To provide services to patients with long-term diseases, you need to have the infrastructure available to do it and to make effective use of this infrastructure. This includes facilities, equipment, processes and people.

Effective delegation

If you are to improve the way you use the skill mix in your pharmacy and delegate effectively, you need to ensure that your staff have the appropriate skills and knowledge to undertake tasks efficiently and effectively. This will ensure that you are confident about the tasks being carried out to the expected standards.

You should evaluate who needs to be trained as an ACPT, a technician or a dispenser. When doing this, you should also think about succession planning. What would happen if a member of your team left? What pressure would this place on the processes in the pharmacy? How would you replace them?

You should think about your own capability too. What skills will you need to be able to deliver services that support patients with long-term conditions? Some will be generic, such as counselling skills, supporting behaviour change and promoting adherence. Other skills and knowledge will be specific to the service you are providing.

Collaboration, not competition

Being successful in providing services to patients with long-term conditions means working in collaboration with other healthcare professionals, rather than competing with them. Newly commissioned services need to add value to the NHS, not replicate current services.

To do this, you will need to find out what different members of the healthcare team are doing to support patients with different long-term conditions in your area. This will include GPs and nurses in primary and secondary care. One way to identify the support that patients receive will be through the care pathways agreed within localities.

By identifying the needs of different patient groups and the support they already receive, you can work out which pharmacy services would benefit them.

Equipment and recording

The equipment you require will depend upon the services you plan to provide. Some simple equipment could be obtained to provide complementary services to current patients at little cost. For example, a standardised electronic blood pressure monitor that is used to monitor blood pressure in all patients who receive antihypertensives or treatments for cardiac conditions can also be used to monitor blood pressure in pregnant and diabetic patients.

Services may also require IT support. Access to the internet to obtain information or check the information that patients have seen already will be important during an intervention. Recording of outcomes is vitally important in demonstrating the benefits of the services provided. Recording this electronically will facilitate analysis.

Appropriate facilities

The facilities you have for delivering services needs to be appropriate. For simple talking-based services, such as an adherence support service, the consulting room specification for MURs may be sufficient. Services that involve diagnostic testing may require an electricity supply and facilities to wash hands.