Pharmacy information flows

PRSB is consolidating the current six uses of pharmacy standards which we previously published in 2019 into a single community pharmacy standard to support implementation by community pharmacy system suppliers.

The work will also enhance the standard so that it will be able to support new services being developed and piloted under the new community pharmacy contractual framework. This is likely to include point of care testing (anti-microbial stewardship), smoking cessation referrals from secondary care, the Hepatitis C testing service, cardiovascular disease (hypertension) case finding service, palliative care and contraception provision.

The standard will support community pharmacies to deliver their expanding role in health and social care information recording and sharing. It will ensure that citizens have access a range of useful public health and medicines-related services at their local community pharmacy.

Enhancing the role of community pharmacists will help reduce the workload of GPs and other primary care staff and ensure that information can be routed from community pharmacies into GP records to ensure that the GP has a comprehensive record of care provided to a person with a minimum amount of GP practice administration.

Key stakeholders for existing pharmacy standards will be contacted about the consolidation work. A multidisciplinary webinar on 9th December to discuss the information requirements for the enhanced standard is being planned. If you are interested in being involved, please contact info@theprsb.org.

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests.
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history.

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning.

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”