Andre Yeung on being on a mission to make things better in pharmacy

Andre Yeung

 

Andre Yeung is a pharmacist, NHS England Network Chair and architect of the Digital Minor Ailments Referral service. By his own admission, he is on a mission to make stuff better for patients.

 

He was recently elected to the Royal Pharmaceutical Society English Pharmacy Board. He topped the poll in England with 941 member votes.

 

We caught up recently to talk all things pharmacy.

 

What have you learnt from your career progress so far?

 

“I qualified ion 2000. I started as a community pharmacy business. My father was a community pharmacy owner. I grew up with the expectation that I would work in the family business but that came to an end when my father sold the business in 2006 when the market was riding high. I began working for one of the multiples, became an area manager. I then got an opportunity at Celesio to do a business development role across a number of settings across England and into Scotland too. I worked with some fantastic people. After three years of that, I took time out and did an MBA at Durham. I came out of that MBA thinking differently and started my own consultancy. A few years later I a am carrying out a number of functions. I’ve worked with the NHS, Pharmacy Voice the PSNC and others.”

 

How did you find the election process and what were the top line findings in your survey?

 

“I think it’s your job to understand how members are feeling. My role will be to represent the views of the members. I will be accountable to members. I found myself in a position where I started to run but realised how little I knew about what pharmacists think about various topics.

 

“It was a practical thing to do to find out what others are thinking. I wanted to seek to understand and then move forward and have an influence. It was a very positive experience. Some of the other people were gracious enough to give me a pat on his back too.”

 

There were no hustings so was this the easiest year ever to get elected?

 

“I genuinely don’t know. I don’t know why that was but to be honest I wasn’t sure if that would have been beneficial for me because understanding what pharmacists are thinking rather than broadcast. I hope to contribute by helping my board colleagues set the tone for the organisation and hopefully influence positive change in pharmacy. I’m looking forward to working with fellow board members and the executive team”

 

What is your key objective for your time on the board?

 

“I have always been outward looking. Many pharmacists, ourselves included are in business and the market is constantly changing. I’m slightly obsessed with making sure I serve members as best as I can. I hope to be an outward-looking board member who can stay in touch with members. I hope this will give me a mandate and empower me to some really great stuff for members and the profession and the RPS.”

 

Is there a dearth of leadership in pharmacy at the moment and does this drive negative narratives in the media?

 

“I think it would be remiss not to recognise the fact that in community pharmacy especially things have been tough for a long time now. As someone speaking to community pharmacies on a daily basis we have to recognise the last few years have been difficult for everyone. Therefore it is a trend and I do observe it offline too. Like all humans we affected by the environment we operate in especially for business owners. It doesn’t give a lot of opportunity for positivity int he wider profession.

 

“In terms of vision and strategy over the last five years, people inside and outside community ask me ‘what is the vision?’ so I agree there is an issue there. Maybe the narrative is changing due to recent changes.”

 

Do we need to imagine community pharmacy in a post-NHS era?

 

“I think I have a different opinion to you. In England community pharmacy I am seeing green shoots. Im seeing signs of things that give me reasons for hope. The tone of the conversation is changing behind the scenes. I definitely see, through projects I’m involved in, opportunities for the future. The Long-term plan is critical and community pharmacy are mobilising to take advantage of these

 

What is the digital minor ailments referral service?

 

“This is a service that I’m involved in that was developed through help from NHS England in the North East of England. We were lucky enough to get an opportunity in the North East around an idea to refer patients from NHS 11 to community pharmacy. I think to date we have had 25,000 patients referred through that channel. It is a service around which enthusiasm has grown around it. It is something that community pharmacy is offering that no-one else can.

 

“We have similar projects starting elsewhere in the country and I think this is great. The vast majority of community pharmacists are deeply enthusiastic about this type of clinical role. The digital minor ailments service already involves lots of things community pharmacists are doing already.

 

“If you take the digital minor ailments referral service you get patients referred to community pharmacy to have a proper consultation. Medicine is a really important tool in our armoury, you want training and some equipment. I think independent prescribing is part of our future but I think we need to work out how we get there. I think it’s an evolution. It is a huge investment.”

 

Have you got any outcomes to report from this service?

 

“We’ve got lots of information. The service is safe. The pharmacists are doing a great job. Patients love it. And we have been able to scale activity. It is important that the service joins up activity with other areas of the system like NHS 111. It is shifting the patient expectations of what a community pharmacist should be doing and how community pharmacists are perceived.”

 

Andre also joined us recently on the podcast. Click here to listen to the full conversation.

 

 

 

Community pharmacy prescribing in Scotland

Sam Falconer is a community pharmacist. His current role is that of pharmacy manager at Kilwinning’s Townhead Pharmacy.

 

Sam and his team are carving out a reputation for innovation and excellence in the delivery of pharmaceutical care a the heart of their community. Sam is an independent prescriber and he has been using this qualification to deliver a common clinical conditions service.

 

This service involves him assessing and prescribing for conditions like tonsilitis, ear problems, chest complaints and other ailments not covered by the Scottish Minor Ailment Service. He is already making an impact locally and the people that use his services are extremely satisfied with the work he does for them.

 

He was good enough to join me on the podcast to talk through how he has achieved this but also some of the challenges along the way.

 

If you want to understand how to run a well thought through independent prescriber led community pharmacy common clinical conditions service then this podcast is for you.

 

 

If you prefer to never miss an episode you can subscribe on your preferred podcast platform. Just click on the links below to get going.

 

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In data we trust: The changing face of Scottish healthcare

 

Recent developments in the Scottish health data landscape.

 

While it seems unlikely the words of British economist, Ronald Coase, will ever lose their relevance in politics – “torture the data, and it will confess to anything” – we are in an age where the mantra that “data is king” is spreading.

 

The most recent meeting of the Life Sciences Cross-Party Group (CPG) in the Scottish Parliament, convened by Kenneth Gibson MSP, heard contributions from various members of the medicines, medical devices and healthcare industry and academia, all keen to promote the possibilities of health data to deliver improved outcomes.

 

The recently inducted Minister for Trade, Investment & Innovation, Ivan McKee, is proving himself to be a data enthusiast. When the potential for data protection issues to act as roadblocks to the “significant growth trajectory” of Scotland’s life science sector was put to him during the CPG, he queried whether this was more of a perception and not the reality for data gathering, not least given the strict controls placed on how people’s health data can be used. He declared his desire to push forward “as far as possible” any proposals brought to him related to data health capabilities and assured attendees opportunities to achieve safer and more cost-effective care through the use of data was high on the agendas of his ministerial colleagues, Joe Fitzpatrick and Jeane Freeman.

 

A presentation by Dr Iain Findlay, recently retired Consultant Cardiologist, NHS Greater Glasgow and Clyde and Prof Colin McCowan, Professor of Health Informatics, Robertson Centre for Biostatistics at the University of Glasgow, focused on a joint working collaboration between NHS Greater Glasgow and Clyde, the Golden Jubilee National Hospital, the University of Glasgow, the DataLab and AstraZeneca UK. While tracking the journeys and outcomes of patients with acute myocardial infarction in the context of a “complex, acute healthcare system”, the collaboration delivered a near real-time electronic ACS (Acute Coronary Syndromes) registry, demonstrating how existing data could be made to “work harder” and deliver a clearer picture that could impact work in a number of areas, notably in unwarranted variation.

 

The suggestion was made however that more honesty was needed in discussions that focused on the extent to which data was being turned into information that clinicians could use to deliver better and different care to patients. Some of those in attendance conceded Scotland was indeed on the cusp of falling behind other nations in its ability to use real-world data to influence patient outcomes, and a concerted effort was needed to ensure Scotland realised its data-driven potential.

 

Subsequent to the CPG, the risks posed by Brexit to the sector were laid out in a publication from the Scottish Government, titled Scotland’s Place in Europe: Science and Research. The paper set out the implications of Brexit for Scotland and “constructive alternatives”. The importance of international collaboration is outlined alongside the benefits of continued involvement in programmes such as Horizon 2020. On the same day, First Minister, Nicola Sturgeon, announced £5m of funding from the national Interface programme was to be invested in Scottish businesses to match them to Scotland’s “world-leading academic expertise” in pursuit of “practical industry innovation”.

 

Since then, there have been developments on a number of fronts. From news from the UK Government that the Industrial Centre for Artificial Intelligence Research in Digital Diagnostics (iCAIRD) is to open in Glasgow, which will bring together experts to explore the role of AI in treating strokes and some types of cancer, to the launch of a new directory to link industry with NHS clinical, academic and trade organisations during the Scotsman Life Sciences Conference, the status of data is rising. The new directory, launched by Glasgow co-chair of the Life Sciences Scotland Industry Leadership Group, Dave Tudor, is described as an “easily searchable database” and is to be known as the Scottish Health Research & Innovation Ecosystem. Its function sits well with the priorities outlined at the Life Sciences CPG, to see better links between those in the industry looking to develop innovative treatments and techniques with those in clinical, academic and trade organisation roles keen to advance new approaches to patient care.

 

During the Safeguarding Research Collaborations & Scientific Excellence debate in the Scottish Parliament that took place on Wednesday 7th November, Conservative speakers gave assurances the UK Government was acting to achieve an “orderly and negotiated” Brexit and reiterated their desire to see the UK Government “ensure that the visa system is structured to attract students and staff of the highest calibre to work in UK universities and research centres”. However, Scotland’s Minister for Further Education, Higher Education & Science, Richard Lochhead, raised concerns and cited the results of a survey carried out by trade union body, Prospect, which found 70% of EU scientists in the UK were thinking of leaving after Brexit. While Jamie Greene MSP (West Scotland) (Con) suggested there was little sign of a slowing down in participation in research on the international stage and offered the formation of the iCAIRD facility as evidence, the Liberal Democrats highlighted a survey carried out within the Francis Crick Institute in London that found 97% of staff thought a hard Brexit would be damaging for UK science. After Labour speakers called for the UK Government to listen to warnings from leading academics of the “dire consequences” stemming from Brexit, Gil Paterson MSP (Clydebank & Milngavie) (SNP) highlighted the cessation of trials of a new heart drug by Recardio due to uncertainty around EU withdrawal, specifically over whether the European Medicines Agency would accept data generated in the UK post-Brexit.

 

This year’s Digital Health & Care Week has catalysed a panoply of activity and includes the Digital Health & Social Care Conference. The focus this year is on the recommendations of the Scottish Government’s Digital Health & Social Care Strategy: Enabling, Connecting and Empowering and progress in the implementation of digitally enabled services.

 

This story was supplied as part of our partnership with healthandcare.scot. 

Scottish community pharmacy financial package announced

This week the Scottish Government have confirmed the 2019/2020 financial package for community pharmacy. The settlement has now been put in place on a 1-year community pharmacy funding package to cover the financial year 2019-20.

 

Highlights of the 2019-20 settlement include the following:

 

  1. The remuneration Global Sum will be reset for 2019-20 at £183.559, an increase of £2.6 million on the previous year.
  2. The non-Global Sum shall roll forward at its current level set at £1.3 million.
  3. That the Pharmacy First service is integrated with the national Minor Ailment Service from 1 April 2019 and remuneration level set at the existing level of £1.1 million.

 

The financial package could not be accepted by the Community Pharmacy Scotland (CPS) Board. CPS said they appreciated the “constructive nature of the intense talks with Scottish Government colleagues who worked to try and achieve an acceptable outcome.”

 

CPS said that there are many outputs within this package that they were willing to accept. In particular, they welcomed the commitment to Pharmacy First through the introduction of funding into guaranteed streams and they remain committed to working with the Scottish Government and others to ensure that this builds towards the extended Minor Ailment Service from April 2020.

 

The CPS negotiating team said they “will continue to engage with the Scottish Government to attempt to resolve the one outstanding issue as soon as possible.”

 

Much like the Scottish Government, CPS have said they remain committed to the ‘Achieving Excellence Strategy’ alongside our own ‘Vision for Community Pharmacy in Scotland’.

 

Martin Green, Chairman of the Board for Community Pharmacy Scotland, said:

 

“We are not quite where we want to be with this negotiated financial package and I sincerely hope that we can continue to work with the Scottish Government to resolve our one remaining difference and will be looking for a commitment to do so. Nevertheless, this financial package has been negotiated during a time of significant political uncertainty and during a financially challenging period for all parties involved.

 

“We have reached this point and are disappointed full resolution couldn’t be achieved but will continue to work on designing future services for patients such as the extended Minor Ailment Service which should be ready to roll out in April 2020.”

 

You can read the Scottish Government circular here.

 

 

 

“It’s about self-care and self-management” says Rose Marie Parr

 

Scotland’s Chief Pharmaceutical Officer (CPO), Professor Rose Marie Parr, delivered the keynote address at the Celtic Conference in Edinburgh last month, looking at the role of pharmacy as Scotland continues its journey to integrate health and social care services. Professor Parr began by drawing attention to the deep-rooted inequalities in health that persist across the country.

 

“Pockets of deprivation in Scotland are absolutely real and significant, and it’s there that we see real poverty and what that does to the health [of those people]. So although we may have gorgeous, green, remote and rural areas, we absolutely do have pockets where health gain is never to be seen.”

 

“Integration is the word”

 

Looking at broader trends, she reflected:

 

“It’s wonderful that people are living older, but we are living older with a bit more disease, and it’s how we cope that matters. It’s about self-care and self-management. But it’s not just about how the ‘worried well’ cope but how people in more deprived areas cope as well.”

 

“Each of our countries have got different ways of coping with that and here it’s the realistic medicine agenda where we are trying to change the culture; it’s not all about drugs and it’s not all about medicine. It’s also about wellness and care…people potentially want to be treated at home, they don’t really want to be treated in a big hospital…it’s about being in a more homely setting for people who may be needing support.”

 

“The vision for pharmacy hasn’t changed for a long time”, Professor Parr notes, “And that’s a good thing I think.”

 

“We have at least ten years of consistency of saying we want to be a bit more integrated and an enhanced part of a modern NHS in Scotland; we have had pharmaceutical care at the heart of what we do and pharmacy for a long time.”

 

“Integration is the word”, she states emphatically.

 

“We do think it’s the right thing to do to talk about care, not just medicines. There is something there in developing an interprofessional team and talking about the whole team, not just pharmacists when we talk about delivering pharmaceutical care.”

 

Key to this interprofessional collaboration is the part being played by the recently appointed clinical fellows. As part of the implementation of the Scottish Government’s latest pharmacy strategy, achieving excellence, the fellows bring together colleagues in medicine, dentistry and other areas.

 

The Scottish pharmacy clinical leadership fellowship scheme, launched in September 2018, aims to provide NHSScotland with a group of senior pharmacists and pharmacy technicians ‘committed to pharmacy development’ who ‘have enhanced the capability to offer leadership in their workplace and potentially at national and international levels’.

 

The role of community pharmacists

 

On the innovations taking place across Scotland to improve pharmacy, Professor Parr states:

 

“One of the key issues for me is about the expertise of pharmacists and technicians being able to help people, whether it’s through initiatives like pharmacy first which has been trialled over a number of months and that’s worked really well for patients and for GP practices.

 

“We have got community pharmacists taking up prescribing courses, because at the end of the day why would you not want that to happen…when, in essence, we are at the heart of prescribing.

 

“There’s lots of work to be done I think around our systems before we can achieve all of our ambitions.”

 

An advocate of communities having more say in where pharmacies are cited, Professor Parr suggests the framework for pharmaceutical care planning needs to be modernised:

 

“It is right and proper that we build on what community pharmacies been doing for the last ten years or so.

 

“[Looking at community pharmacy] I think ambitions here are fantastic, that we should be the first port of call to support the wider NHS. This is where we want to go; it is the high street clinical aspect that’s vital as its where we have clinical people talking to patients and their carers and adding health value from cradle to grave.

 

“We should be in the right place at the right time, I don’t think we are presently.

 

“I do think we need to talk through that how best we can get that network of community pharmacy in the best place for people in need. We need to make sure we are joined up and we absolutely aren’t joined up in Scotland in the way we should be.”

 

“[The framework] needs to be updated; this means legislation changes that need to be consulted upon and it needs to move on I think in an evolutionary – and not revolutionary – way.”

 

Pharmacotherapy

 

Up to 70% of GP practices in Scotland have pharmacists present now, but the CPO advises the sector needs to look at how that number can be increased.

 

“This is a growing area – some it can be challenging and can be frightening. We are creating a pharmacotherapy service in Scotland where we are placing pharmacists and technicians and others within GP practices to try and help the chaos that is prescribing and repeat prescribing in a GP practice.

 

“…because of where we are in our health service and the scramble for some health professionals including GPs and nurses, pharmacy is almost the answer for everything…

 

“Pharmacy is the new black.”

 

No “pill for every ill”

 

Professor Parr emphasises a key part of the most recent strategy focuses on the safe use of medicines.

 

Warning against a culture that expects a“pill for every ill” culture, she reflects that “this isn’t quite right”.

 

“If we don’t have a conversation with patients generally about the new shiny pill that may also cause lots of problems…it will be those people who can afford the new medicines being actually able to take them.

 

“We don’t want to be there…We know the biggest problem about medicines and where we actually fall down…is at the interface – we need to look at [the interface] in all healthcare settings how can we make that better.”

 

Recruitment & retention

 

No area of the health service is without workforce recruitment and retention issues, and pharmacy has proved to be no different, the CPO reflects. To change how some services are delivered and to shift the burden of prescription management away from GPs, Professor Parr acknowledges:

 

“It’s really hard asking people to do clinical work when actually the risk of this will sit with them. If you ask GPs who takes over this in referring and not referring, the GP gathers up those clinical risks and we are now asking pharmacists and their staff to do that too, so I understand it’s a scary place to be.”

 

Again, she notes, the role of one of the clinical fellows will be to look at the skillset of pharmacy staff to ensure they are equipped to adopt such risks.

 

“There is something in there about how we codesign with both technicians and pharmacists as we go forward; this will be really important because that’s what it’s all about really, shifting the balance of workforce.”

 

“It is the people in this room and the people out there; it is the thousands of people in the NHS that will work to make this possible, and I’m sure it will not be the same or the way we designed it, it will be better.”

 

Rose Marie also joined Johnathan on the Pharmacy in Practice podcast. You can listen here.

 

 

 

Podcast: BPSA conference Monday round up

This week in Nottingham the British Pharmaceutical Students’ Association are holding their annual conference. The theme this year is global pharmacy.

 

Tonight we were joined by Andrew Moy (Northern Area Co-ordinator), Rhys Llewellyn (Western Area Co-ordinator) and Kweku Bimpong (Publications Officer). to give us an update on day one of the conference. We will be podcasting from the conference throughout the week.

 

 

About the annual conference 2019

 

The Annual Conference is the flagship event of the BPSA and is hosted at a different School of Pharmacy every year. There are always a host of interesting speakers from all different areas of the profession, giving you the opportunity to hear about career paths that you may not have considered before. Moreover, the conference is a great place to meet like-minded passionate students, all keen to make a difference to the profession.

 

Global Pharmacy

 

The theme of the Annual Conference this year is Global Pharmacy. Millions of lives are lost to preventable diseases. Pharmacists are the medicines experts and are well-equipped to achieve Global Goal 3 from WHO – “Good health and well-being”. During the Annual Conference, you will learn about the roles of pharmacists worldwide, how pharmacy and the pharmaceutical industry can improve the health of the underserved populations, develop knowledge about global health issues and reflect on the roles of pharmacists in improving global health.