Review of NHS Pharmaceutical Care of Patients in the Community in Scotland

Technology

62. Community pharmacy is already well placed to take advantage of the developments in IT, with connection to the NHS network, electronic transmission of prescriptions, electronic patient registration, and ongoing development of in-house systems. But, as stated above, it is important that this is all linked to the implementation of the overall eHealth strategy in Scotland. There is significant potential use of mobile devices and smart media to provide improved services to patients, e.g. for repeat prescriptions, and access to records and information, but it is important that those who cannot or choose not to access such solutions are not disadvantaged.

63. There is increasing use of new technologies to support people in their own homes, involving the health and social care sectors. NHS 24's Scottish Centre for Telehealth and Telecare (SCTT) is leading a programme of work as part of the DALLAS (Delivering Assisted Living at Scale) initiative to examine how quality of life can be improved and independent living supported for those with long term health and care issues. We recommend that the implications for, and the potential to integrate with, pharmaceutical care need to be explored as part of this programme. The growth of additional technologies to support the adherence of patients may also offer further opportunities for pharmaceutical care.

64. A number of community pharmacies have introduced robotic dispensing systems, which have the potential to offer significant gains in terms of safety. As the range of barcoded products increases and as confidence in these systems grows, it should be possible for the pharmacist just to perform a clinical check of a prescription, rather than checking the finished product. This will free the pharmacist from the dispensary bench, and potentially the pharmacy, and liberate time. Further efficiencies may require a more substantial and nationally driven process, using the experience of countries such as the Netherlands, with pharmacies working together to support a network of robotic central filling, dispensing, and return of repeat prescriptions to local pharmacies. Such a system could reduce stockholdings and further free up staff time in individual pharmacies. We recommend that Scottish Government should explore the potential with the profession, including the implications for capital investment.

65. The technology associated with medicines themselves is changing, with the development of pharmacogenetics and the potential for more personalised drug therapies. This, coupled with the increasing use of more specialised medicines in the community, e.g. for chemotherapy, will required appropriate expertise and information to be available in community based pharmaceutical care.