The work described here was shortlisted for the UKCPA Best Abstract award at the Pharmacy Together 2019 conference.
Care for patients with chronic diseases is best led by a specialist multidisciplinary team. However, Specialist Pharmacy Services (SPS) were not recognised in the UK Inflammatory Bowel Disease (IBD) standards published in 2013.
Pharmacy specialisation is developing rapidly and needs to be recognised at a national level. National service standards must integrate Specialist Pharmacy Services to ensure high quality patient care, informing health policy makers when formulating national health care strategies. We report on the incorporation of Specialist Pharmacy Services into the IBD standards and e-benchmarking tool.
The objectives were to:
- Define the required quality and quantity of IBD SPS in IBD units
- Integrate a description of SPS into the UK IBD standards
- Define the SPS description for the IBD e-benchmarking tool.
IBD UK, a multidisciplinary alliance of 17 patient and professional organisations, was convened to update the current IBD standards. To inform the development of medicines optimisation related standards, IBD units with developed Specialist Pharmacy Services were surveyed through the UKCPA network to identify the quantity and quality of advanced practice, requesting information of service provision and the relevance of the Advanced Pharmacy Framework (APF).
An e-Delphi consensus process was undertaken by IBD UK to refine a set of evidence- and expert opinion-based recommendations for optimal service delivery across the patient journey, with the criteria of 80 percent agreement in order for statements to be retained.
The new standards informed a benchmarking tool which enables self-assessment supporting quality improvement and additional resource requests where needed. Descriptors were developed in two consensus workshops by IBD UK with expert pharmacy representation.
Specialist Pharmacy Services need to be embedded in all chronic disease healthcare standards to enable recognition and commissioning of expert pharmacy practice.
Four units, two teaching hospitals and two district hospitals with developed Specialist Pharmacy Services were surveyed. This data informed four relevant standards which are key to pharmacy leadership, medicines expert roles and multidisciplinary team working for patients from diagnosis to long-term care. The proposed standards were submitted to the Delphi process.
IBD UK agreed 59 standards in total. The four standards which described Specialist Pharmacy Services were incorporated with 100 percent agreement.
Based on the pharmacy survey results, IBD UK defined 0.6 WTE of multidisciplinary team Specialist Pharmacy Services per 250,000 population. There was agreement to define high quality practice through the Advanced Pharmacy Framework. The benchmarking tool defined A-D descriptors for Specialist Pharmacy Services, with A as ‘excellent, proactive’ and D as ‘minimal, inadequate’ care.
The new IBD UK Standards 2019 mandate units without Specialist Pharmacy Services to develop specialist IBD pharmacy services supporting best patient care for the IBD cohort and advance expert pharmacy practice nationally. Specialist Pharmacy Services can make valuable contributions to patient care and need to be embedded in all chronic disease healthcare standards to enable recognition and commissioning of expert pharmacy practice.
The IBD UK Standards 2019 for the first time embed and describe Specialist Pharmacy Services as an integral part of the IBD multidisciplinary team managing IBD patients.
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.