is, there are three
times more people in care home beds
than in hospital beds.2 Studies show that
many patients living in care homes are
not getting their health needs regularly
assessed, resulting in many avoidable
hospital admissions.3 So, aged care is
another sector where primary health
practitioners, especially pharmacists,
are being asked to be more involved.
There is minimal data about the
health needs of care home residents.
Health data needs to be properly
linked so that population health can be
managed across all sectors.
Although over the past 10 years NHS
expenditure has doubled and life
expectancy increased, for many elderly,
the quality of life and their health has
diminished. Long term conditions
and multi morbidity are on the rise.
In fact, people with multi morbidity
account for 33% of all GP consultations.
The system does not reward GPs for
preventing hospitalisation and episodic
payments are not conducive to better
management of long term conditions .
A team based approach, with pharmacy
at the centre, is needed to better
manage long term conditions.
A new look health system?
NHS England's Five Year Forward View
paper outlines a plan to break down
barriers between GPs and hospitals,
between physical and mental health,
and between health and social care.
It encourages GPs to combine with
specialists, nurses and other health
professionals to provide integrated out
of hospital care. It also promotes GP
out-of-hours services integrating with
hospital emergency departments and
more preventive medicine. So a new
health system needs to strengthen
and improve community care, to get
rid of the divisions between primary,
secondary and tertiary services and to
provide better continuity of care.
What will pharmacy look like?
New science, including genetic
profiling, improved drug efficacy and
high speed informatics will change
future prescribing and treatments.
Technologies, such as robotics,
will change dispensing, supply systems
and communications. Health records
will be (eventually) shared by all health
professionals and their patients.
In England, medicines dispensing
from one or two centralised
locations, with national Amazon-style
ordering and delivery systems are
To save costs, UK NHS requires more
effective medicines optimisation,
improved prescribing and better
management of elderly people,
minimal hospitalisation due to
medicines error, reduced medicines
wastage and markedly improved
medicines adherence for patients
with long term conditions. For these
improvements to occur, pharmacists will
need to be imbedded in clinical teams
in hospitals, care homes, GP practices,
personalised medicines centres and in
integrated care positions.
Pharmacists already play an important
role in assisting patients to bridge the
care gap, or 'that place in the middle',
The stars are aligning for a
clinical and digital future
BY LINDY SWAIN
"PHARMACISTS CAN GREATLY
MANAGE THE GP OVERLOAD,
AND MANAGE THE ELDERLY
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