Abstract
The nation of Singapore highly values its health service as well as the component of healthcare delivery that includes clinical pharmacy and administration. The Ministry of Health (MOH) engaged the services of Dr. Richard Parrish to better understand the relationship between the Singaporean citizenry and its clinical pharmacists. Through a series of five lectures, structured from the national to local unit level, four roundtables, two hands-on sessions, and three workshops, clinical pharmacists and administrative leadership participated in “open-mic” style lectures, discussed the issues facing Singapore pharmacy in its current provision of healthcare services, and deliberated on the future resources required to meet projected healthcare needs. From three distinct perspectives, these discussions were very frank, transparent, and passionate about what practitioners and administrators thought Singaporean health leadership needed to address in terms of (1) what programs and practices to continue; (2) what ones to start; and (3) what ones to evaluate. Each of the areas below will be framed using these three perspectives in order to clearly reflect the ideas and suggestions expressed in each of the 14 group sessions. These recommendations are forwarded to MOH pharmacy leadership for consideration and action. In addition, we met with MOH leaders regarding non-medical prescribing (NMP), and discussed strategies and tactics that seemed successful as well as unsuccessful in other jurisdictions when adopting expanded scope models for clinical pharmacists and other qualified healthcare providers that include prescribing of medications.
Highlights
Because there are four official languages, Singapore pharmacy has a number of strengths that have developed from this diversity, coincident to the rise of clinical pharmacy, internationally
Healthcare provision is structured from the national to unit level where clear divisions of scope and service administration are evident
The range of services requires that 450 full-time equivalent (FTE) pharmacy personnel are needed; a career ladder framework-basic, intermediate, and advanced practitioner-is established to promote internal advancement and job satisfaction
Summary
In general, and healthcare and clinical pharmacy, in particular, are rich in cultural diversity. (3) infectious diseases; (4) neurology/psychiatry; and (5) nutrition support These advanced practice professionals are certified through attainment of board certifications offered through the American Board of Pharmacy Specialties affiliated with the American Pharmacists Association. The Ministry of Health (MOH) has developed a structure for advocating for integrated health practices Within this framework, the Agency for Integrated Health includes the Integrated Health Information. Specialties and sub-specialties in pharmacy developed from a variety of needs and wants, both internal and external to the profession These service functions include: Medication Adherence, Medication Optimization, and Patient Wellness. It is shifting reimbursement from quality to value, and healthcare to health These changes in focus have set in motion a number of local disease management functions that could be performed by any willing and qualified provider, including clinical pharmacists and advanced practice nurses. Implementing a supplementary/dependent prescribing role of pharmacists, nationally and generally, through concerns that many pharmacists cannot be expected to prescribe with any level of quality, requiring an assessment and demonstration of continual competency for prescribing undertaken through SPC
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