Dr Nenad Miljković PhD is head of the hospital pharmacy services at the Institute of Orthopaedics Banjica in Belgrade, Serbia, and president of the European Council for Pharmacy Education Accreditation. June saw Dr Miljković officially take up the post of president of the European Association of Hospital Pharmacists, and he talks to Saša Janković about his aims – and hopes – for hospital pharmacy during his three-year tenure and the cross-border approach he champions.
‘Three years is an awfully short period of time,’ says Dr Nenad Miljković PhD when considering the timeline to make his mark as president of the European Association of Hospital Pharmacists (EAHP). ‘But the way has been paved by great predecessors and we have an amazing group of people on the board and among the staff so I’m trying to be ambitious, and I’ll do my best.’
Having 36 member countries in the association offers a broad scope, with Dr Miljković stating his ‘personal wish’ for his tenure is to ‘have each member country feel connected to the others and be able to provide their feedback on current problems’, as well as ‘seek solutions from EAHP on a pan-European level’.
Dr Miljkovic sees the Statement Implementation Learning Collaborative Centres (SILCC) programme, which allows hospital pharmacists to visit hospitals in other European countries to learn about pharmacy procedures linked to the European Statements of Hospital Pharmacy, as a key driver for this change.
‘Another goal of my presidency is to have SILCC centres in as many countries as possible out of our 36 members,’ he says, ‘and since all hospitals willing to apply to become a SILCC host can assess their pharmacy using the EAHP Self-assessment tool, I am keen to encourage and support more to get involved.’
A multidisciplinary approach
It is exactly this collaboration that first attracted Dr Miljkovic to a career in pharmacy. ‘When I graduated from high school, I knew I wanted to stay in natural sciences and have an opportunity to see how my interventions could impact someone’s life,’ he explains.
‘I chose pharmacy because the experts for medicines applied in humans are pharmacists, which means you get approached for help by your community, by nurses, other pharmacists and physicians, and it’s a great feeling to really help and be valuable to the team.’
In addition to his pharmacy degree with a specialisation in clinical pharmacy, Dr Miljkovic holds a dual master’s degree in European public health from the University of Sheffield School of Health and Related Research and the University Sorbonne Paris Cité, French School of Public Health.
‘The reason I left Serbia to do my postgraduate studies in the UK and France was because I’d seen that healthcare professionals and pharmacists tend to stay connected within their own circles,’ he says. ‘But I realised that if you really want to understand the context of how you deliver your healthcare services, you need to understand the system outside your primary role.’
Tackling medicines shortages
Back home in Serbia, Dr Miljkovic obtained his PhD in clinical pharmacy at the University of Belgrade in 2021 for health risk assessment in medicine shortages in cooperation with KU Leuven – a topic that’s becoming increasingly relevant in the European healthcare landscape.
‘My dream would be to increase the lobbying power of EAHP and policy activity towards burning issues such as workforce shortages, medicines and medical devices shortages,’ he says. ‘But, on the other hand, even though we live in a time of challenges, and we need to respond to crisis, we should also look at the future and embrace things that are coming our way – like digitisation – and use them to our advantage.’
In more precise terms this means ‘enabling healthcare professionals to have fast, authorised access to data on patient health, so we can respond with our interventions as quickly as possible to improve health outcomes, not just within the systems but among all European countries.’
Dr Miljković’s research focuses on health risk and patient clinical needs assessment, medicine shortages mitigation strategies analysis, including therapeutic substitution, healthcare services organisation and prospective risk evaluation, which means he is ideally placed to make a difference in this space.
His plan is to continue the momentum created by EAHP’s much-cited 2023 Medicines Shortages Survey – which confirmed that evolving shortages of medicines and medical devices continue to present a public health threat across Europe – and champion the role of hospital pharmacists in tackling this.
‘One of the research projects done in one of the EAHP member countries on shortages revealed that fewer than 2% of hospitalised patients were aware of any shortage, which means that what our lovely modest, discreet, silent, hospital pharmacists are doing is solving these problems and not informing anyone apart from their managers about it,’ he says.
Championing hospital pharmacists via EAHP
This brings him to another priority: improving awareness of the hospital pharmacist’s role among patients and colleagues and reinforcing their reputation within secondary care – something that his predecessor András Süle also addressed.
‘Another of my hopes for the next three years is to make people more aware of hospital pharmacists in the same way they know about community pharmacies. I really want our visibility and connectivity with other professionals to be widely transparent, open and visible,’ Dr Miljković explains. ‘And, on the other hand, I would like us to be strong in being aware of how important we are for the healthcare system – because just imagine your hospital without a hospital pharmacy.’
A further role he wants to promote for hospital pharmacists is as vaccination promotors. ‘EAHP is a member of the European Coalition for Vaccination, and we strongly believe that hospital pharmacists have a very important role in raising awareness of the importance of vaccination across the health system and this is yet to be fully utilised,’ he says.
‘When a patient gets admitted to hospital, if a hospital pharmacist sees that they are at great risk of certain diseases, or they are over 75, the hospital pharmacist can recommend vaccines they need to get after they are discharged, and this is extremely important because we still have fragmented immunisation information systems.’
EAHP progress and potential
Alongside all this, there is much on the horizon for hospital pharmacy in Europe that Dr Miljkovic wants to encourage his healthcare colleagues to embrace.
One of these priorities is sustainability, which was the theme of EAHP’s 2024 Congress in March, and Dr Miljkovic says he is‘really proud’ that the association has a working group on the topic.
‘The EAHP Environmental Sustainability Working Group published its latest report in June and I’m really glad that this remains on our agenda despite the pressing issue of shortages because it’s important to recognise that if you tackle shortages and policy and lobbying you will obviously tackle sustainability,’ he says.
‘This is definitely something I mention when I talk to the European Commission, but it is also important for hospital pharmacists because they should evaluate their processes from the perspective of sustainability.’
Digitalisation and technology are other key areas of development. ‘It’s going to sound like a cliche but, like it or not, artificial intelligence (AI) is going to become part of every single topic and system in healthcare,’ he says.
‘We must try to see AI as an opportunity, which means we should invest time in it and deploy and interpret it in a way which will provide faster and more efficient services to our patients and other healthcare professionals. Yes, this will be a huge challenge, but it is coming, and we can’t pretend it doesn’t exist.’
Dr Miljkovic believes, if harnessed correctly, AI could be an ally in tackling workforce and medicines shortages. ‘Artificial intelligence is a great way for us to increase the number of hospital pharmacists by covering certain aspects of our everyday tasks with AI so we can do more for our patients,’ he says.
‘I think that the future will bring many challenges, but on the other hand, it will bring many opportunities, and it’s up to us and future generations of hospital pharmacists to take this challenge and move forward to be more efficient for our patients.’
