Practice as an Independent Prescriber (IP) involves continuous learning, continuous quality improvement if you like, to ensure that practice always advances to meet patients’ needs.
I see the link between the RPS Faculty and the IP role as a virtuous circle. Prescribing helps my Faculty portfolio, which in turn helps my continuous development as an IP. My prescribing role, subsequent mentorship of colleagues and teaching contributed to my Faculty portfolio, particularly in clusters 1 and 5, ‘Expert Professional Practice’ and ‘Education, Teaching and Development’.
My lifelong RPS Faculty portfolio, using the Advanced Pharmacy Framework (APF) provides a structure to reflect on practice and to record my Continuing Professional Development (CPD), particularly prompting me to always consider the benefit to my patients. Feedback from patients is particularly useful in noting the service impact for CPD. My CPD recording is a reminder of the importance of reflection and learning for future service provision.
There are frequent learning opportunities, often several daily, prompted by the APF. Here are three summaries of portfolio entries which can map to many further competencies, for example sharing and discussing these can be mapped to ‘6.4 Creates Evidence’:
1. A GP colleague asked my advice on prescribing an unfamiliar antibiotic recommended by a microbiologist prophylactically for a patient with recurrent urinary tract infections. I discussed this with the local antibiotic pharmacist and following consultation with microbiology, prescribed a urinary antiseptic liaising with the patient and community pharmacist colleagues, thus reserving the antibiotic for treating any possible recurrences. Maps to competencies: 1.1 Expert Skills and Knowledge; 1.2 Delivery of Professional Expertise; 1.3 Reasoning and Judgement, 2.1 Communication; 2.2 Teamwork and Consultation.
2. I helped a patient in my medication review clinic be more informed about the benefits of his hypertension and statin treatment and how to cope with possible rebound acid if he decreased his omeprazole dosage. From initially being hesitant about seeing a pharmacist prescriber, having previously consulted only a GP or practice nurse, he subsequently sent a note to the Medical Director supporting the multi-disciplinary team concept and provided a comment for my RPS revalidation pilot. Maps to competencies: 1.1. Expert Skills and Knowledge; 1.4 Professional Autonomy; 2.1 Communication; 2.2 Teamwork and Consultation.
3. When a regular hypertension review patient requested strong opioids for back pain, I assessed his back pain risk, referring him to an Occupational Therapist led ‘Back Skills’ course, thereby helping him avoid inappropriate treatment and possible escalating dosages. Maps to competencies: 1.1 expert professional practice; 2.1 & 2.2 collaborative working relationships; 3.6 motivational (of patient to accept alternative strategies); 6.1 critical appraisal of evidence and application to individual patients.
For ongoing CPD, I strongly recommend getting to know the Advanced Pharmacy Framework and how its structure can help focus your CPD.
The RPS Competency Framework for all Prescribers, accredited by NICE, supports all prescribers in their practice.
Rob Davies was awarded membership of the Faculty in 2014. He qualified as an Independent Prescriber in 2008, subsequently running a hypertension and cardiovascular risk clinic in a 6000 patient town centre GP practice. He now works in the BCU Health Board run innovative multi-disciplinary primary care service of ‘Healthy Prestatyn/Rhuddlan which he describes in this RPS blog.