Updating the RPS Professional Standards for Hospital Pharmacy 2017.

1. Updating the RPS Professional Standards for Hospital Pharmacy 2017. External reference group webinar 11 April 2017

2. Welcome and introductionsCatherine Picton, FRPharmS FFRPS

3. Section Title Agenda for the webinar • A brief history of the hospital standards • Overview of the update process • Role of external reference group • Scope of the 2017 update • Feedback and discussion • Next steps

4. Section Title Professional standards for hospital pharmacy – a brief history • Published in 2012, first professional standards published by the new RPS • Developed by the profession • Quality (describes what good looks like) • Supportive, enabling and professionally challenging • Detailed handbook to help with implementation and a range of other resources and tools. • One year development sites programme shared experiences of implementation and helped define the RPS work programme.

5. Section Title Professional standards for hospital pharmacy – a brief history 2014 hospital standards refresh • Triggered by the publication of the Francis Review into events at mid-staffs • Took into account developments in Scotland and Wales • Standards largely consistent with recommendations in Francis and other reports • The refresh gave renewed emphasis to key themes: • Candid, open, transparent culture • Patient feedback and involvement • Environment that supports continuous learning

6. Section Title Professional standards for hospital pharmacy – a brief history • Broad framework to support pharmacists and their teams to develop professional practice, improve service, shape future services, deliver quality care • The framework focuses on the delivery of quality pharmacy services (dimensions of which are patient experience, effectiveness and safety). • These are professional standards not SOPs (level of detail). • The handbook supporting the standards is used to link to relevant resources.

7. Section Title Professional standards for hospital pharmacy – a brief history

8. Section Title Professional standards for hospital pharmacy – a brief history WHERE THE STANDARDS ARE USED • Self assessment by hospital teams and as part of the development site project • Benchmarking against other hospitals as part of the NHS Benchmarking programme • Referenced by RCP as part of their Future Hospitals programme • Used to develop professional standards for homecare and professional standards for secure environments • Used for RPS consultation responses, media responses and position statements • Used by regulators (professional and system) to identify “what good looks like”,

9. Section Title Update Process • The 2017 update was triggered automatically (review date on the 2014 standards) • Following the RPS process for the development of professional standards: https://www.rpharms.com/support-pdfs/professional-standards--guidance-and-frameworks-development-manual.pdf

10. Section Title Update process

11. Section Title Key milestones

12. Section Title Role of expert advisory group Purpose of the External Reference Group • The project objective is to update the RPS professional standards for hospital pharmacy services. The update will reflect the current evidence base, the requirements of current and future care provision and patient need. The external reference group is a virtual network of key stakeholder organisations and individuals whose active involvement in the updating of the standards will ensure that the standards remain fit for purpose now and in the future. Functions • To comment on drafts of the hospital standards throughout updating process. • Provide support and guidance to the lead author where required. • Input into strategies to disseminate the revised standards. • Facilitate endorsement of the guidance by relevant organisations if appropriate. • Once published promote the guidance to own organisations and through own networks.

13. Section Title Scope of the review • Literature review • Pharmacy services in scope • Steering group

14. Section Title Literature review – What’s new, what has changed? • To identify – what’s current, omissions and what needs to be modified • With a focus on the hospital pharmacy ‘landscape’, main drivers for change and service/workforce innovation

15. Hospital Pharmacy Standards Any new hospital pharmacy standards published? • International Pharmacy Federation (FIP). In 2015 FIP updated the Basel statements. These are standards for hospital pharmacy practice worldwide. Further details on the development of the standards and what they cover: http://fip.org/basel-statements • European Association of Hospital Pharmacists (EAHP). In 2014 EAHP provided European statements of Hospital Pharmacy with commonly agreed objectives which every European health system should aim for in the delivery of hospital pharmacy services. • NHS England Model Hospital Pharmacy Metrics. Part of the model hospital dashboard published by NHSI (see also Cater review). • SpecialistPharmacy Services (2015). Practices to support safer use of medicines in hospitals. Includes ‘best practices’. • Wright A, Vaillancourt R, Bussieres J, Lebel D, Sarakbi D, et a. Best of Both Worlds: A Comparison of Canadian and International Best Practices for Hospital Pharmacy Services. Canadian Journal of Hospital Pharmacy, Jan 2015, vol. 68, pp. 48-53.

16. Drivers for change • Carter review and hospital efficiencies programme (DH, England 2016) • Consolidation and outsourcing • Increasing clinical pharmacy activities • Model hospital metrics • (also RPS definitions to support benchmarking to be published soon) • Transformation of seven day clinical pharmacy services in acute hospitals. NHS England (2016) • Re-balancing of medicines legislation • decriminalisation of dispensing errors; accountability and role of the Chief Pharmacist • Digital medicines strategy (pace of change with technology) • Falsified Medicines Directive (and delegated Acts) • integrity of the medicines manufacturing/supply chain

17. Drivers for change – Regulatory standards • Standards for pharmacy professionals (GPhC, revised version is not in effect yet). Key updates: “Safe and effective care” - re-emphasises the importance of person-centred care; Speaking up when things go wrong. An “open culture” in pharmacy; Empathy and compassion are a key part of professionalism. • CQC – new inspection model (2015). Fundamental standards: Person-centred care; Dignity and respect; Consent; Safety; Safeguarding from abuse; Food and drink; Premises and equipment; Complaints; Good governance; Staffing; Fit and proper staff; Duty of candour; Display of ratings. • Healthcare Inspectorate Wales (www.hiw.org.uk) . Themes include learning disabilities, discharge into community, community mental health. “Together for health” includes improved patient experience. • Healthcare Improvement Scotland (www.healthcareimprovementscotland.org). The prevention and control of infection throughout healthcare is everyone’s responsibility and is a major component in the drive towards a safer NHS Scotland.

18. Drivers for change NICE and SIGN guidance: • NICE guideline. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. [NG5] (2015). Medicines reconciliation -sharing information on transfer (ideally within 24 hours of transfer). • NICE guideline.Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. [NG15] (2015). Organisations establishing antimicrobial stewardship teams should ensure that the team has core members (including an antimicrobial pharmacist and a medical microbiologist) and can co-opt additional members depending on the care setting and the antimicrobial issue being considered. • SIGN discharge document. http://www.sign.ac.uk/guidelines/fulltext/128/index.html • UKMi and Thames Valley and Wessex Chief Pharmacists Network (2014). Medicines Helpline for Hospital Patients: National Standard. Innovation and new models of care: • Hospital pharmacists reducing antimicrobial resistance • Vanguards are leading the way with new models of care (as described in the FYFV, England). • Innovation and the pharmacy team. Technicians administering medicines (on wards); pharmacists working in the emergency department

19. Relevant RPS professional standards/guidance Patient experience: • Seven-day services in hospital pharmacy. In 2014 the RPS launched the seven days service in hospital pharmacy report. • Patient experience report. In 2015 the RPS launched a report on improving and evaluating patients’ experiences of care. Patient safety • Professional Standards for the reporting, learning, sharing, taking action and review of incidents. Developed by the RPS, APTUK and the Pharmacy Forum of Northern Ireland (2016). Medicines optimisation • The RPS principles of medicines optimisation (patient-centred focus). Helping patients to make the most of medicines. Good practice guidance for healthcare professionals in England 2013. QA and aseptic preparation • Beaney, A ed on behalf of the RPS and NHS PQAC. Quality assurance of aseptic preparation services. Published by the RPS in 2016. Specials resources: • Professional standards: guidance for the prescribers of specials. Published by the RPS in 2016. • Guidance for the procurement and supply of specials. Published by the RPS in 2015.

20. Section Title Pharmacy services in scope • Acute • Mental health • Prisons • Community services • Hospices • Ambulance service • Private Professional standards for optimising medicines for people in secure environments Specific professional standards for optimising medicines for people in secure environments have been developed* and were published by the RPS in 2017. For use in England but may also be a useful reference in Wales and Scotland.

21. Section Title Next steps • Complete literature review. Report of how the literature review impacts on the hospital standards. • Triangulate literature review with comment and feedback from the steering group and others. • First revisions made to the hospital standards and agreed by steering group. • Posted on RPS website over the summer for comment. External reference group will be alerted once posted. Next webinar: • 4 October 2017 at 2pm