Pharmacy in prison – uniquely challenging, uniquely rewarding

Tom Cox MRPharmS, Community Pharmacist and RPS Welsh Pharmacy Board member
Tom Cox MRPharmS, Lead Prison Pharmacist, North Wales

by Tom Cox MRPharmS, Lead Prison Pharmacist.

Medicines optimisation in prison – the challenge

It’s long been recognised within prison populations that there’s a high prevalence of substance use disorder in connection with prescription medicines. This is often found alongside problematic polypharmacy situations.[i] My main objective as a Lead Prison Pharmacist is to optimise medicines and resolve problematic polypharmacy, to try and rehabilitate people held in custody.

Medicines optimisation within a prison takes many forms, just as it does in other areas of health care. It starts with comprehensive medicines reconciliation when people arrive at the prison. Compared with the general population, people in custody have often lived chaotic lifestyles, either on the outside of prison, or perhaps in other prisons, so the first step is to understand what they have been taking, and how they have or have not been managing their medicines.

A particular problem we encounter during medicines reconciliation is that when a person arrives in prison, they often have other people’s prescription medicines in their possession, as well as their own. This forms important evidence for any resulting medicines optimisation.

Read more Pharmacy in prison – uniquely challenging, uniquely rewarding

Palliative and End of Life Care – why getting it right is so important

Dr. Idris Baker, National Clinical Lead for Palliative and End of Life Care in Wales
Dr. Idris Baker, National Clinical Lead for Palliative and End of Life Care in Wales

by Dr. Idris Baker, National Clinical Lead for Palliative and End of Life Care in Wales

Are you serious?

 

“Are you serious about this? Who do you think you are?” the out of hours coordinator asked me. “Sending a man like this home? Asking for morphine for him to go with? A man like this needs to be in hospital.”

The problem was that Bill – he wasn’t “a man like this”, he was this man– didn’t want to be in hospital. He was in A&E, and he was screaming, and he could only tell me two things: he wanted painkillers, and he wanted to go home. He only had these two wishes and he hoped I could grant him both.

 

Bill’s story

 

His family filled in some blanks. Bill had advanced pancreatic cancer, his chemotherapy hadn’t worked, and he knew – they all knew – that he was dying. No one had given him any decent painkillers. It had got so bad that they had to bring him to hospital. We had old hospital notes and it all checked out, so there was nothing suspicious about the story. Bill was dying, in pain, and scared. I was scared too, a new young casualty officer facing a long bank holiday weekend, and I didn’t know much but even I could grasp a bit about Bill’s situation.

Read more Palliative and End of Life Care – why getting it right is so important

Putting Medicines Safety First in Wales

26.06.14 Royal Pharmaceutical SocietyRob Davies, member of the Royal Pharmaceutical Society’s Welsh Pharmacy Board reflects on the 2015 Medicines Safety Conference and the benefits of attending this year’s forthcoming event.

As a pharmacist and independent prescriber, medicines safety is an issue close to my heart. It is our pre-occupation as a profession, ensuring medicines are appropriate for the patient, are taken safely and as intended. I was excited therefore to attend the RPS Wales annual Medicines Safety Conference last year to hear about strategic plans for Wales and to learn more from practice examples. Read more Putting Medicines Safety First in Wales

We need more pharmacists in the general practice team

Rena AminBy Rena Amin, Joint Associate Director Medicine Management, NHS Greenwich CCG

Having a pharmacist working as part of the team in a GP practice isn’t a brand new idea – I’ve been doing it for the last ten years. I have colleagues doing the same in pockets around the country but I hope it won’t be long before it’s seen as the norm.

People might be sceptical about seeing a pharmacist in a GP surgery. Why do we need pharmacists in GP practices? What would they do? And how would they benefit the patient? Read more We need more pharmacists in the general practice team

Prescription charges are causing medicines poverty

nealpatel2By Neal Patel, Head of Communications, RPS

The Government announced today that prescription charges in England will rise from £7.85 to £8.05 on 1st April.

Prescription charges have risen for 34 of the past 35 years.  Research consistently shows 1 in 3 people who work and have a long-term condition struggle to afford their medicines.  Many have to choose between paying for their medicine or household bills such as food and heating.  They face medicines poverty because they have a lifelong illness they don’t want.  How can this be fair?  And what can be done about it? Read more Prescription charges are causing medicines poverty

Better use of repeat dispensing would improve patient care

Ash_Soni_0411By Ash Soni, Vice Chair of the English Pharmacy Board
The Government announced today that prescription charges in England will rise from £7.85 to £8.05 on 1st April.

A new report, Prescription Charges and Employment, from The Prescription Charges Coalition has found that the cost of prescription charges prevents over a third of people with long term conditions who pay for their prescriptions from taking their medicines as prescribed. Some face medicines poverty, having to choose between paying for their medication and household expenses such as food or heating. Read more Better use of repeat dispensing would improve patient care

Paying the price: prescription charges

By Phil Reynolds, Policy and Public Affairs Officer, Crohn’s and Colitis UK

Picture the scene, after weeks of chronic debilitating symptoms and repeat visits to the doctor you finally get referred on to see a hospital specialist.

The day finally arrives and your consultant breaks the news that you have a chronic long-term condition. You’ll need regular medication for the rest of your life to try and control the symptoms. How much will all this cost? Impossible to know, but as of 1st April 2013, it’ll be £7.85 per prescription until you qualify for an age-related exemption in later life. Read more Paying the price: prescription charges

How can we improve transfer of medicines information?

By Heidi Wright, RPS Policy and Practice Lead

Taking a medicine is the most frequent method that patients use to improve their health. In particular, older people and those with long term conditions rely heavily on medicines as a way of managing their illnesses.  These patients, often with strict and complicated medication regimes, are some of the most vulnerable to problems with their medicines when they transfer care settings. Whether it’s from care homes to hospitals, or mental health hospitals to home, these are times when the risk of medication errors tends to increase.

In fact, research shows that around 60% of patients have 3 or more medicines changed during their hospital stay, 20% experience side-effects after having their medicines changed and almost half of all patients experience an error with their medicines after they are discharged from hospital. Read more How can we improve transfer of medicines information?

Getting to know our new MSPs

By Iain Brotchie, Head of External Relations (Scotland) at Royal Pharmaceutical Society

At the last Scottish Parliament election in May, over 40% of the MSPs who were elected had never served in the Parliament before. For many of them, there is low awareness of what pharmacy does these days beyond dispensing. Other services on offer, and other sectors of the profession, are a mystery to many of the new intake. Read more Getting to know our new MSPs