The Topol review and pharmacy

Article: The Topol review and pharmacy

From data to information, from information to improved choice of medicines and so to improved outcomes

The practice of pharmacy in the UK has historically been based around three areas:

People – with patients at the centre and including the personal interaction with pharmacy staff (Pharmacists, Pharmacy Technicians and support staff) and the wider multidisciplinary clinical team in hospital and across the patient journey.

Clinical – understanding of the safe and effective use of medicines.

Supply – of medicines safely and cost effectively.

However, to truly optimise the use of medicines an additional dimension is required – Digital. This requires a culture change in how pharmacy professionals are developed and view their roles and skills for understanding the science of clinical informatics. It is no longer just volumes of medicines, costs or Key Performance Indicators as to speed or safety of supply that are needed. True Medicines Optimisation requires structured data systems to allow the capture, analysis and clinical use of patient level informatics. This will enable the connection of:

  • Prescribing information – diagnosis and indication for a medicine;
  • Product and supply information;
  • Digital medicine tools to support diagnosis, self-care and monitoring of patients’ responses to medicines;
  • Reporting outcomes from the use of the medicine in terms of patient benefit and health gain;
  • Patient factors including concordance and any potential harms;
  • Costs, clinical choice and efficiency of supplied medicines.

The Topol review has identified how the healthcare workforce needs to be prepared to understand, use and maximise the opportunities from the digital future. This ‘reset’ of the professional view on the use of data will require multiple changes to embed digital approaches in strategies, polices, formative education, training and approaches to patient care with medicines are considered across the healthcare system in England. This will take leadership at all levels and will support the digital transformation agenda in health and social care. Pharmacy teams are rapidly developing cross sector portfolio type roles that are more supportive of multidisciplinary team working and care closer to the patients’ home. Technology will support and enable these new working methodologies.

There is an absolute need for a pharmacy workforce that is skilled in the interpretation of data to provide useful information that, through understanding and interpretation can be used to improve clinical outcomes and patient safety.  For the pharmacy professions, the concept of data driven care is built on the thesis that we need to consider how pharmacy will move from holding a lake of medicines related data, to embedding this in our culture and using it to improve patient care. Owen is a pharmacist; see where his pharmacy and Informatics journey takes him over the next ten years?

There are more than 1 billion prescriptions supplied in primary care annually with a smaller volume but, often more complex range of higher cost and risk medicines supplied in secondary care. Pharmacy teams therefore need to understand the science of informatics and why data structures, standards and systems are important to their practice and patients care across all parts of the patient’s heath journey. This requirement will become further emphasised as healthcare moves into the new world of genomics and personalised medicines and the scale and scope of data and need for interpretation and action explodes!

Andrew Davies

Andrew.davies@nhs.net

@HospChiefPharm