Integrative medicine approach to treating cancer patients

By Louisa Davies, Senior Clinical Oncology Pharmacist at University College of London Hospital

I love my job! I’ve been a qualified clinical pharmacist for 12 years and am very fortunate to work at the wonderful Macmillan Cancer Centre at University College Hospital in London as a specialist oncology pharmacist. I find it immensely rewarding as every day is an opportunity to support someone along their cancer journey.

I have a personal interest in wellness and the growing use of supplements for health and over the past few years I have seen more and more patients adopting an integrative approach to their cancer care. At UCLH we recorded that around 35% of patients we saw in clinic were taking or wanted to start taking supplements to improve their side effects or boost their immunity whilst on anti cancer therapy. Read more Integrative medicine approach to treating cancer patients

Revalidation for pharmacy professionals

By Nigel Clarke, Chair, General Pharmaceutical Council

Over the past three years, the General Pharmaceutical Council has done a great deal of work on professionalism – how to ensure that the standards we set support professionalism; and, as important, how to assure patients and the public that registrants are upholding these standards and keeping up with their knowledge and skills, and with new developments in the professions.

This work has coincided with a period of change in the pharmacy sector – changes in the healthcare landscape, the role of pharmacy and the expectations placed on pharmacy professionals; and changes in the core knowledge and skills required to deliver safe, effective, person-centred care.

As a part of this effort, we have engaged with members of the profession, with patients, and with other healthcare professionals to hear their views on professionalism, and, in particular, how they can be assured that pharmacy professionals have up-to-date knowledge and up-to-date understanding of issues affecting healthcare, pharmacy and the way care is delivered.    Based on their feedback, and underpinned by the findings in the pilot programme we undertook last year to test our approach, we have proposed to introduce revalidation for pharmacy professionals.   That proposal is the subject of our recent consultation on revalidation.

.    Our approach aims to do away with exhaustive record keeping and ‘tick-box’ exercises – which many registrants felt were no longer fit for purpose, and the public find hard to equate with professional development – and introduce a more thoughtful approach to ensuring that professional development is not just documented, but embedded in practice.    Our proposal incorporates peer discussion, and reflection on the GPhC’s standards for pharmacy professionals and registrants’ individual practice to provide meaningful reassurance to the public that real learning and improvement are taking place.

Among the key changes we are proposing with revalidation are: reducing the number of required CPD records from nine to four; conducting a peer discussion with a colleague or someone who understands your work; and writing a reflective account detailing how you are meeting one or more of the standards for pharmacy professionals. We are also proposing that, rather than ‘calling’ records periodically for review, the GPhC would require them to be submitted annually; with a small sample (about 2.5 per cent) randomly selected for review.

This approach is designed to underpin the professional approach of pharmacists and pharmacy technicians, and reflects too the way in which other professions are now engaging in revalidation. It is based upon the view that a consistent pursuit of improvement in practice is the best way to ensure ongoing high standards within pharmacy, and with it greater safety for the public and patients. During our initial pilot, this approach has been widely supported by the professionals who took part.

I would encourage all pharmacy professionals to weigh in with their views on our proposal.  Have there been any points or considerations that we’ve missed?  Are there any changes that we need to make?  Are there emphases that we’ve not properly understood?

And while it is likely that the final plan will not come into effect until 2020, pharmacy professionals can and should begin to prepare themselves now for the inevitable changes that will come from this effort.

As a start, I would encourage all registrants to read the new standards for pharmacy professionals, which sit at the heart of the proposals for revalidation.   Understanding the standards and thinking how they can and should be embedded in practice will be an important best practice to embrace in preparation for revalidation when it comes into effect.

Registrants can also begin to talk about their practice with their colleagues and peers.  The idea of a ‘peer discussion’ may feel daunting at first, but many of our pilot volunteers realised they were already having these kinds of conversations, albeit informally, and that the candid insights and advice they received helped to improve their practice.    So, I would urge you to reach out to colleagues and peers, or perhaps tap into the resources available to pharmacy professionals, such as the RPS Faculty, and start these conversations.

Revalidation will be an important step for the pharmacy sector and for the GPhC as its regulator.   Aside from assuring the public that pharmacy professionals are maintaining high standards of practice and improvement, our revalidation proposal represents our commitment to regulating in a way that is flexible, that supports professionalism and that is fit for today’s pharmacy and healthcare environment.  I look forward to sharing some of the feedback we hear from our consultation when I speak at the RPS conference in September.   I hope to see you there.

Better information on patient information leaflets

By Professor D.K Theo Raynor, Professor of Pharmacy Practice, University of Leeds
A new report published by the Academy of Medical Sciences says that medicine information leaflets are too scary with too much focus on the potential side-effects of medicines and not enough on their benefits. The report calls for them to be rewritten to give a more balanced view.

This is a comprehensive and thoughtful report looking at enhancing the use of scientific evidence to judge the potential benefits and harms of medicines. Of particular interests to those working in Pharmacy are the recommendations relating to patient information leaflets (PILs) – found in the pack of every medicine dispensed in the UK. The key recommendations relating to ‘Improving the content of PILs’ are:

• All parties to improve the comprehension and readability of patient information leaflets in line with the current legislation.
• This should ensure a balanced appraisal of the medicine’s potential benefits and risks is made accessible in these documents.

These recommendations echo the recent report for the European Commission on the ‘shortcomings’ of PILs produced by the Universities of Utrecht and Leeds.(1) Not mentioned in the Academy’s report is that for more than 10 years, manufacturers have had to ‘user test’ their PILs with lay people – so they are already ‘revised in consultation with patients and carers’. Despite this testing, further improvements are needed, with a more rigorous application of the user testing process, ensuring that it is iterative – with repeated testing and improvement until the required level of readability is reached. Read more Better information on patient information leaflets

A medicine review is about stopping medicine as much as it is about prescribing

By Dr Mahendra Patel, English Pharmacy Board Member

The RPS has published a joint report with RCGP on polypharmacy “The challenge of polypharmacy: from rhetoric to reality”. The report is a practical guide for the delivery of improved care and increased safety of our patients.

Multimorbidity is perceived as an inevitable consequence of an ageing population, with increasing ‘polypharmacy’ necessary to prevent complications arising from long term conditions.  Patient conditions are often treated individually and they are prescribed medicines accordingly. However, medicines that were once prescribed may no longer be necessary as well as in some instances new medicines may not be required. Pharmacists have a key role in supporting patients to get the most out of their medicines and ensure that they are only taking the medicines that they actually need. Read more A medicine review is about stopping medicine as much as it is about prescribing

Research is everyone’s business

By Sonia Garner, Research Support Manager, RPS

Research is a young person’s game, an academic career pathway, something that doesn’t apply to me – to me, a middle-aged pharmacy professional with a background in community pharmacy support.  So it was with some trepidation that I found myself booked into the NHS Research and Development (R&D) Forum Conference in Manchester, May 15-16 2017: not only booked in as a delegate but with a poster presentation and an RPS stand to man.  So how did this come about?

Ten months ago I was appointed to cover a maternity leave position at the Royal Pharmaceutical Society (RPS) as a Research Support Manager with responsibility for the Research Ready accreditation scheme for community pharmacy. Read more Research is everyone’s business

What is the concern about Atrial Fibrillation?

Sharron

By Sharon Gordon, Pharmacist Consultant Anticoagulation & Faculty Fellow of The Royal Pharmaceutical Society

Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia affecting 1-2% of the UK population. AF is affecting approximately 10% of the population over 75 years old and 18% of those over 85 years old. It is a predominant cause of stroke and a serious concern in in our aging population. Clinical outcomes in terms of increased disability are considerably worse for AF-associated stroke and mortality from stroke is doubled in patients with AF. Read more What is the concern about Atrial Fibrillation?

How to get an NIHR research fellowship

Mandy WanBy Mandy Wan, Lead Paediatric Clinical Trials Pharmacist at Guy’s and St Thomas’ NHS Foundation Trust and HEE/ NIHR Doctoral Research Fellow

I was delighted to hear just before Christmas that I was successful with an NIHR fellowship application and want to encourage more pharmacists to apply for funding and to lead research.

I have been a paediatric clinical trials pharmacist for most of the past 10 years, so am lucky to already be closely engaged in research work and have an understanding of how research can really impact day to day practice.
I applied for NIHR funding 2 years ago but I wasn’t successful. This time, I decided to apply again with a different topic. My research question came from a common query that kept coming through to the pharmacy department; what dose of Vitamin D is appropriate in children? Read more How to get an NIHR research fellowship

The rise of antibiotic resistant bacteria

Dr Jacqueline Sneddon

Dr Jacqueline Sneddon MRPharmS FFRPS
Project Lead for Scottish Antimicrobial Prescribing Group

Consider this scenario. Your younger child has been awake all night, crying with earache. They’re upset and tired, and so are you. Your older child had a flu bug last week, and you have already taken three days off work to look after them. You’ll take the little one to the doctor in the morning and get antibiotics to clear it up. You’ll probably have to pester the GP for them, but you’ll do it so your child feels better quickly and you can go back to work sooner.

In addition to being really worried about our little ones, as parents, we also have to cope with the guilt of being away from work for too long, and for many parents this is unpaid leave.
The sight of a poorly child is an upsetting one. The hope that antibiotics will reduce the time our children suffer with pain, sometimes means that exhausted and worried parents demand a prescription for antibiotics, even though the GP didn’t really think they were necessary. Read more The rise of antibiotic resistant bacteria

Stop the over medication of people with learning disabilities

david-banford(1)By David Branford, Chief Pharmacist, Derby Hospital


The nation was shocked by the Panorama expose of cruel behaviour to people with a learning disability living at Winterbourne View in Bristol. The subsequent enquiry not only raised many concerns about the care of people with a learning disability but also about the use of antipsychotics and antidepressants.

Subsequent investigations and actions took two paths. The first, a series of studies demonstrated widespread use of many categories of psychotropic drugs often in combinations. In addition there was widespread use of PRN psychotropic drugs. The second was NICE guidelines relating to aspects of treatment of people with a learning disability.
Stopping Over-medication of People with Learning Disabilities (STOMPLD) 2016 is a campaign launched by Alistair Burt today. It aims to improve the quality of life of people with a learning disability, by reducing the harm of inappropriate psychotropic drugs which are used as a “chemical restraint” in place of other more appropriate care and treatments. Read more Stop the over medication of people with learning disabilities

My Faculty Journey

JOnathan Burtonby Jonathan Burton

I guess I had several motivations for wanting to join the RPS Faculty. I liked the idea of gaining some recognition for being committed to my job, always trying to do things better and taking a real interest in my profession. I also thought it would be a useful process in terms of helping me identify my weak areas of practice, I’m a contractor as well as a patient facing pharmacist so I find it quite difficult to access peer review, I’ve always sort of made up my professional development as I’ve gone along! Read more My Faculty Journey