Unfreezing the leaders with titles

Meet the new boss Same as the old boss

I've blogged previously about my frustration with the new term Medicines Optimisation, however on Wednesday I discovered someone who was willing to put forward their views that medicines optimisation was significantly different to medicines management, due to a completely different focus.

I remained unconvinced, as it seemed to me that his arguments were related to failings in medicines management that were unrelated to medicines management as a philosophy of practice. Medicines management is about building safe systems of medicines use that maximise patient outcomes with the best possible value for money. Medicines management is not about frantic cost-saving in a way that incurs costs or harms elsewhere in the health economy. Where this happens, it's a response to the management climate of that organisation and a simple change of name won't solve the pressure that those pharmacists are under to cut costs.

If on the other hand, it's about individual-patient focus, then that takes away from local-population-level pharmaceutical public health role.

When I was a younger and more innocent pharmacist, I was taught basic change management using the Unfreeze-Change-Refreeze model. So far I've not seen anything to say what was needed to change about medicines management (the unfreezing bit), I'm just seeing the refreezing, as if medicines management never existed. Medicines management worked for my team, so I want to know what's different and how it will be better.

I saw the first glimpse of a positive answer to this in a blog post published last night - but does this fit the national idea? One comment I've seen over the past 48 hours about medicines optimisation had me somewhat unhappy:

perhaps it is for pharmacists to describe and lead the change.

It is not for pharmacists to receive this new terminology and describe it, we need leaders to lead this change. I know there's lots of encouragement that little players like me should be "Leaders without Titles", but we need Leaders with Titles to lead this change. It's a change that's going to affect everyone in England, so this is a change that needs to be led for pharmacists at the national level.

Otherwise we will continue to have this situation where no-one is sure what medicines optimisation. I don't want the chief GP from Manchester meeting the chief GP from Cornwall and them both saying different things about the impact of their local "Medicines Optimisation" pharmacists because this confusion has been allowed to fester.