Organisation of pharmacy support to CHS

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Chapter: Hospital pharmacy : Community health services

As the White Paper 2010 changes are imple-mented it is essential that the skills and competencies of CHS specialist pharmacy staff are maintained in order to support other CHS professionals and vulnerable patients who may have complex needs in relation to their medication.


Organisation of pharmacy support to CHS

 

England

 

As explained in Chapter 1, the NHS is undergoing a significant organisa-tional change as the text is compiled. Prior to this, CHS were recently reorganised as primary care trust provider services, separated from commis-sioning. Some CHS providers may develop into independent organisations as foundation trust or social enterprises; others may vertically integrate with an acute or mental health trust. As the White Paper 2010 changes are imple-mented it is essential that the skills and competencies of CHS specialist pharmacy staff are maintained in order to support other CHS professionals and vulnerable patients who may have complex needs in relation to their medication.

 

The emerging models for pharmacy services include:

 

·      a team of pharmacists, technicians and support staff directly employed by the larger CHS providers with SLAs in place with an acute or mental health trust for supply and dispensing

 

·      a lead pharmacist directly employed by the CHS provider with responsibility for advising the organisation on medicines management and coordinating and monitoring pharmacy services provided in contracts or SLAs

·      integration of the CHS provider functions into an acute or mental health trust such that CHS pharmacy staff are employed by and are part of the hospital pharmacy team independent provider provision.

 

Scotland

 

NHS trusts for acute, mental health and primary care were disbanded in Scotland in 2006 when the concept of single-system NHS boards was created. These boards are re-empowered with the delivery of healthcare (previously devolved to trusts) as well as responsibility for the planning and assessment of health needs. The NHS boards also paved the way for more integrated health and social care under joint management arrangements. Although some sup-port for CHS is provided by primary care-based pharmacists, the majority of it is integrated into the roles of acute and mental health pharmacy teams. The CHS work is likely to be part of an individual’s role rather than there being a specialist post.

 

Wales

 

The reorganisation of NHS Wales means that health boards are responsible for planning and providing healthcare to all their population. This includes primary, secondary, tertiary and community care. At the time of writing, individual health boards are still determining their structure but locality working is becoming common. Health board pharmacy teams are responsible for providing support across the area and will need to become more involved with CHS.

 

Nationally, a strategic delivery group has been charged with delivering pharmacy services, including contractual services, and a director for medi-cines management in Wales has been appointed.

 

Northern Ireland

 

The Health and Social Care Board in Northern Ireland works with the Public Health Agency to address the health needs of the population. As in Scotland, the majority of support for CHS is integrated into the roles of acute and mental health pharmacy teams and is likely to be part of an individual’s role rather than there being a specialist post.

 

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