Climate Change Charter actions

Climate Change Charter actions

How to put your commitment to tackle climate change into action.

Signed up to our Charter, but want to take up further personal commitments to become more sustainable?

Pharmacy Declares have compiled some ideas for more personal commitments to get you going.

Remember: you don’t have to do them all, and some are longer-term than others.

Here’s a handy list of positive actions for anyone who wants to do their part to fight climate change.

Education
  1. I will undertake personal education on sustainability or planetary health issues, for example, via the elFH ‘Environmentally Sustainable Healthcare’ module
  2. I will undertake Carbon Literacy training
  3. I will incorporate sustainability principles into my projects and research
  4. I will incorporate sustainability principles into my audit, quality improvement or research work
  5. I will teach others via sustainability-related education or training events
  6. I will ensure that any educational event I run can be accessed remotely.
Inhalers
  1. I will counsel a patient on inhaler technique
  2. I will ensure people with asthma have personalised asthma action plans in place
  3. I will promote spacer device use in children prescribed pressurised metered dose inhalers
  4. I will ensure all patients using more than one inhaler are prescribed similar device types
  5. I will encourage the return of unwanted and used inhalers to pharmacies for safe disposal
  6. I will review patients and, where used, ensure that the salbutamol MDI with the lowest carbon footprint is supplied.
Plastic reduction
  1. Eliminate the use of unnecessary single-use plastics, such as cups, spoons, and bags, and look for alternatives I can personally use.
Clinical care
  1. I will ensure I undertake a full drug history/medicines reconciliation of new patients in hospital
  2. I will counsel patients on their new medications, in hospital, in the community setting and via the New Medicines Service
  3. I will undertake structured medication reviews, for example, with STOPP-START or ACB tools
  4. I will teach patients, especially children, how to take tablets to reduce the use of liquids
  5. I will strive to optimise medication use, for example, in response to pharmacokinetic parameters, patient symptoms and Therapeutic Drug Monitoring
  6. I will optimise medication use at points of care transfer, for example, via the Discharge Medicines Service
  7. I will incorporate deprescribing guidance into formulary application proformas/shared care guidelines/clinical guidelines
  8. I will produce, analyse and interpret data to allow for evidence-based decision making
  9. I will take part in available pharmaceutical recycling schemes, such as blister packs, inhalers and insulin pens.
Pharmaceutical waste management
  1. I will obtain and use drug labels in my pharmacy which state ‘return to pharmacy’
  2. I will produce, use and/or promote pharmaceutical waste guidance for my organisation
  3. I will ensure I counsel patients on how to appropriately dispose of their medications.
Digitisation of care
  1. I will learn how to use and offer remote working facilities such as e-consulting.
Green space
  1. I will offer or take part in green-prescribing initiatives
  2. I will green up my workspace: no area is too big or small when supporting conservation and biodiversity efforts; rewilding an area, for example, a garden, a pathway or a window-box!
Diet
  1. I will reduce meat consumption / increase more plant-based food options
  2. I will choose seasonal produce
  3. I will choose waste-free lunches (packed lunch)
  4. I will use a reusable coffee cup/water bottle
  5. I will avoid food waste.
Low carbon-commutes and travel
  1. I am going to choose to walk, cycle, take public transport or car share
  2. I am going to utilise e-vehicles for transport or delivery.

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Strengthening Pharmacy Governance (Supervision)

Policy position statement RCPharm believes that supervision legislation is needed to protect the public. We advocate for changes to the current legislation to enable progressive, safe and effective pharmacy services within a modern and advancing NHS. RCPharm supports the principle of moving specific components of legislation to regulation. Any changes should be supported by clear professional guidance. The following eight principles should apply to any change: Pharmacists and the pharmacy team should be accessible, approachable and available in a reasonable timeframe for patients  Supervision by a pharmacist and delegation of activity should be decided by the Responsible Pharmacist (RP), supported by regulation to ensure appropriate pharmacy services can continue in their absence  Pharmacists must be enabled to expand their professional and clinical services for better patient outcomes  Pharmacy technicians, as registered professionals, must be enabled to take increasing responsibility for managing technical tasks such as routine dispensary processes  A pharmacist can only be the Responsible Pharmacist (RP) for one pharmacy at any one time  Digital opportunities should be harnessed to enable pharmacists to undertake more professional roles from pharmacy premises  A shared understanding and interpretation of supervision legislation is needed. This should be supported by clear up-to-date professional guidance while maintaining a focus on patient safety and wellbeing  Any changes to legislation should lead to improved patient care, not lead to an increase in risk to patient safety, and any changes in workload must be considered Pharmacists and the pharmacy team should be accessible, approachable and available in a reasonable timeframe for patients. Community pharmacists are among the most accessible healthcare professionals. This accessibility and approachability mean that pharmacists can provide patients with medicines advice and support when needed. The pharmacy team have the skills and knowledge to help support patients and escalate queries appropriately for the pharmacist's attention within a reasonable time. With pharmacies offering more services which require time in a consultation room, the expectation of access needs to be managed carefully. Supervision by a pharmacist and delegation of activity should be decided by the Responsible Pharmacist (RP) and supported by regulation to ensure appropriate pharmacy services can continue in their absence. The current legislation allows pharmacists to be absent from the pharmacy for up to two hours. However, during this time, patient care is currently impacted in terms of the supply of medicines and access to professional advice. Change required Legislation change is needed to enable appropriate medicines that have been clinically checked, dispensed, and accuracy checked, to be given to a patient or their representative when the pharmacist is signed in as RP but absent. This would require that a pharmacist has approved the medicines are suitable to be given to the patient with no planned further intervention by the pharmacist. Given to the patient includes being handed out by trained pharmacy staff when the pharmacist is not present, being delivered by a delivery driver, or being put into a vending machine. In all three scenarios, arrangements must be in place to enable the patient to ask for a consultation with the pharmacist, using technology or in person, within a reasonable time. There should be no change to the sale of Pharmacy (P) medicines as it is important that the pharmacist can intervene when these medicines are sold. This category is important to allow patients access to certain medicines without the need for a prescription. Any change in the need for a pharmacist to oversee P medicines sales and be able to intervene could affect future POM to P switches and have a detrimental effect on patients' ability to self-manage appropriate conditions. Supply of P medicines via NHS services, such as Pharmacy First and Common Ailment Services, requires a pharmacist to be present. These services have achieved equity of access for deprived populations and therefore, a change to permitting the sale of P medicines without a pharmacist present would introduce a new inequity. Pharmacists must be enabled to expand their professional and clinical services for better patient outcomes. It is essential to future-proof the supervision arrangements to ensure community pharmacists can provide an expanding range of professional services for patients. This includes regular, planned and ad hoc patient consultations in consultation rooms within the pharmacy premises and the provision of symptom assessment, advice and/or treatment. Therefore, patients need access to a pharmacist, and long periods of absence from a pharmacy are undesirable. This must be balanced against the provision of the current services, which may require an occasional home visit by a pharmacist to ensure a patient is fully involved in decisions about their medicines. Pharmacists need to be able to make professional decisions to support the best care and outcomes for their patients. It is not possible to plan for every eventuality, and professional decision-making is a skill; this must be encouraged and supported by robust record-keeping. Change required Successful provision of all professional roles can be achieved through a combination of a good skill mix in pharmacies and clear interpretation of the current supervision legislation. Pharmacists must have the confidence to delegate to pharmacy technicians and other staff according to their skill set and competencies underpinned by clear frameworks for establishing competency in pharmacy staff. Appropriate staffing levels, competencies and clearly defined processes which trigger appropriate referral to the pharmacist when necessary, are key to delegation and freeing up time for clinical care achieved by appropriate workforce planning. This would enable the pharmacist to leave the pharmacy premises for short periods, for example, to undertake a home visit, while still being contactable if advice is required urgently using technology. If absences were short and infrequent, this would avoid reduced access to services provided directly by pharmacists. Therefore, a clearer interpretation of legislation around the pharmacist being able to intervene in a medicines or advice supply situation is required. Workforce planning is needed in each country to ensure continuity of workforce for pharmacists and pharmacy technicians, and that staffing levels are of a sufficient level to avoid a reduction in pharmacy services and face-to-face access to a pharmacist when desired. Pharmacy technicians, as registered professionals, must be enabled to take increasing responsibility for managing technical tasks such as routine dispensary processes. RCPharm recognises the important roles of pharmacy technicians as registered professionals who are accountable for their responsibilities and should be encouraged to work to the top of their competencies. Recognising and enabling the roles of pharmacy technicians to lead on the technical processes/services within the pharmacy, and undertake accuracy checking where appropriate, will support pharmacists to fully maximise the opportunities in the current legislation. Defined career pathways for pharmacy technicians would support retention and recruitment into the profession. More frameworks for quality assurance, which enable pharmacy technicians to develop, are needed within pharmacy. A pharmacist can only be the Responsible Pharmacist (RP) for one pharmacy at any one time. It is essential to have professional oversight by a pharmacist in every community pharmacy. RCPharm is opposed to remote supervision and believes that patients require access to a pharmacist, in person if desired, and long periods of absence from the pharmacy are undesirable. Some pharmacies will require more than one pharmacist on site to safely deliver the range of medicines supply, clinical and public health services required by the NHS. Digital opportunities should be harnessed to enable pharmacists to undertake more professional roles from pharmacy premises. Digital systems need to be safe, efficient and fit for purpose to support clinical decision-making. Better use of digital technology, such as remote and asynchronous consultations, can be used to provide patients more choice and access to pharmacists where they are unable to travel to the pharmacy. Digital developments should also be maximised, so pharmacists can engage virtually with local multidisciplinary team meetings and multi-professional patient consultations without leaving the pharmacy premises. Advances in technology will mean robotics and artificial intelligence will improve clinical decision-making; opportunities for near-patient pharmacogenomic testing and treatment monitoring will widen. We do not support the use of digital technology to allow remote supervision of a community pharmacy. A shared understanding and interpretation of supervision legislation is needed. This should be supported by clear, up-to-date professional guidance while maintaining a focus on patient safety and wellbeing. It's important that NHS bodies, the General Pharmaceutical Council, and pharmacy contractors apply supervision legislation in a consistent manner to ensure equity of access to pharmacy services for patients. Consistency in the interpretation of supervision legislation across all pharmacies would also enable pharmacists and pharmacy teams to work in the same way to provide truly person-centred holistic care, offering a full range of services in all locations. Pharmacists acting in good faith, putting their patients' needs first, should feel supported to do so without being hindered by legislation. Change required NHS bodies, the General Pharmaceutical Council, and pharmacy contractors must agree a consistent interpretation of supervision legislation. Pharmacists and pharmacy teams must be educated on what supervision legislation means to ensure they can apply it in a way which allows them to provide a person-centred service enabled by quality systems, processes and risk assessments. RCPharm will provide updated professional guidance, toolkits and supporting documents, supported by the GPhC, on how to interpret the guidance in practice to assist pharmacy teams. Any changes to legislation should lead to improved patient care, not to an increase in risk to patient safety, and any changes in workload must be considered. The priority must remain to provide the most effective and safe care for patients. This means any changes to legislation should not result in an increased patient safety risk or a reduction in accessibility to a pharmacist when a patient needs it. With ever-increasing clinical commitments in community pharmacy, employers must establish suitable working conditions and provide the right environment for pharmacists to be able to focus on their clinical roles and the right skill mix to allow pharmacy teams to manage the technical workload. RCPharm believes pharmacists should embrace new ways of working to shape what pharmacy will look like in future: the opportunities within the existing supervision legislation should be used to their full potential, alongside the changes described above, to achieve this and ensure pharmacists and pharmacy teams maintain and deliver high standards of clinical and medicines governance.

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