The future is accessible

by Helen Reilly, Head of External Relations, RPS in Scotland

This International Day of People with Disabilities, I attended Inclusion Scotland’s The Future is Accessible 2019 event on behalf of RPS. I wanted to find out about the practical things that employers can do to help reduce the disability employment gap.  

In Scotland, data shows that in 2018 the employment rate for those classed as disabled under the Equality Act 2010 was 45.6 per cent which is significantly lower than the employment rate for non-disabled people (81.1 per cent). Scottish Government has committed to halving the disability employment gap by 2038.

Workplace benefits

By delivering more inclusive workplaces and improving employment practice for disabled people employers can secure a range of benefits. A more diverse workforce provides a wider perspective, offering insights for decision-making, and leading to the delivery of services that better meet the needs of all people.

At the event we heard from a number of employers about their positive experiences of recruiting an Inclusion Scotland intern and the benefits this brought to the whole team. We also heard from those with lived experience of the barriers faced by disabled people seeking employment. 

Kiana Kalantar-Hormozi, a previous intern from Evenbreak, told us ” The truth is that we’re innovators, creative-thinkers and problem solvers. So it’s time to rethink recruitment strategies to benefit your organisation – are you missing out on untapped talent?”

Small changes matter

There are some small and simple changes that organisations can make to their recruitment processes and ways of working to make their workplace more accessible for disabled employees. These include looking at working hours, increasing flexibility and offering interview support. 

There were also presentations from interns about their employment journeys and the opportunities that getting work experience opened up for them. Mags Moore of Sopra Steria saw their intern gain confidence and become a valued member of the team. 

She said, “There is an amazing talent pool waiting to get a foot on the employment ladder. You can give them that chance”.

Disability Confident

Diversity and inclusion is important at all levels in the workplace as it helps employees to feel accepted and valued. Staff who feel valued and supported are more likely to give their best and be motivated to be more productive, creative and innovative. This is why RPS has committed to improving how we recruit, retain and develop people with disabilities by signing up to the Disability Confident scheme, which supports employers to make the most of the talents people with disabilities can bring to the workplace.

Mags Moore told us that she believed that TEAM stands for Together Everyone Achieves More and I think this is a very fitting reflection of how diversity in the workplace benefits everyone.

Get your flu vaccination!

by Paul Bennett, RPS Chief Executive

I’ve had my seasonal flu vaccination – have you had yours?

It’s become part of my routine, and I make sure I get a flu jab every year. I get it to make sure I stay well, along with the people I come into contact with who may be vulnerable, my family and colleagues.

It’s a very sensible precaution because influenza is easy to pass on, even if you don’t show symptoms. It can have a devastating impact if it takes hold.  Every healthcare professional working with patients should get vaccinated – it’s not too late.

We often think of flu as something little more than a bad cold.  It’s so much worse than that, In 2018/19, there were an estimated 1,692 deaths associated with flu.

Flu has a legacy of tragedy behind it.  The 1918 influenza pandemic killed more than both WW1 and WW2 combined.

We experienced something, thankfully on a less devastating scale, in more recent times. Back in the last decade, the UK suffered as part of the outbreak of Pandemic H1N1/09 (or Swine flu as it became known).

At its peak there were estimated to be 110,000 active cases in a single week in the UK. This caused much disruption to the lives of many of us. I remember spending days planning for massive workforce disruption as part of the leadership team of my organisation at the time. Our challenge was to support ill colleagues while continuing to serve the patients who depended upon us. Maybe that’s why I take these things seriously.

The RPS supports the call for all healthcare professionals to be vaccinated. It’s just common sense and yet not enough do. And every year, the Chief Medical Officer and Chief Pharmaceutical Officers call on healthcare workers to be vaccinated. As the professional membership body for pharmacists, we must lead by example, and that’s why I encourage all our employees and members to do the same thing. Protect yourselves, your family and the rest of the population.

Working for you on workforce wellbeing

by Sandra Gidley, RPS President

The extent of workforce pressures on the mental health and wellbeing of pharmacists, pre-regs and students is shocking. 

When we asked you to tell us about your experiences in our workplace wellbeing survey in September, over a 1300 of you responded in a fortnight.  Thank you to everyone who shared their stories with us and our survey partner, the charity Pharmacist Support.

Pharmacists all over the country told us they are suffering from severe stress and burnout because of the pressures they are facing at work.

This is totally unacceptable.

The data you have provided us with is powerful. Our next step is to lobby governments, NHS and employers across Great Britain to make sure all pharmacists get equal access to wellbeing support.  At present, only those pharmacists employed directly by the NHS get access to help, alongside doctors and dentists, who get it regardless of where they work.  We are fighting for all of you to get the same support.

Key themes

Workplace pressure contributes significantly to poor mental health and wellbeing.  Some of the themes we’ve picked up include how poor mental health is not specific to one sector of practice, it can affect all pharmacists wherever they work.  A large proportion of respondents told us they are at a high risk of burnout.  Many of you have also said that you’re very concerned about the effects your stress has on patient safety. In addition, survey respondents feel that workplace pressures can cause people to disengage from their role, creating personal unhappiness and a less productive workforce.

Campaigning for you

Our lobbying work around this is now focusing on getting preventative measures in place and structured mental health and wellbeing services for all pharmacists. I’d go as far as saying that the NHS is at risk of creating workforce inequalities by providing support services for some staff and not others. We need to learn the lessons from the workforce pressures our GP and nurse colleagues have experienced, rather than make the same mistakes.

Next steps

In December we’ll be publishing a summary of the topline survey results and will provide a more detailed report in Spring 2020.  We’ll then hold a roundtable with key stakeholders to identify solutions to the problems raised in the survey.  We’ll continue to engage with you, the NHS and government to get equal access to the right support for the profession.

Confidential help

Remember, if you’re struggling to manage your wellbeing, you’re not alone.  Pharmacist Support – the profession’s charity – has free and confidential services that may help.  For information, a stress helpline, specialist advice, wellbeing workshops and online resources visit Pharmacist Support info@pharmacistsupport.org  or call 0808 168 2233.

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 

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.

Our mentoring relationship

Being a mentee: Aamir Shaikh

I met my mentor Aamer Safdar whilst working at Kings College London. I was the 3rd year Professional Lead, and was introduced to him and he told me about his background, both personal and professional.  Just by listening to him, I knew that his values were similar to my own. 

Challenge

I now work at BUPA as the Chief Pharmaceutical Officer’s Clinical Fellow, but before that I worked within the Education Directorate at RPS.  It was there I worked alongside Aamer in projects involving undergraduates.  You will hear that pharmacy is a small world and this is one such example!  My manager explained how it is important to work alongside colleagues who will challenge your thinking and I found this in Aamer.  Our mentor/mentee relationship first established when we went out for dinner as a post-work group; it was here when I decided to formalise my mentor/mentee relationship with him. 

Benefits

I’ve benefited greatly from the mentor/mentee relationship. It’s given me thinking space but its been advantageous to both my personal and professional life to have someone to challenge my own thinking in whatever situation or scenario I am experiencing.  In our last meeting Aamer and I spoke about authenticity, congruence and integrity.  I found it particularly useful hearing from someone in Aamer’s position, a current GPhC Council member and previous RPS English Pharmacy Board member, about how important it is to stay true to your own values and what these values really mean.

We use the RPS mentor platform to record our meetings and have found that, as well as the normal methods of keeping in touch, the platform has been beneficial in keeping us focused. I couldn’t stress the importance of having a mentor enough.  It has really helped me focus whenever I have found myself in a sticky situation and I’m grateful for the time Aamer has shared with me.

Being a Mentor: Aamer Safdar

I have been a mentor to many people inside and outside of pharmacy and have used a variety of methods with my mentees which have included traditional face to face sessions as well as mentoring exclusively by email and by phone; in the latter two cases, I never met my mentees in real life until much later in our relationships! 

I currently mentor two pharmacists, at different stages in their careers, using the RPS mentoring platform.  The platform is useful because I have outlined the areas in which I would like to mentor in to manage my mentees’ expectations. 

Sharing experiences

In both of my meetings, we spoke about our careers and challenges at different levels and I was able to share my experiences and wisdom from both my day job and from being in national boards.  Much of my wisdom has come from my own mentors, who have been different people at different stages of my career,and with different perspectives and advice.  Without a mentor to bounce things off, I doubt I would have done many of the things I have done in my career.

Find out more about our mentoring scheme exclusively for members

Strengthening Antimicrobial Stewardship through training

by Vincent Ng, Professional Development Pharmacist

The challenge   

This year the UK Government updated its 5 year action plan on Antimicrobial Resistance (AMR), which details ambitious goals such as reducing antimicrobial usage in humans by 15% and halving gram negative blood stream infections by 2024.

A major part of this plan involves improving how antimicrobials are used through Antimicrobial Stewardship, for example by reducing inappropriate prescribing. As experts in medicines and advocates for medicines optimisation, all pharmacists have a role to play.

Supporting pharmacists through training

Earlier this year, we delivered a 3-month training programme to pharmacists from primary and secondary care in London, Kent, Surrey and Sussex, funded by the Health Education England AMR Innovation Fund. This was an exciting opportunity for us to support pharmacists from a range of settings and scopes of practice to learn about Antimicrobial Stewardship and get involved in their workplace.

What did the training involve?

  • Face-to-Face training day delivered by national experts
  • Quality improvement project in the workplace, supported by online group feedback sessions facilitated by UKCPA Pharmacy Infection Network tutors
  • Structured self-assessment and self-directed learning
  • GPhC revalidation entries
  • End of training assessment with experts from our Antimicrobial Expert Advisory Group

What our learners are saying

“I was given the opportunity to be part of the AMR programme this year and found the programme very useful. It has propelled me in the right direction with regards to leading on AMR within my organisation.  The key resources provided during the programme and the link to a tutor gave the confidence I needed to complete my project. My quality improvement project involved the review of patients with UTI to ensure appropriate prescribing and accurate documentation process.  Although the project was only focused on a small cohort it was very useful to see the changes and improvement that was made. I have not just stopped with the project but have also made myself an AMR champion with AMR now formally included in my work plan. I am now creating a training matrix to increase awareness within my organisation.”

Jenkeo Olowoloba, Community Health Specialist Pharmacist, Medway Community Healthcare

“The training helped me develop my skills as a competent and confident AMS practitioner. Participating in this training programme enabled me to significantly improve my quality improvement skills, extending my skills beyond audits and re audits. I demonstrated QI methodology and embedded behavioural interventions to improve the quality of the 72-hour antibiotic review carried out by clinicians.  I also designed a scoring tool on the Perfect Ward App to measure the quality of an antibiotic review which led to reducing data collection time from 15 minutes to 5 minutes. I enjoyed the entire experience and valued the constant support provided by our tutors, RPS team and colleagues. The practice-based discussions benefitted my practice significantly, being able to share ideas and learn from experts as well as each other. Thank you RPS for an amazing opportunity!

Bairavi Indrakumar, Senior Clinical Pharmacist, Royal Free London NHS Foundation Trust

Getting started

Take the first step by finding out more about how your organisation is doing against key AMS indicators. Work with your peers and colleagues to better understand how things are working. PHE Fingertips and OpenPrescribing.net are examples of useful open-access sources of data that you can explore.

Talk to your key stakeholders to come up with shared objectives and work together on a plan to make improvements.

Inspire and get inspiration

Why not link up with others who are also working on AMS and AMR?

Update! We’ve been commissioned to provide AMS training in England in 2020. Find out more and book your place.

We are undefeatable: join the campaign to get active!

by Suzanne Gardner, Sport England

You may have seen the “We Are Undefeatable” campaign from 15 leading health and social care charities and Sport England.

It aims to support people living with health conditions to build physical activity into their lives, in a way that their condition allows, and to celebrate every victory big or small.

The TV adverts you’ll have seen are inspired by, and feature, the real-life experiences of people with long-term health conditions getting active despite the ups, downs and unpredictability of their condition.

Pharmacists already play a key support role for the 1 in 4 people now living with at least one long-term health condition. People with health conditions are twice as likely to be inactive[i] despite the compelling evidence for the role of physical activity in the prevention and management of long-term conditions.

Want to get involved? Check your activation pack!

Many pharmacists are already supporting people to get active through the Healthy Living Pharmacy scheme. To help you make the most of the national campaign 12,000 Community Pharmacies in England have been sent activation packs, which include:

  • An activation brief providing details about the campaign and links to resources to support you to have physical activity conversations with customers. These include the Faculty of Sport and Exercise Medicine’s Moving Medicine resource (developed in partnership with PHE and Sport England), the Royal College of GPs Physical Activity and Lifestyle Toolkit and the PHE E learning for health physical activity modules.
  • 2 A4 posters featuring Jo and Heraldo (Two of the Undefeatables).
  • 100 conversation starters and a dispenser for these for use in the pharmacy.
  • Access to a campaign film for use on screens
  • Social media content.

Healthy Living Bonus

The great news is that these resources can also be used to help meet the Healthy Living Pharmacy requirements linked to lifestyle advice and physical activity.

And if the campaign inspires you to get active yourself it’s a bonus!

Further copies of these resources can be accessed through the Public Health England Resource Centre  https://campaignresources.phe.gov.uk/resources


[i] (Sport England (2019) Active Lives Survey 2017/2018).