An open invite to be a guest blogger on pharmacyinpractice!

download

HAVE you got something to say, or to share, or to get off your chest? Can you educate, inform or inspire pharmacy professionals? Do you know of any local pharmacy projects that would be of interest to others?

Then we’d love you to contribute to Pharmacy in Practice.

As you can see from the site, there are articles from many contributors with a range of qualifications, skills and experiences: pharmacists, GPs, nurses, students, patients and many more.

Everyone is welcome to contribute. Read the information below, then please consider submitting an article.

You know you want to… no need to be shy.

About Pharmacy in Practice?
You can read more about the website and us here.

Why do you do it?
It’s fun (we do it in our spare time for free) and we want to share information that is useful.

How do I submit a blog?
Simply e-mail your piece to johnathanlaird@hotmail.com or ross@pharmacyinpractice.org. Blogs can be written, video or audio in nature. Please include a brief description of your current role and your Twitter user name.

What happens after I submit it?
The article will be edited and scheduled for publication.

Do contributors get paid?
Are you having a laugh? Your payment is the warm fuzzy feeling you get when you see your article on the website and the knowledge that it’s probably helping improve professional practise.

Why should I bother?
Don’t you like feeling warm and fuzzy? Well, it’s a great entry for your RPS Faculty portfolio, it’ll look good on your CV and is excellent for engaging with other healthcare professionals.

Are there any guidelines in terms of word count?
There is no strict word limit, however, around 500-600 words seems to work well.

Are there any golden rules?
This is a blog for pharmacy professionals, so any articles have to bear that in mind.

So, there’s a good chance your experience and knowledge could help others, don’t keep it to yourself.  It’s time to get sharing. Please get in touch!

 

Prison pharmacy is just like Shawshank!

shaun hockey

WHEN I heard the clang as the gate was closed behind me for the first time, I have to admit that I was a bit nervous. Would there be serial killers walking around all over the place? Would there be fights left, right and centre and where was the pipe I could escape if I was mistakenly locked in a cell in true Andy Dufresne style from Shawshank!

That was 10 years ago and I’ve now worked in six different prisons and I have to say, I find it extremely rewarding. There’s no doubt that it can be a challenging environment to work in – the nature of the patients you are working with dictates that. Over 140,000 people pass through the prison estate each year, with many having very complicated home lives and with a mixture of social, emotional, physical and intellectual challenges. Much of the way pharmacy services are provided in secure environments is derived from the Department of Health Document A Pharmacy Service From Prisoners (2003). The document states that prisoners are entitled to the same healthcare provision as patients outside prisons and that patients should be “in possession” of their own medication by default and “not in possession” only in exceptional circumstances.

The best thing about working in prisons or secure hospitals though is working with the other members of the healthcare team – GPs, dentists, general and mental health nurses, physio’s, radiographers, pharmacists and pharmacy technicians. We all work together to deliver the best possible care to the patients, whatever they have done and however they present. It’s a real contrast to working in a community setting which can seem like a far cry from multi-disciplinary working.

So what does a normal day in a prison pharmacy look like? That actually depends on the type of prison you are working in. When a person is arrested their first night in prison will be in a local prison. Each area/region will have a local prison to which people are remanded to and in these prisons, they have to deal with many acute health issues. These health issues could be physical, emotional or psychological in nature or in many cases, a combination of all three and add to that sprinkling of freshly ground substance misuse and you have the recipe for the sharp-end of prison healthcare.

The healthcare teams in local prisons have to support and stabilise these patients as quickly and professionally as they can. This job usually falls to the nurses who I think do a great job in what can be very challenging conditions. For the acutely unwell, GPs are available on-call during the night and at weekends and the healthcare teams have access to Out of Hours medication that’s supplied from the pharmacy to an Out of Hours location(s). The local prisons have a big turnaround of patients every week with patients transferring, being released or re-distributed around the prison estate. Working in a pharmacy in a local prison can feel a bit like working in a community pharmacy sometimes with nurses requesting medication ASAP as a patient is on the bus ready for transfer ‘now’ or just about to go to court or suddenly becoming acutely unwell.

In the maximum security estate and other non-local prisons, patients have usually been in the system for some time and their acute healthcare issues have already been met. However, as with any substantial population, there are always acute healthcare needs and long term conditions to be managed. In some ways for prison healthcare you can draw an analogy with a local acute healthcare trust – the A+E or AMU is akin to the local prison and the wards in that hospital analogous to the rest of the prison estate. In contrast to the community like nature of local prisons, the rest of the estate can feel more chilled as patients medication can be managed more easily in most cases.

So, from a professional and financial perspective, locum work in secure environments is really worth considering. We have probably placed upwards of 50 people in prisons and only one who decided prison pharmacy wasn’t for them.

Accessing locum sessions can be tricky, but if you are ready, willing and able to give it a go call an agency with experience working in secure environments and they can guide you through the essential compliance and security requirements.

Shaun Hockey is founder and director of Pharmacy Personnel and Medical Personnel

Follow Shaun @shaunhockey

Professor Harry McQuillan and CPS aim to improve patient care with Pharmacy First

Professor Harry McQuillan

Professor Harry McQuillan


WE
recently launched our Manifesto on behalf of our members to highlight how community pharmacy can continue to evolve to enable the NHS to survive and prosper deliver. There were three overarching areas, I will focus on the first area: Pharmacy First.
The term ‘Pharmacy First’ is coined for the public to consider making their local community pharmacy the first port of call for access to NHS services.

Under the Pharmacy First heading we offer three proposals:

  • Extension and wider promotion of the NHS Minor Ailment Service with current eligibility criteria replaced by a universal service – Pharmacy minor ailments treatment already shifts care in a cost effective manner away from GPs and other healthcare services. Proper promotion could maximise this impact, ensuring the public can access services at the right time and at the right place with interventions from highly trained pharmacy teams. The Minor Ailment Service is a successful community pharmacy service and this success can be built upon.
  • Appropriate access to relevant patient information to allow more effective treatment of more patients in the community – Data protection and confidentiality is paramount in the regulated pharmacy environment, but access to information could help pharmacists support patients better. This will save time for GPs and the out-of-hours services, allowing patients to be treated effectively and efficiently in the accessible pharmacy environment.
  • Improved referral pathways between settings involved in patient care – This does not just include links with general practice which are very good in general, but with other health and social care providers such as optometry and dentistry. This would allow seamless links to be built for patients between healthcare providers, allowing the expertise of each provider to be used appropriately for the right patient.

When viewing the current healthcare landscape, there is a clear need (as identified by many stakeholders, including the auditor general) that NHS services need to be delivered in new and innovative ways. Much of this is down to the ageing population who are living longer and in their own homes. Add to that the headline stories around stretched GP and A&E services, then every service provider needs to look at what they can do to ensure patient needs are met.

The recently published national Out of Hours review, commissioned by Scottish Government and led by Sir Lewis Ritchie, also highlights a need to think differently about care provision in and out of hours. Community pharmacy is identified as being a key partner in the delivery of care with patients.

Indeed the report specifically mentions the Minor Ailment Service, patient record access, and the development of the community pharmacy network as key components supporting care provision for patients.

Of course all this has to be delivered against the backdrop of tightening health budgets and significant pressures on the NHS.

Audit Scotland recently said in its report on the NHS in Scotland that ‘the Scottish Government has not made sufficient progress towards achieving its’ 20:20 Vision of changing the balance of care to more homely and community-based settings’.

Given that community pharmacies are in the heart of communities we would be looking to provide solutions such as those illustrated above to support the aims of the 20:20 Vision through novel approaches to healthcare delivery.

Community pharmacy, working with the public and our healthcare colleagues can play a key role in the future of the NHS as we continue to champion and support excellent health outcomes for all in the communities we serve.

Professor Harry McQuillan is Chief Executive at Community Pharmacy Scotland and visiting Professor at the University of Strathclyde

Follow Harry @HMcQCPS 

I’m a pharmacist that’s all!

Calum Plenderleith

Calum Plenderleith

 

I AM a community pharmacist!

So far as part of my 9 hour shift today, I have dispensed and given out medication to 367 different people equating to 987 different items; had a consultation and supplied a patient with emergency contraception; counselled 2 people on their new anti-coagulation medication, one of which required me to contact their doctor as it interacted with one of her current medicines which could have caused hospitalisation; given out (free of charge) medication for minor ailments to infants and adults who cannot afford to buy it; made 4 significant prescription interventions one of which meant amending antibiotics to prevent an epileptic man having a seizure; dispensed emergency hormonal medication for a patient receiving IVF; communicated with 2 local hospitals to organise the discharge of 3 patients from my town freeing up hospital beds and getting them home for the weekend; given an emergency supply of insulin to a type 1 diabetic on his holidays who left his medication at home; performed first aid on a postman who had been bitten by a dog and is taking warfarin (increased bleeding)…and all of the other things necessary to run a successful pharmacy!

Three things are necessary in order to do the above
1. Excellent support staff!
2. A smile!
3. NHS funding for pharmacy and primary care services!

The government are cutting funding to all community pharmacies in October, which for roughly 3,000 pharmacies will result in closure.
I am only one community pharmacist and have had a very normal day!

Without the pharmacy there today, a number of people could have been in left in very difficult situations!

Proposals by the government will result in increased pressure on GPs and already saturated emergency health care services, unsafe practicing environments, understaffed pharmacies (your prescription will take even longer! ) or no pharmacy at all!

Unfortunately, there isn’t a great deal that can be done and I don’t suppose a petition or strikes will help but, most people who don’t work with or in a pharmacy are completely unaware of the current or future situation!
This blog is written simply to raise awareness of the situation and hopefully get the general public (our patients!) backing us!

In healthcare, hope can sometimes be the denial of reality!

 

MY father was the type of man who didn’t see a doctor. Working for the local oil refinery, he sometimes worked 24 hour shifts, or seven consecutive days. He was scared of very little in life, but he definitely wasn’t keen on people in white coats.

http://www.youtube.com/watch?v=Nk9mBWH8zek

He’d gone to ‘night school’ for over a decade, working to improve his lot, to eventually hold the post of head of building sciences at our local technical college. His energy and drive in personal development, combined with his dislike of white coats, is what sealed his fate.

After finally seeking advice from a doctor, he confided in me that he felt something was wrong, but still wanted to take his students through the full academic year before seeking help. By the time summer came, he had a brain tumour that was too advanced to be treated.

The last 18 months of his life were text book terminal stages for a person with a brain tumour, with the anticipated end affecting our family for the next two or three decades.

What didn’t happen, was someone questioning the amount of pain relief he was purchasing before he finally saw a doctor. Addiction or need? If it is addiction, then steps should have been taken, if need, then he should have been signposted for further examination.

An informal environment with a healthcare professional working with him, may have convinced him to seek further help. It may have made a difference to his life expectancy and the quality of his life.

Twenty eight years after his death and his son serves on a local health and wellbeing board, currently dealing with swingeing reductions in expenditure on public health services. The impact on people’s lives is of clear concern and it is vitally important to the health of our nation that our services are invested in and developed.

The World Health Organisation says we spend less per head on healthcare than any other western European country. Comparison of any other healthcare system against our beloved NHS is always difficult, but it’s clear that our spending is very cost-effective before we take the current efficiency savings into account. We spent $3600 per person on healthcare, compared to $4864, $5093, $6145, and $5006 from France, Belgium, Netherlands, and Germany respectively.

The recent announcement which proposes a reduction in community pharmacies in England is naturally a concern for the profession and a real concern for patients. What will be the impact on the community pharmacy network? How will good pharmacies be identified and their ongoing success assured? How will pharmacies operating in smaller villages across the country manage to continue?

We are awaiting further information from the Westminster Government on the detail and how changes will be made effectively without a reduction in standards of care or patient experience.

Local reductions in drug and alcohol, smoking cessation, and weight management services reflect the additional efficiencies councils are required to make, with everyone knowing costs will rise in the future when more expensive interventions will be needed for those we must ignore, with potentially ongoing care provided for the rest of people’s lives. People who wanted to seek help, away from a formal healthcare environment.

Losing a family member is always difficult. Knowing someone is sick and in denial is a tragedy, but not having resources available to help those who want it should be a crime.

Charles Willis is head of public affairs at the Royal Pharmaceutical Society

Follow Charles @RPS_Stakeholder