Shaping the future of medicines and pharmacy

NHS England’s Associate Chief Clinical Information Officer (Medicines), Ann Slee, looks at how digital technology will help deliver the NHS Long Term Plan:

It is clear from the NHS Long Term Plan that digital transformation remains a key priority.

What is different from previous documents is that digitally-enabled transformation is woven throughout the whole plan and that technology will play a key part in realising the core aims.

The focus is now on ensuring that everyone that needs to access information can do so using digital means in every location in which they need it – medicines has been identified as a priority for this in every survey conducted over the last few years in every care sector.

In hospitals this is being enabled by accelerating the use of ePrescribing systems. The use of more mature functionality to support improved prescribing and medicines administration is also underway with the global digital exemplar sites. The first sites to undertake closed loop medicines administration are now live and key interfaces to other systems are in development.

The use of standards is critical if information is to be available across the system – identified in both the long term plan and the Department of Health and Social Care’s technology vision. The dictionary of medicines and devices (dm+d) is the key that is now being augmented with messaging standards for the rest of a prescription.

The definition of these standards will be complete in the Spring, opening new possibilities for accessing and transferring prescription and related information.

These message standards will provide a raft of opportunities that can support the transformation of services and provide improvements to patient care across all care sectors. In tandem with this, and using this information, an additional set of standards for the capture and communication of structured (and coded) clinical data by pharmacy practitioners during patient consultations has been produced and used to inform the development of functionality to support care transfer.​

These provide the basis to underpin future developments supporting integration of pharmacy across the system and ensuring that relevant data is made available to the wider clinical record to support referral and clinical documentation in primary care.

Another longer term focus is ensuring the smooth digital transfer of prescriptions for all medicines and providing patients with the ability to track their prescriptions – work to support this via the NHS App is already underway.

We are also looking to make better use of the data that systems can provide to allow us to better understand the way in which medicines are used, to help inform and drive improvements in prescribing quality and antimicrobial stewardship.

All of this has to be underpinned by appropriate approaches to medicines safety – realising the true benefits of digitisation means that all systems will need to adopt standards and optimise systems on an ongoing basis. Central to this will be having a workforce that is trained and skilled in clinical informatics – there are now many opportunities to pursue for training and support yet, as a profession, pharmacy is not leading the charge, despite our long history in adopting digital systems.

The Faculty of Clinical Informatics provides professional support and the Digital Academy, extended as part of the plan, is open to pharmacy. Applications open again later this year – it would be great to see more pharmacy staff becoming involved and their expertise developed and recognised. The recently published Topol report also heralded the introduction of Topol fellowships.

The plan offers up many opportunities and provides continued focus on the use and acceleration of technology to reshape and underpin the way in which we work – if you haven’t thought about how you are going to use systems and shape the way in which you support patients now is a good time to get involved.

Ann Slee

Ann Slee is NHS England’s Associate Chief Clinical Information Officer (Medicines).

She is a hospital pharmacist by background and has led various local and national initiatives around digital medicines and ePrescribing with experience in the development and deployment of digital technologies. She holds several honorary academic appointments and was a member of the advisory board for the Wachter review.

Ann is a Founding Fellow of the Faculty of Clinical Informatics.