How to ensure effective mentoring

Stephen Goundrey-Smith explains how pharmacists can benefit from mentoring and gives his recommendations for ensuring mentees and mentors get the most out of a mentoring relationship

Mentoring is a useful tool for those interested in career progression or simply anyone wanting support. 

Mentoring is a one-to-one relationship of professional development, usually between someone seeking professional progression and a more experienced practitioner. This could also include someone seeking to develop new expertise and a practitioner already active in that area.

Mentoring is different from coaching in that mentoring is concerned with professional development, rather than learning specific skills but many commentators argue that there is considerable crossover between the two.

Mentoring has been shown to have a positive impact on career development in healthcare, helping to improve confidence and interpersonal skills of mentors as well as mentees. It also improves career retention rates and work performance. Moreover, work among psychiatrists showed that mentoring greatly benefited professionals who worked in multidisciplinary teams or who were isolated from their peers in daily practice. Read the full article here

Find out more about RPS Mentoring and how it can help you.

Reducing antibiotic prescribing through system leadership

by Katie Perkins, Medicines Management Adviser Hastings & Rother Clinical Commissioning Group

At the end of 2018 I took on the role of CCG medicines management lead for antimicrobial prescribing (alongside promotion to Medicines Management Adviser and respiratory lead). I work across two CCGs which cover 43 GP practices.

RPS AMS training

The RPS AMS training programme became available at just the right time in terms of my new role and immediately before the start of our 2019/20 prescribing support scheme. I was already out and about talking to GPs about their antibiotic prescribing and in particular three out of the 10 practices that I look after were particular outliers for antimicrobial prescribing. The learning that I undertook as part of the course, particularly in Quality Improvement (QI) methodology was invaluable and we were given a brilliant opportunity to “try this out in practice” with tutor support.

My QI project

The QI project I chose was to reduce inappropriate prescribing of antibiotic rescue packs for COPD exacerbations and ultimately for this to help reduce the total number of antibiotic items (per STAR PU) prescribed by the practice.

I carried out a patient level search at the practice to identify people with COPD who were prescribed an antibiotic rescue pack on repeat prescription. 22 people were identified and 9 of these had received six or more courses in the preceding twelve months.

In preparation for presenting this to the practice I met with a nurse at another practice which had robust and effective processes in place for the issue and follow up of COPD rescue packs – this was helpful in ensuring that I had a realistic handle on what is reasonable to expect in practice.

I met with the four practice GPs, pharmacist and practice manager and presented them with the list of these patients. I asked them to review each one to determine if the antibiotic remains appropriate. I provided them with current national guidance from NICE on this area as well as our local formulary guidance.

Where an antibiotic rescue pack was appropriate, the GPs were asked to consider only prescribing this as an acute prescription (not on repeat) or, as a compromise, if they would prefer to keep them on repeat, to consider a maximum of two issues before the patient was reviewed. I was surprised that the practice agreed to move all prescriptions to acute and for all new rescue pack prescribing to be issued only on acute.

They also agreed to include instructions in the rescue pack directions for the person to contact the surgery when they started taking it. The practice already had a leaflet that they give out to people when they are first prescribed a rescue pack – they now aim to give this out more consistently.

Results and impact of my QI project

Before the QI project (February 2019) the practice was the highest prescriber of antibiotics in the CCG (total items/STARPU). The latest data from PrescQIPP (August 2019) shows that the practice has dropped to the 9th highest (out of 23 practices) and reduced their total antibiotic prescribing by 10%.

Practice bar charts Antibacterial items/STAR-PU showing 12 months rolling data to August 2019

This is likely to be in part due to the reduction in rescue pack prescribing but I suspect that the project may also have provided a renewed focus on reducing inappropriate antibiotic prescribing more generally.

Getting all the GPs and the practice pharmacist together and presenting the data to them face to face really got them thinking about the possible consequences of these repeat prescriptions. They all committed to reviewing these patients and they have changed their behaviour when it comes to managing COPD rescue pack prescribing.

Next Steps

As mentioned previously the response to my QI project proposal by the practice pleasantly surprised me and this has given me the confidence to roll the QI out to the other 42 practices across the CCGs. I also plan to look at other areas of repeat prescribing of antibiotics such as UTI prophylaxis and long term prescribing for acne and rosacea.

Find out more about our AMS training in England

Inclusion and diversity update

by Paul Bennett, RPS Chief Executive

As your professional body, we are now working towards an inclusion and diversity strategy for pharmacy that values difference. We want to recognise, celebrate and encourage all voices and experiences across pharmacy so we can better represent you and our patients.

I’ve had the pleasure of attending three recent events hosted by the RPS to engage with members on this really important issue. The first was a celebration during Black History Month of the BAME community’s contribution to pharmacy and we had fantastic contributions and insights shared on the day.

The second was an Inclusion & Diversity workshop which was a key milestone on the programme of work we’ve embarked on. Being authentic at work, and in turn being able to feel a sense of true belonging, is something that means so much to each of us individually and I’m keen to champion this here at the RPS. I’m a strong believer that you can only be your best self if you are allowed to be the person you truly are in your workplace, so this programme, under the guidance of our excellent Chair, Asif Sadiq MBE, will produce a strategy that we hope will resonate across the profession as well as within the RPS itself.

The third event I attended was the Retired Pharmacist Group of the RPS. It’s clear to me that older age does not mean a decline in drive, energy and enthusiasm for the profession (or for life!) and I came away feeling both inspired and thankful to have among our membership such passionate and professional people who we can all learn so much from. I do hope RPG members take up my invitation to become RPS Mentors!

Our recent I&D survey of members has highlighted that they wish us to do more in the areas of disability, race and age, and we’ll be looking at how we can do this most effectively. We’ve also got a timeline of our activity so you can track our progress.

My view is that we can only be effective at tackling I&D issues if we’re not afraid to hear about the problems and challenges faced and address them. This requires each of us to have the courage to speak up and commit to not walking past inappropriate activity where we see it. Those of us in a position to create the environment for concerns to be raised without fear should do everything we can to enable that to happen.

I said at our I&D workshop that at times I had been self-conscious as a white, middle aged, heterosexual male trying to engage in conversation about BAME and LGBT+ issues as it might be perceived that I had no credibility to do so. Having talked about this with many people, I now realise that I’m not alone in having that concern BUT that it’s better to share my perspective, understand it for what it is, listen to all the other perspectives and actively contribute to this vital agenda. No one individual can profess to speak on behalf of groups of others, as we each have a unique perspective – we are all individuals after all, even though we will identify with certain groups.

RPS can only have credibility in this space if we ‘walk the talk’. Part of our commitment is therefore to do what is right by publishing data that shows our performance as an employer striving to create equal opportunity. We already publish data on our gender pay gap here at RPS and in future I am committing that we will also publish data on ethnicity and pay. We are not required by law to do either but it’s simply the right thing to do, as we believe we should lead by example.

I encourage you to engage with this discussion about inclusion and diversity whenever and wherever you can and to champion everyone’s right to be their authentic self in the workplace. Being authentic, feeling comfortable with who we are and bringing a diversity of perspectives and views to work will enrich the RPS and help us deliver the best possible support for our members, whatever their age, race, gender or sexuality.

Mentoring – a role for retired pharmacists

by Theresa Rutter, FFRPS FRPharmS

Most of us will have done some mentoring and many like me will have no formal qualification. I became interested after being mentored years ago by a non-pharmacist working towards a formal mentoring qualification. I found the process so useful that I wondered why it wasn’t embedded within the profession as a self-development tool.

Mentoring as a retired pharmacist

We retired pharmacists have the experience and skills to support the self-development of pharmacists at all stages of their career.

I started to mentor before retiring and have continued since with up to 6 mentees at varying intervals. They work in different sectors and levels of seniority.

Their areas of focus have included leadership, effective team work, staff management, prioritising, change management, problem solving, negotiating, influencing and work life balance.

The competencies (in the Advanced Pharmacy Framework) relating to these generic skills do not go past their expiry date.

I’ve found that career progression often means that mentees come to value satisfaction about their performance and recognition more highly.

Feedback from my mentees about their experience of mentoring

  • Mentoring provides a safe space and encourages them to explore options and find solutions to challenges
  • Retirees may have more time & flexibility to fit round the working hours of mentees
  • The empathetic relationship helps them to be honest about problems and areas for self-improvement
  • The sessions give them head space for reflection and creative thinking

What’s in it for mentors?

  • Stimulates neuronal pathways (use it or lose it)
  • The opportunity to share expertise and see mentees thrive is rewarding
  • It’s always good to get positive feedback

How you can get involved in mentoring?

It’s easy to sign up – RPS has launched a new mentoring platform which facilitates easy and appropriate matching of mentor to mentee. You need to reflect on the skills you can offer to the mentees, complete your profile and then keep an eye on your emails for requests from potential mentees, which you can either accept or decline.

For mentees, the same principles apply. They need to reflect on what they would like to get from a mentoring relationship and once registered can select a mentor based on their preferred profile of skills and experience, interest and local area (optional).

Sign up at www.rpharms.com/mentoring 

My aspirations for the NHS Community Pharmacist Consultation Service

As the new Community Pharmacist Consultation Service goes live, English Pharmacy Board member Andre Yeung, a key developer of the earlier Digital Minor Illness Referral Service, offers his thoughts on how to make it a success.

How did the Community Pharmacist Consultation Service develop?

My good friend and colleague Mike Maguire and I actually started talking about this right back in the summer of 2014. Back then NHS 111 wasn’t really referring to community pharmacy – they mainly sent patients to GP services, walk-in centres or A&E departments. It got us thinking that community pharmacy could do so much more in this space if we only just connected the network up with NHS 111.

After our NHS Pharmacy Integration-funded pilot in December 2017 we’re now presented with a national roll-out this October. It’s taken some time to get to this point, and it took a little bit of convincing about pharmacists’ role, but I believe the future delivery of this service is really important for community pharmacy and the NHS. We’ve had over 28,000 patients referred into community pharmacies as part of our pilot and community pharmacists have done an absolutely astounding job of clinically assessing, advising, treating, managing and escalating patients within an integrated primary care system. 100% – we’re now the first port of call for minor illnesses here in the North East.

Why do you think the CPCS is so important?

My belief is that Community pharmacy developing a role in acute out of hospital care is more important than the sum of all other commission services that have been commissioned through community pharmacy.

Why? Firstly, because acute care is needed and appreciated by patients! Secondly, it doesn’t just disappear if pharmacy doesn’t do it so it’s needed by the NHS too. Thirdly, the size and scale of this is massive.  It seems to me a ‘no brainer’ that if pharmacy helps out our GP and nurse colleagues they too would start to argue that the right place for managing patients with minor illnesses is within community pharmacy. Pharmacy can provide patients with excellent access to services and because of our scale can take pressure off NHS colleagues as we head into the busy winter season.

What are the considerations that are needed to enable around a national roll-out?

It’s a big task to get the best out of this service. In some respects, this is business as usual for pharmacists, in others it’s completely different. I don’t think there’s been a more challenging service launch in the history of community pharmacy.  As of October 29th we’ll be connected to the NHS in a way that we haven’t been in the past. People will be monitoring and counting on our clinical interventions so we need to ensure the quality of what we deliver is of a really high standard across the board. If we can do that, and I believe we can, then this could be a seminal moment for our profession – a really positive turning point that leads to further developmental opportunities in the clinical arena. How great would it be to achieve amazing results with the spotlight on us like never before?

What message would you give to front-line pharmacists?

These are a few of my top things to remember about CPCS:

  • CPCS about YOUR clinical assessment in the pharmacy. Get the info you need and make your own professional clinical judgement as NHS 111 have only done a triage based on what the patient has reported on the phone. A great clinical assessment keeps the patient safe, is rewarding for the pharmacist and importantly helps patients get well as they have the right plan in place.
  • Three most likely outcomes of your assessment will be a) you can help the patient, b) you need to escalate the patient or c) you can’t help the patient but you don’t need to escalate.
  • Safety net every patient: advice on when to act and how to act if things don’t improve or get worse.
  • Keep decent clinical notes in the IT system, for patient benefit and yours.
  • When you escalate in hours, most times you’ll need to speak to the GP not the receptionist. You’ll be escalating because you have a clinical concern so it’s only natural you’ll want to communicate this to the receiving GP – it’s both helpful and courteous to do so! Out of hours you’ll be going back to NHS 111 via the healthcare professional line so be prepared to request a referral or support from the clinical assessment service.
  • Reflect on your practice. If you need some additional training then sort this out as part of your CPD.

What are my aspirations for the future of the service?

Initially, this is about community pharmacy the sector maximising this opportunity. It’s about us ‘knocking this out of the ballpark’ so to speak. That’s my main aspiration!

If we achieve this then the NHS have already outlined an opportunity to work with GP referrals into community pharmacy for minor illnesses.

In the future, what would be good would be some additional training, access to some POMs and some basic equipment (oximeters, BP monitors, thermometers etc.).  This will allow us to see other types of patients as our functionality increases. Why not see patients with suspected UTIs, with impetigo etc? I know my colleagues at the Royal Pharmaceutical Society will be pleased to hear me say that I think the roll out of Pharmacist Prescribers will eventually come on the back of all of this work. We’ll need them as we do more and more in this domain.

It’s all very exciting! Caveat to all of the above? We MUST deliver this first phase of the service well.  Organisations need to support our front line pharmacists and pharmacy teams to deliver quality. They absolutely have the capability to do it, they’re amazing, but they will need our help and support to make it happen!

Our Mental Health and Wellbeing Campaign

By Jonathan Burton MBE FRPharmS, Chair of the Scottish Pharmacy Board

I think we can all agree that being a pharmacist can often be stressful and demanding. My personal experience of managing my wellbeing, in the context of my work as a community pharmacist, has been a journey.

Early in my career (I’m 20 years qualified now) I often struggled to control stress & anxiety when workload was high in the pharmacy, I could be irritable and looking back I’m sure this was noticed by and affected my work colleagues and patients alike. I co-own the company I work for and this had the added effect of causing me to feel a lot of guilt, even in situations in the pharmacy that I couldn’t really exert any control over, as I inherently felt it was always in part my fault if my team and I were struggling. I seemed to carry this with me all the time. 

Further on in my career now I feel I manage these emotions better, but I still notice the negative impact that busy and stressful days and experiences have on my life & general wellbeing. I can control it at work better, but at home sometimes it’s still a struggle. If you ask my wife and children they’ll tell you, I often find it difficult to switch off from work and it sometimes takes me some time after arriving home before I feel I’m the husband to my wife and father to my boys I think I should be. If it’s a tough week at work I often stop looking after myself, my diet worsens and exercise stops. 

I consider myself lucky, I enjoy my job and have always felt fortunate to be a part of a profession that cares for others. But as health professionals we need to look after ourselves and each other as well as the public and patients we care for. We are human, and we will have our struggles with our wellbeing and mental health, but this does not mean we don’t deserve help to manage these challenges. 

If you are a pharmacist reading this, and haven’t done so already, please help the RPS and Pharmacist Support fight for better access for pharmacists to help with their wellbeing and mental health issues by completing our survey. It really will make a difference, thank you.

My first week as an RPS intern

Simi Aguda, Second year pharmacy student

I’m Simi Aguda, a second year Pharmacy student at the University of Portsmouth. I recently had the opportunity to work within the Royal Pharmaceutical Society in Education and Professional Development.

My first week began with an introduction to the different teams at the RPS by Aamir Shaikh, a Professional Development Pharmacist who supports early career pharmacists.

I met with the different departments and organisations within the Royal Pharmaceutical Society, including the BNF, Pharmaceutical Journal, Education, Team England, Events, Marketing and Professional Support. I was immediately welcomed and was excited to see what the professional body of Pharmacists got up to ‘behind the scenes.’

My first project was to review the RPS website from a student perspective, suggest improvements and present my findings to the Marketing Team. I needed to be analytical and precise and further develop my presentation skills, as well as evaluate whether the content of the website matched the needs of Pharmacy students like myself. After the presentation the changes were made to the website and my feedback was taken on board. I noticed how the RPS valued giving and receiving feedback, and that as a student my opinion and thoughts mattered. This has been an integral part of my experience and demystified my preconceptions of the RPS and their culture.

My second project was analysing data collected from Pharmacy students and Pre-Registration trainees and identifying changes and patterns from the data set and how this could improve RPS membership. In addition, I had the opportunity to work with Gareth Kitson, Professional Engagement Lead, whose role is to promote pharmacy across England, as well as liaise with the media and Government to champion and speak up for Pharmacy. This broadened my perception of potential pharmacy careers.

Next, I had the opportunity to meet with the head of Marketing, Neal Patel. I was invited to discuss how the RPS can engage with students like myself, this was an incredibly informative meeting and provided me with insight into how dedicated the RPS is to helping Students, Pre-Registration trainees and qualified pharmacists. The focus was always on how the RPS can support its members. As a student I was unaware of the resources available for me. I have since met other interns who were placed within the Pharmaceutical Journal, and we have worked together to create content for the RPS digital channels.

Uncovering hidden histories at the RPS Museum

by Matthew Johnston, RPS Museum

Part of our work here at the RPS Museum includes researching various aspects of pharmacy history so we can enrich our displays, tours and articles, especially those areas that are currently under-represented in the museum.

A recent focus of this research has been to uncover more stories relating to BAME communities. This isn’t an easy task as historical registers of pharmacists did not record information relating to ethnicity. In addition to this lack of documentary evidence, there is little visual material available, particularly in the early years of the Society before the widespread introduction of photography.

But we didn’t let that stop us. When we look through the records, we can see tantalising glimpses of stories that we can use as a starting point for our research. The earliest specific reference we have found in the Society’s archive is the arrival of the first black African student at the School of Pharmacy in 1847, as noted in the report of the Annual General Meeting of May 1848, which reflects the attitudes of the time:

It is also gratifying to find that some have come from distant countries, and one of these, an intelligent African, is probably the first native of that soil who will apply a knowledge of Chemistry acquired in an English School, with the view of promoting the arts of civilization among his colored brethren.”

But who was this student? Frustratingly he isn’t named, but he may have been Joseph Mailloux. The Society published its first list of ‘Foreign Life Members’ in the Pharmaceutical Journal in 1856 and Joseph is listed as having been admitted to membership in 1847. He was based in Mauritius, which at that time was a British colony. His certificate number of 28 shows that he took and passed one of the Society’s exams, so would have been studying at the School around the time referred to in the above report.

Despite poring over the various resources available to us, we couldn’t find out much more about Joseph Mailloux. He remains on the Society’s register until 1877, so seems to have had a 30-year career. An annotation in the Registrar’s copy of the register confirms that his removal was because he had died, but no obituary was published in either the Pharmaceutical Journal or the Chemist and Druggist, a familiar story with international members of the Society at this time.

There is still a lot of work to do in terms of including more marginalised voices in the museum. Hopefully this blog has shown that there are stories to be told and histories to be revealed – we just need to keep on digging to find them and highlight diversity in the profession.

RPS at Conservative Party Conference

By Sibby Buckle FRPharmS, Chair, Pharmacy Digital Forum and English Board member

Sibby Buckle and John Lunny with the Secretary of State for Health, Matt Hancock

A rainy Manchester was the setting for this year’s Conservative Party Conference. The slogan “Get Brexit Done” emblazoned across the outside of the convention complex to greet the mix of party members, campaigners and lobbyists. It was a recurring message throughout the proceedings, with the party of government looking to focus on issues other than Europe, but Brexit still dominated much of the speeches and debates.

With a new Prime Minister, a reshuffled Cabinet, and continued speculation over a potential general election, the backdrop for this conference was far from usual. Indeed, after a Supreme court ruling, Parliament itself was still sitting while the conference was going on. Would opposition parties try to table votes so that Conservative MPs would have to travel back to London? Would there be a vote of no confidence in the Government? Would the Conference need to finish early? As it was, none of this came to pass and the party managed to set out its agenda largely unimpeded.

The policy announcement on health which received the most attention in the news was for the extra £13.4Bn funding for hospital infrastructure, but there were lots of other events and debates in the conference fringes as well.

I was delighted to join representatives from a number of Royal Colleges at a roundtable on workforce, hosted by the Royal College of Physicians and the British Medical Association, as well as Health Committee member Andrew Selous MP and Marcus Fysh MP. The discussion focused on how to make the NHS the best place to work and how we can support recruitment – a key theme of the Interim NHS People Plan. This is a big focus for the RPS, looking at a range of issues such as education and training, recruitment into new roles such as in primary care networks, and how pharmacists’ mental health can be supported in an often-pressurised work environment.

I also raised the need for funding for Community Pharmacists to train as Independent Prescribers (IP’s) to help ease the pressure on GP’s, and encourage the public to visit their ‘Pharmacy First’. This is becoming more pressing as the move to give prescribing rights to Physicians Associates, Anaesthetists Associates, and Clinical Scientists increases. I don’t want our Pharmacy profession left behind!

Fringe Events

At an NHS Confederation fringe on “The NHS in a post-Brexit world” with Vicky Ford MP, a member of the Science and Technology Committee, I highlighted how pharmacists are key to helping patients access their medicines, particularly in the event of potential shortages. Indeed, we have already had the first ‘Serious Shortage Protocol’ (SSP) announced.

I then hot-footed it to a roundtable with Turning Point on health inequalities and the Government’s prevention green paper, using this opportunity to flag the need for an agreed mechanism for Pharmacists to be enabled to, and fully engage in, ‘social prescribing’.

Health Secretary Matt Hancock MP spoke really positively about pharmacy later that day “in conversation” with the Centre for Policy Studies. When asked about the new announcement on hospital funding, he went on to highlight the importance of supporting prevention and how pharmacists can play a vital role in helping people stay healthy and out of hospital, as well as treating minor ailments in the community and taking pressure off GPs. He welcomed the direction of travel set out in the new community pharmacy contract so that pharmacists can provide more services and said he hoped this would be further expanded in future to make even greater use of pharmacists’ clinical skills.

It was great to hear the message getting through about how pharmacists will be really important to helping deliver the NHS Long-Term Plan. With the “final” NHS People Plan expected in the coming months, we’ll keep talking to Government and the NHS about supporting the profession to get the best results for our patients.

Yes, a conference focused on Brexit, but with Health still firmly on the agenda.

Your introduction to drug safety

By Professor Saad Shakir, Director at Drug Safety Research Unit

We are delighted to be joining forces with the Royal Pharmaceutical Society to provide this course to introduce pharmacovigilance to pharmacists. Pharmacovigilance is defined by the European Medicines Agency as “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other medicine-related problem.”

Monitoring safety and pharmacovigilance are key activities during the lifecycle of a medicine, both at the pre-marketing stage and once it is licensed for use in humans. No medicine is without risk of adverse effects and the science of drug safety involves assessing and optimising the risk-benefit balance for each medicine.

This course will detail the key role that pharmacists have to play in pharmacovigilance and will explain why it is important to report adverse drug reactions and methods for doing so. Presentations will be complemented by interactive sessions.

Routine risk minimisation measures are required for each drug and include the SmPC, PIL, packet size and the legal state. For products where these are considered insufficient, additional risk minimisation measures will be required in order to optimise the risk/benefit balance and maintain patient safety in everyday use of the drug. Community pharmacists are frequently involved in additional risk minimisation measures usually at the point at which a medicine is dispensed. For example, pharmacists may be asked to keep a log to indicate whether they have provided a patient card to the patient with their medicine (in addition to the PIL) and explained its use. The patient card may list serious potential side effects and actions to be taken in the event of occurrence.

This blog aims to provide you with a glimpse of the course. We do hope that you will be able to join us!

Book your place now

https://events.rpharms.com/website/672/home/