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Demand for hospital services, including those provided by pharmacy, across seven days is increasing in the United Kingdom and across Europe. The factors driving this include an increasingly frail elderly population, and increasing expectations from the public. And why not? We expect a range of consumer services across seven days now, including the ability to buy basic commodities such as food and fuel, as well as “luxury” commodities such as widescreen televisions and smartphones. Given that illness is not dependant on the day of the week, how can we continue to operate a good pharmacy service only between Monday and Friday?
At Northumbria, we now deliver clinical pharmacy services to all acute medical and surgical wards every day of the year. As well as receiving positive feedback from nursing and medical staff, pharmacy staff themselves recognise the value to patient care that they are bringing. There are also ways to measure this improvement, and our target for medicines reconciliation on admission, for example, is now 95%. There are additional benefits to providing such services, with pharmacy staff more likely to be present when prescribing decisions are made, therefore impacting on both quality and safety. The service is driven by the clinical need, but is underpinned by a supply service. It is important to differentiate between the two, rather than thinking of a seven-day service purely as a supply driven service.
The impact of providing seven-day clinical pharmacy services in Northumbria is maximised due to our relatively large numbers of pharmacist prescribers. In this way, we are not dependent on other clinical staff, predominantly medical, in order to effect changes and optimise medicines use at the point of prescribing.
Many pharmacy staff will throw their hands up and state that in current financial climates, it is simply not possible to bring about such changes, without seriously impacting on an already over-stretched budget, or compromising safety in the service already provided Monday–Friday. Can we afford to make the change? The question is, can we afford not to?