You can run, but you can’t hide – the future of drug testing in sport

By Richard Parsons, Pharmaceutical Scientist and expert in drugs and sport

The Olympic Games in Rio officially open later today yet already we have been embroiled in degrees of controversy. At the forefront is the controversy surrounding doping. We are playing a cat and mouse game with the doping cheat – we develop new and more sensitive tests for the latest doping agents, and in response they try to circumvent those tests by developing new drugs and new doping regimes. Thus we go round in a cat and mouse circle of detection and avoidance. We are playing a game of catch-up in which we are greatly assisted by whistleblowers, insiders who pass new drugs onto the World Anti-Doping Agency (WADA), or provide information on doping procedures employed, quite often at great risk to themselves. Read more You can run, but you can’t hide – the future of drug testing in sport

Top tips to get you through your Hospital Interviews

MichaelMichael Champion, Student, Social Media and Communications Lead of RPS East Anglia and Anticoagulation Practitioner at West Suffolk NHS Foundation Trust, tells us the tips that got him through his Hospital pre-reg interviews.

 

Read more Top tips to get you through your Hospital Interviews

Preparing for your Hospital Pre-Reg Interviews

Aamer ImageWe spoke to Aamer Safdar, Principal Pharmacist Lead for Education and Development at Guy’s and St Thomas’ NHS Foundation Trust and RPS English Pharmacy Board Member about the best way you can prepare for your Hospital pre-reg interviews.  Read more Preparing for your Hospital Pre-Reg Interviews

Top tips for your pre- registration year

RPS member Morenike Adeleke has just completed her pre reg year, check out her fantastic advice to anyone just starting out.

I did my degree at Medway School of Pharmacy and completed my pre-reg year with Delmergate Ltd, a small independent 20160724_185642chain of pharmacies in Kent. I actually lived out for the year as I’m based in London but the branch was located in Herne Bay. I was nervous about living out, since it was a very rural area and I didn’t know anyone. I did miss home a lot but I was able to go home at the weekends so it wasn’t all bad.

My tutor gave me a lot of freedom to assist her in doing services, and she also gave me a lot of time on the counter. This greatly boosted my confidence. Whenever the counter assistant was off, I would cover for her. This meant that I could put my OTC knowledge into practice, and I became very confident with dealing with patient queries.

Some key highlights were when I supplied salbutamol inhalers to a school and organising all of that, forging a relationship with the GPs at our neighbouring surgery (and all the subsequent prescription issues I sorted out), seeing how a pharmacist can check a patients INR and dose their warfarin, discussing prescription issues with hospital consultants (once a patient had got a hospital prescription with someone else’s details on it), seeing how a pharmacist tests a patients’ cholesterol, blood glucose and blood pressure, the time we thought a box of morphine had been stolen, discussing a patients inhalers after we discovered they were overdosing COPD medication, a safeguarding issue, and an inspection! I was very fortunate to see a lot of things during my pre-reg year, and I built a good rapport with a number of our patients.

I would advise all pre-regs to begin revision from day one. Have a notebook so you can write down everything you have seen, and everything you want to look up. I did this and I found it helpful, because sometimes work gets too busy to look something up, and then you forget what you wanted to research.

Learn absolutely everything there is to know, from how the pharmacist conduct MURs or ward rounds, to how the end of month paperwork is submitted. Lay out a weekly plan for revision and follow it, but leave it flexible to change. Deal with as many queries as possible, and ask as many questions as possible. If you’re not sure, CHECK! There’s no need to feel silly. If a patient asks a question and you’re not sure, just say “I’m sure it’s this but I’m just going to double check to be safe”. Most patients like it when you’re thorough.

Don’t be afraid of patients or talking to them. This is especially important if you’re in community. You’ve got a Masters in Pharmacy, so you know your stuff. Also, don’t get intimidated. I found that some patients thought they could get me to sell things to them because they see a young and inexperienced person. Be confident and stand your ground.

The RPS pre-reg associate membership was very helpful throughout the year. I went to some local practice forums, and I used a lot of the resources, especially the guidance on OTC medicines. I am an RPS member and I also attended the revision weekend with Nadia Bukhari, which I found beneficial.

As for tutors and progress reviews, I would write up evidences throughout the year so that when your review comes up, you aren’t stressing over it. Also, don’t get stressed over it. It’s just a meeting with your tutor to discuss your progress. Keep doing the right things and you will be fine.

It can be daunting at first when you’re fresh out of university and you’re working with staff who know your branch inside out, but you are training to be a pharmacist and you should be respected. At the same time, don’t Lord that fact over them!

Make every task you do related to your study or your practice as a future pharmacist. When dispensing, think of what all the medicines are for, side effects etc. Review the prescription for legal and clinical appropriateness. When doing controlled drugs, review the laws in your head. When you’re on the counter, look at all the medicines, and revise them there and then. Look at the patient leaflets etc. It’s your opportunity to do that.

Find out more about RPS membership for pre-registration trainees.

Pharmacist prescribing – past present and future

Kirsty Chambers 2Ravi-Sharma1-300x225By Kirsty Chambers (Clinical & Operational Lead Pharmacist GP Connect) & Ravi Sharma (Head of General Practice Pharmacy at Green Light and Senior Clinical Practice Pharmacist at Honeypot Medical Centre)

Over the last two decades non-medical prescribing has undergone something of a revolution. 1986 was the breakthrough year when district and community nurses were granted limited prescribing rights; through the 1990’s the Nurse Prescribing Formulary was developed and when the new millennium dawned pharmacists started to get involved. Presently, the list of allied healthcare professionals (AHPs) that have some level of prescribing privileges is almost unrecognisable from when the concept of non-medical prescribing was born.

As the new Prescribing Competency Framework is published, more and more people are undertaking their prescribing qualifications in response to the huge increase in demand for prescribers. As NHS burdens intensify on a daily basis we must utilise each profession’s skill to their maximum level. Whilst trying to fulfil the almost impossible task of providing more by spending less, there needs to be an acceptance and push for more integrated working and an awareness of how to extract the most out of the available skill mix.

New ways of working and developing models of care via the standardisation of prescribing amongst healthcare professionals should lead to an increase in quality, safety, efficiency and ultimately better patient outcomes. The Prescribing Competency Framework incorporates ‘shared decision making’ and ‘prescribing as part of a team’ as key components. This is about building a relationship with both the patient and other colleagues that are involved in their prescribing journey. Continuity of care and mutual understanding of each other’s purpose can only enhance the services and quality of care we are offering.

In our workplaces there are multiple prescribers – nurses, GPs and pharmacists. We have established an excellent relationship that allows each of us to contribute effectively to the patients without duplication or omission. A number of examples where as a collaborative team of prescribers we have been able to provide better support and management to those with complex long term conditions as well as some of our most vulnerable patients (elderly, housebound, mental health). This framework will allow us to develop our understanding further and learn to work in partnership even more effectively. It can also be straightforwardly used to support yearly appraisals and eventually revalidation.

The NHS values of person-centred care and ‘no decision about me without me’ are prominent throughout the framework. It ensures prescribers work safely and effectively while allowing development of scope and the ability to work at maximum skill level by having competencies underpinning your professional responsibility as a prescriber.

Medicines have the potential to significantly improve the quality of lives and patient outcomes if prescribed appropriately. We have been given a chance to get this right with the framework as a fundamental tool to encourage higher standards for prescribing and united working between professions. The future of prescribing looks bright.

 

The coming revolution in personalised medicines

Mike Hannay - Small

Mike Hannay MRPharmS

The decoding of the human genome has paved the way towards a silent revolution currently ongoing within the pharmaceutical industry; its name is personalised medicines and the effect this is set to have on the wider healthcare system within the next ten years is profound.

As a direct result of the human genome project the understanding of the genetic basis of disease has grown to a level which was unforeseen even 5-10 years ago. The implications for this on patient care are staggering, soon medicines will no longer be selected for patients according to empirical guidelines, but will be matched as a result of their individual genetic makeup. We will be able to select the best drug for that patient from within its class based on the accelerating body of evidence currently being acquired. Further tests carried out on specific metabolic processes coupled with precise in situ-drug formulation technologies such as 3D printing will allow for highly accurate dosing resulting in more optimal plasma levels, with a reduction in adverse drug reactions.

This may sound like science fiction, but the technology is already here, the first 3D printed medicine has recently been approved by the FDA, furthermore genomic sequencing costs have reduced steadily from $10 million in 2006 to around $1000 in 2016 and continue to decline, meaning it will soon be economically feasible for widespread application. The impact that these changes will have on the development, selection, optimisation and supply of medicines is difficult to understate.

Community pharmacies are in the best position to put personalised medicine into practice by facilitating the selection, optimisation and supply of personalised medicines; no other group of scientists or clinicians is better able to accomplish this, however this can only happen if the profession acts now to take on the knowledge and expertise needed to fit into this emerging care pathway.

What is required is for pharmacy educators to integrate the teaching of personalised medicines into their course material. The science behind medicines is at the heart of pharmacy education, and this is the reason the profession is respected as the authoritative source of information when it comes to the science of medicines. If this is to remain the case then pharmacy educators must keep abreast of these new changes and ensure that both new and current members of the profession are thoroughly informed on what they need to know, and how they can apply it.

I’ll be speaking at the RPS conference this year to outline these changes, the impact they’re set to have on the profession as a whole, and how best we can plan to be ready for them as they are unveiled in the coming years.

The RPS conference will be held in Birmingham, Sunday 4 September – Monday 5 September 2016. Find out more about key issues affecting pharmacy and how we can solve them.

To secure your place at the RPS 2016 Annual Conference visit: www.rpharms.com/RPSconf16

Supporting The Changing Role of Pharmacists within Primary Care

By Paul Gimson MRPharmS

Improving medicines safety and ensuring quality improvement are vital components required for the maintenance and growth of any modern healthcare system. There are a multitude of healthcare professionals which make valuable contributions to this field, but as pharmacists increasingly find themselves working in new sectors, including primary care, the opportunity for the profession to increase its impact on quality improvement is expanding. 1000 lives Wales started as a two year healthcare improvement initiative, seeking to save 1000 lives and prevent 50,000 episodes of harm within NHS Wales. The campaign initially ran from 2008 until 2010, however after reaching its initial goals the methodology used by the campaign was expanded into new areas, forming 1000 lives improvement which continues to this day.

In 2015-16 we worked with over 40 partners to deliver 182 events, and through our ‘improving quality together’ programmes we’ve provided training to over 8,000 people. Together with NHS Wales working with the aim to reduce harm and improve patient safety we’ve been involved in quality improvement programmes, designing services related to maternity care to mental health.

I work with 1000 lives Wales as the lead for primary care, seeking to integrate our philosophy of quality improvement within this sector. The emerging roles for pharmacists within the primary care sector in GP practices and care homes, which we’ve seen becoming increasingly widespread across Wales as part of the new primary care plan for Wales, form an integral part of this strategy.

I’ll be speaking at the RPS conference this year to highlight the importance of quality improvement.. I will discuss the new primary care model that is emerging in Wales, and the changing and growing role that pharmacists are playing in it.

The RPS conference will be held in Birmingham, Sunday 4 September – Monday 5 September 2016. Find out more about key issues affecting pharmacy and how we can solve them.

To secure your place at the RPS 2016 Annual Conference visit: www.rpharms.com/RPSconf16

Identifying Education, Training and Development as part of your Faculty portfolio

Professor Bryony Dean Franklin FFRPS MRPharmS

When it comes to the Faculty, the general advice I’d heard was toBryony dean portrait April 2013 start with the cluster you’re most comfortable with, that’s why I’d left Education, Training and Development until nearer the end. However when it came to starting this cluster I was more certain of the process, therefore I found it much easier than I had first anticipated. I started by downloading the Faculty Core Professional Practice Curriculum for Education, Training and Development from the RPS website. This includes six individual competencies:

  • Role model
  • Mentorship
  • Conducting education and training
  • Professional development
  • Links practice and education
  • Educational policy.

I then read the general descriptions for each of these competencies, together with the specific descriptions for each of the three levels (advanced stage I, advanced stage II, Mastery) I did some brainstorming to come up with examples of my practice that worked with each competency including what evidence I could provide for each.  I scribbled these thoughts on the curriculum document as I worked through it.

As with all of the clusters, I found some of the competencies harder to address than others and for some of them I initially couldn’t think of anything at all. To avoid getting ‘stuck’ I initially tackled those I felt were easier, and came back to some of the others later. I found that for those I was struggling with, if I left it for a week or so I often came up with examples of what I do on a daily basis that fitted the competency – sometimes things that were so obvious that they hadn’t occurred to me initially.  For example, I initially drew a blank for ‘role model’ and ‘mentorship’, but then it occurred to me that a key part of supervising PhD students is to act as a role model and mentor to the student as well as supervising the research.  I think we sometimes take for granted what we do every day.  I was then able to come back and fill in the gaps. There are also some useful tables at that back of the curriculum guide that suggest the knowledge, skills, experience and behaviours for each competency at each of the three levels.

Once I had identified some key pieces of evidence that would address one or more of the competencies, I entered these into the online system.  Since each piece of evidence can have multiple mappings, I tried to pick evidence that would address several competencies to save having to enter too many.  I tried to ensure that the ‘description’ field would be clear to another reader without knowing anything about my particular role, and that I was fairly explicit about how it addressed the competencies concerned. I then mapped the entries to the relevant competencies.  This meant that clusters I did later would already have some evidence mapped onto them, and there were fewer new entries that I needed to make.

I completed the whole Faculty process on my own as there weren’t many other pharmacists I knew doing it at that time – I was in the first wave of Faculty members. However, I’d recommend brainstorming the competencies and suitable sources of evidence with a colleague if possible as I am sure this would be more effective and more motivating.

I found the whole process very useful in identifying any gaps in professional expertise to allow a more focused approach to professional development.  Getting started and entering the first piece of evidence is the hardest – once you have done one, the rest are much easier!

Log in to continue building your Faculty portfolio.

Congratulations to Nadia Bukhari on her achievements as the youngest Female Asian Fellow

Nadia SmallNadia Bukhari has been interviewed by National and International media, as she makes history being the youngest Asian and youngest female to be awarded the status of Fellow of the Royal Pharmaceutical Society. Being a Fellow is the highest recognition that is awarded to RPS members and is an honour which recognises excellence in an individual’s pharmacy career. Read more Congratulations to Nadia Bukhari on her achievements as the youngest Female Asian Fellow