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|A 'level playing field'|
A level playing field is a concept about fairness. It's being even-handed when inviting people to the Medicines Use Review service
A term used to describe a person fluent in two languages
Empathy is the capacity to understand or feel what another person is experiencing. Empathy has been used in this e-learning to motivate the learner to change their behaviour and so improve interaction and engagement with people from under-served communities.
|Equality Act 2010|
The Equality Act 2010 legally protects people in the UK from discrimination in the workplace and in wider society. There are nine protected characteristics (age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; sexual orientation). Any discrimination that occurs because of one or more of these characteristics is unlawful under the Act.
|Health inequalities & health inequities|
The term health inequality refers to differences in the health of individuals or groups. Any measurable aspect of health that varies across individuals or groups can be called a health inequality.
In contrast, a health inequity, or health disparity, is a specific type of health inequality that denotes an unjust difference in health. Health differences here are preventable and unnecessary and allowing them to persist is unjust.
The key distinction between the terms inequality and inequity is that the former is simply a description employed whenever quantities are unequal, while the latter requires passing a moral judgment that the inequality is wrong.
"Arcaya MC. et al (2015). Inequalities in health: definitions, concepts, and theories. Glob Health Action 8:27106"
Institutional discrimination typically refers to the unjust and discriminatory mistreatment, through unequal selection or bias, intentional or unintentional, of an individual or group of individuals that exists within the structures, processes and procedures of an organisation.
|Medicines Use Reviews|
The Medicines Use Review (MUR) and Prescription Intervention Service is an Advanced Service within the English NHS Community Pharmacy Contractual Framework. It consists of accredited pharmacists undertaking adherence-centred reviews with patients on multiple medicines, particularly those receiving medicines for long-term conditions.
Person-centred care supports people to develop the knowledge, skills and confidence they need to more effectively manage and make informed decisions about their own health and health care. It is coordinated and tailored to the needs of the individual. And, crucially, it ensures that people are always treated with dignity, compassion and respect.
There are four principles of person-centred care:
1. Affording people dignity, compassion and respect
2. Offering coordinated care, support or treatment
3. Offering personalised care, support or treatment
4. Supporting people to recognise and develop their own strengths and abilities to enable them to live an independent and fulfilling life
|Prejudice and Discrimination|
Prejudice is an irrational or unjustified opinion or attitude towards an individual based solely on their membership of a social group. Prejudices can either be positive or negative; The negative form of prejudice can lead to discrimination.
Discrimination is the behaviour or actions (usually negative), towards an individual or group of people to deny access to those whom they believe do not deserve the same treatment as everyone else. Discrimination, therefore is an action that denies the rights of a person due to their membership of a social group.
Stereotyping involves identifying features that a group of individuals is supposed to have, making such features the dominant characteristic of the group and then suggesting that every member who belongs to the group possess such features. It is important that we don’t stereotype people but rather seek to view the individual.
|Medically under-served community|
Groups of people who are eligible to receive a health service (such as the Medicines Use Review) but for whatever reason, do not end up receiving the service desite them being potentially most in need.
|Continuing Professional Development (CPD) (pharmacists and pharmacy technicians)|
Begin a CPD entry about how you have reflected on your own practice and now intend to effectively approach, engage and empower patients to take up the offer of a Medicines Use Review.
|Consultation skills for pharmacy practice|
The Consultation skills for pharmacy practice website has been created to support pharmacists and their staff to improve patient consultation skills. The website provides easy access to a range of resources, including guidance, a set of practice standards, learning options, assessment tools and signposting for additional support as well as offering advice to employers and trainers.
|Consultation Skills for Pharmacy Practice: Taking a Patient-Centred Approach|
Produced by the Health Education England (HEE) and Centre for Pharmacy Postgraduate Education (CPPE), this distance learning programme support pharmacy professionals to improve your skills in carrying out consultations with patients.
|English NHS Community Pharmacy Contractual Framework: Services and Commissioning|
This link provides details of the English NHS Community Pharmacy Contractual Framework. Information about the 'Medicines Use Review and Prescription Intervention Service' as well as other pharmacy services can be found here.
|NHS Choices: How your pharmacist can help|
NHS Choices is the UK's biggest health website. It provides a comprehensive health information service to help put patients in control of their healthcare. The website helps them to make choices about their health, from decisions about lifestyle, such as smoking, drinking and exercise, to finding and using NHS services in England.
|NMS and MURs – top tips from community pharmacies|
The link provides 'tried and tested' top tips that cover everything from recruiting patients to managing consultations and engaging with GP colleagues.
This resource will allow you to test and see where your biases may lie. The Implicit Association Test has been developed to measure unconscious or implicit attitudes and stereotypes towards various groups.
BMJ Open online journal: Supporting underserved patients with their medicines: a study protocol for a patient/professional coproduced education intervention for community pharmacy staff to improve the provision and delivery of Medicine Use Reviews (MURs)
By completing this resource you will be able to:
- Reflect on our unconscious biases and how this may impact on the care we provide to those who are medically under-served
- Demonstrate how we can enable individuals to empower themselves to take up the offer of a Medicines Use Review
- Support the development of a personal action plan to promote Medicines Use Reviews to people that are under-served
Content Author: Asam Latif
Author biography: Asam Latif has been a UK registered pharmacist since 1999 and has worked in both community and hospital pharmacy. He has been a researcher for over 10 years principally investigating community pharmacy medicines management services. Specifically, his interest lies in developing e-learning resources designed to change the behaviour of professionals to improve service provision to patents. He is passionate about improving care to individuals who are underserved giving voice to people who are seldom heard.
Patient and Public Representatives: Mahomed Khatri, Abida Malik
Contributors: Kristian Pollock, Claire Anderson, Justin Waring, Josie Solomon, Li-Chia Chen, Emma Anderson, Sulma Gulzar, Nasa Abbasi
Project Mentor: Heather Wharrad
Project developers: Michael Taylor and Simon Riley
Video production/development: Simon Riley, Michael Taylor
Acknowledgements: This e-learning resource has been co-produced with patients and representatives from underserved communities, pharmacists, pharmacy support staff and organisational representatives. We gratefully acknowledge support of all the patients and pharmacy team members who took part.
Funding: The project was funded by the Department of Health through the Health Education England (HEE) and National Institute for Health Research (NIHR) Integrated Clinical Academic (ICA) Programme.
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