My experience at the RPS Mock Exam Event

by Alya Jassim, Pre-registration trainee 2020

The first day of the event started with an introduction to the course, outlining the important changes that we needed to be aware of, such as the updated de-regulation of medicines. The lecturer, Nadia Bukhari, was great at explaining information and giving lots of little hints and tips along the way. The pre-registration manual evidences were again put to light to ensure the topics were fully covered. We then moved on to calculations. There were quick-fire questions to get us warmed up and I liked how the calculations were categorised into 12 categories highlighting the possible questions that the exam could potentially ask, with slight variations. It made things much simpler. A reflection after each set of questions was particularly useful, as we had the opportunity to think about where we may have gone wrong in the calculation.

There were a few ice breaker sessions which opened conversations with other pre-registration trainees and proved great for networking opportunities. After the break, there was a very thorough clinical session about high risk drugs. The key points were again highlighted, and the speaker did a great job at challenging us to think at a deeper level, which gave me a very clear indication about how in-depth my revision needed to be.

After lunch we had another clinical session, however this was slightly more interactive, with a case study of a patient that had several commodities and risk factors. This was particularly useful as it allowed me to look at a case with a more holistic approach rather than look at one aspect. It gave us the opportunity to speak to other pre-registration trainees and discuss our answers. This was a very enjoyable session.

We then moved on to OTC treatments, another interactive session that I enjoyed. There were lots of example questions that could be asked in the assessment, which I used as guidance about what I should be looking out for when studying OTC medicines.

Day Two was the big day where the assessment took place. The assessment started after a very informative law and ethics lecture. The lecturer, Atif Shamim, gave lots of examples that really resonated and were very applicable to real life. I found it very helpful how the references to the MEP were highlighted on each slide.

Paper 1 was the hour-long calculations paper and then after lunch, we sat the second paper, which was the clinical paper. The feedback session was helpful, as I got to see where I was going wrong and what gaps I needed to address in my revision.

Overall, the experience I had at the event was extremely insightful. The information was well organised, the lecturers were very helpful and I found them greatly inspiring. I highly recommend the event for all pre-registration trainees, an absolute must!

If you’d like to find out more about the RPS Pre-Reg events taking place across the country, take a look at: https://www.rpharms.com/events/pre-registration-mock-exam-and-revision-course

A Reflection On The RPS Pre-Registration January 2020 Mock Exam Event

Pardis Amin-Eshghi

Your Pre-Reg year is a tough one, no question: finally putting all of your hard-earned knowledge to work in the real world. And you still have your Pre-Reg exams to pass at the end of it!

Fortunately, the RPS offers events across the country to ensure you get into practice with a minimum of sleepless nights!

These interactive sessions look at real-life examples to help you pass your exams and be ready for practice. They’re an invaluable opportunity to identify your strengths and weaknesses, highlighting key areas to focus your revision on.

At every event you’ll hear from experienced tutors with top tips, both for exams and challenging practice situations. You’ll also get to know fellow Pre-Reg pharmacists, as well as recruiters looking for their next generation of top pharmacists. We spoke to RPS member Pardis Amin-Eshghi, who told us all about her experience of the two-day event in London.

“I heard about the upcoming RPS event from my tutor, swiftly booked my place and then attended a weekend of intense, focused learning on how to pass my pre-registration exam in order to become a qualified pharmacist.

When it comes down to how to prepare, neither the tutors nor the GPhC recommend making your revision an exercise on how much one can memorise from the resource materials (and there is a lot to memorise). It’s more about how well one can apply that knowledge to the everyday scenarios found in practice, whether it be in hospital or community pharmacy.

The Pre-Reg event is split into two days.  Day 1 revolves around clinical lectures, case studies, calculations, and (my personal favourite) OTC. During the sessions, it was great to have the opportunity to bounce off ideas and then network with the other pre-reg’s. In addition to this, the calculation section (hosted by Simon Harris) involved going through all 12 types of pharmaceutical calculation questions listed in the framework – all in a succinct, step-by-step manner.

Being a big clinical buff, one of the highlights of the event was a clinical lecture hosted by Nadia Bukhari (who’s also the series managing editor of ‘Pharmacy Registration Assessment Questions’, a series that has been a staple in my exam practice). I was enthralled by the way the subject matter was taught, with the key take-home message being that this exam is checking our depth in knowledge. When tackling a scenario, ask yourself, e.g. “Why should a patient be on this medication?”, “Why does this medication cause this side effect?”, “What is the result of this interaction?”, “What other medications should this patient be on?” etc.

Day 2 commenced with an interactive session on Law & Ethics, with the main event being the mock paper (done under strict exam conditions, reflective of the actual day), with the questions representative of the style of questions provided by the GPhC. Once both papers were complete, they went through the answers and the rationale behind them. In the end, we got to take the paper/ resource packs home to go over again, along with our booklet of the slides used throughout the event. Overall, I found these events to be pivotal for the learning and development of any pre-reg that’s on the final hurdle to qualify as a day 1 pharmacist.”

If you’d like to take some of the pain out of your Pre-Reg and boost your chances of passing, there are RPS Pre-Reg events across the country – find out more at :https://www.rpharms.com/events/pre-registration-mock-exam-and-revision-courses

Parental leave and returning to work

by Elen Jones, Director for RPS Wales, and Robbie Turner, RPS Director of Pharmacy and Member Experience

Elen Jones

Elen: Swapping the baby wipes, nappies and the bottles for policies, business plans and strategic meetings.

Maternity leave is over. In a blink of an eye, my baby boy is babbling away and walking round the furniture. He’s nine months, I just about feel like I’m getting to grips with being a mum of two and all of a sudden, it’s time to go back to work.

It’s been amazing to spend so much time with the boys; watching the little one develop and being able to take my eldest to school every day as he starts nursery has been brilliant. On the flip side, it’s often felt chaotic. The demands of two children are something else!

Three weeks into maternity leave I attended an interview and was fortunate enough to get a new role as Director of RPS Wales. 

It’s such a privilege to be returning to work and starting this role. I definitely had huge anxiety during the days leading up to my return. How will we cope with getting the boys to nursery and all be out the door by 8am? How will I catch up on the last 9 months? RPS think I’m the right person for the job, but what will members and my team really think? Impostor syndrome was creeping in! I did check out the RPS Return to Practice guide which helped allay some of my worries. I’ve been back in work for two weeks, and I miss my boys very much. Fortunately, my youngest has settled into nursery quite well (better than his big brother did!)

If I’m really honest, I’m actually feeling more like me again. I’m back to feeling more in control, enthused by the work and by my colleagues.  I’m full of ideas, getting out there and speaking to like-minded pharmacists. I’ve caught up with lots of our members already, everyone’s been so kind and supportive.

The sleepless nights unfortunately don’t stop when you return to work, but I don’t mind them as much now, time with the boys has become more precious. I so look forward to getting back from work to their big smiles and hugs.

So, a big thank you to all my colleagues and our amazing members for all the support and your patience while I’ve been away! I look forward to working with you all to make sure RPS and pharmacy continue to go from strength to strength.

Robbie Turner

Robbie: This year I’m going to get an extra three months off work. And, I’ve been surprisingly anxious about it.

Not that pre-holiday anxious when you’re trying to work out exactly how much ludicrously expensive sun cream to pack so you don’t need to bring any back with you. No, it’s a feeling that’s hard to describe but I bet there are millions or people (mainly women) who have experienced it even more deeply than me.

My partner Ben and I are soon (everything crossed) going to adopt two children. We’ve been aiming to make this a reality for over a year now. A big thank you to work friends and colleagues who have given me support and advice over the last year. Your words of encouragement have been hugely helpful. But, nobody warned me about this bit – preparing for paternity leave.

I know we’re lucky at RPS to have a good paternity leave entitlement. As part of our work on inclusion and diversity we identified that our gender pay gap was too high and introducing paternity pay was one of the tools we put in place to start to be a better employer for both men and women. Check out this article “Men’s parental leave is key to women’s progression

I’d like to think that I’ve always been supportive of women (and I think it has always been women who’ve taken any form of parental leave in my teams) when they announce the news that they are pregnant. I’ve cried a few times, but that’s always been with excitement rather than thinking about covering their maternity leave! I know this isn’t the experience of lots of women and that’s one of the reasons why I’m committed to taking my full paternity allowance. What I’ve never considered is what could be going through an expectant mother’s mind when they’re thinking about taking parental leave. And I now have a small insight into both their perceptions AND the realities..

I work with a great team who are brilliant at their jobs.  Even then, I’m worried about the added pressure me going off for three months will put on them.  BUT, when I really reflect, my main worry is the complete opposite. It’s that I will get found out as a bit of a fraud. That everyone will cope just fine without me or (arghhhhh) that it will be even better when I’m not here interfering and distracting people. Will I still have a job at the end of it all? How much will the world of pharmacy have moved on – will I be able to catch back up?

So, if I’m feeling like this – a (fairly confident), white man, in a senior role, only going on paternity leave for three months – then what must it be like for others who don’t have the same privilege of gender, colour, or seniority facing up to a year away from the work place?

Now, when women (and increasingly, men) tell me their great news about their pregnancy or adoption I’ll be just as excited but I’ll also understand how stressful planning for parental leave can be. Wish me luck!

Are you returning to practice? Check out our Return to Practice guide which is packed full of practical advice and tips to help you return to the workplace with confidence.

Help us tell your stories

By Sandra Gidley, RPS President

Pharmacists are highly trained and knowledgeable health professionals. We are available without appointment in our local communities and are on hand in our hospitals to advise patients and doctors on the safe and effective use of medicine.  Many people really value and often rely on their pharmacist to help to keep them well, so I was disappointed to see an opportunity to highlight the valuable role they play completely missed by ITV on its This Morning show last week.

And I was obviously not alone. Many people were moved to raise their concerns with Ofcom, with over 2,300 complaints made over the weekend. It’s no surprise to me that so many people felt so strongly. As pharmacists we are committed to supporting people to live healthy lives, to advise and treat many of the illnesses and conditions that they face. What did surprise me though was how out of touch and misinformed the guests on the show were about what pharmacists actually do.

For some, a big part of the role may be dispensing prescriptions and other medicines, but there is so much more to our jobs. One of the privileges of my position is that I see first-hand that pharmacists are going the extra mile every day. Pharmacists make sure that people – whether they are suffering from a long-term condition, fighting a one-off illness or perfectly healthy – are receiving the best quality of care and medical information possible.

There is strong evidence for our role in helping people to stop smoking and we are well equipped to advise about alcohol use and weight management in a sensitive and discreet way. We can help people stay healthy, avoid having to visit their GP and stay out of hospital, we support the earlier detection of long-term conditions, and we provide easy access to expert advice on medicines. We work in the community, hospitals, GP surgeries, care homes, prisons and lots of other sectors. And I could go on….

RPS has taken immediate action to counter the comments made last Friday and you can be assured that we will continue to champion the role of pharmacists, challenging misconceptions and promoting the great work that you do day in and day out.

But we can’t do this without you. We need you to tell us your stories, what you do every day, so we can shine a light on the profession’s achievements. Get in touch on TwitterInstagram or Facebook and share your  stories using #WeArePharmacy.

Together, we are pharmacy.

General Election 2019 – A bright future for pharmacy?

By Sandra Gidley, RPS President

The NHS has become a key political battlefield and is featuring prominently in party political manifestos. With the election just a week away, what’s being promised by the parties and what does the future hold for pharmacy?

No crystal ball

We want to ensure that the role of pharmacists and the wider profession in delivering safe and effective healthcare becomes a central tenet of health policy. Our manifesto sets out some of our key campaigns such as patient safety, medicine shortages and growing pressures on the workforce.

We want the next UK Government to invest in pharmacy to maximise its contribution to healthcare. We want to see patient access to medicines secured in a complex global market and a clear future relationship with the EU (and the rest of the rest of the world) to make this happen.

Greater investment in the training and education of pharmacists is also vital. We have made it clear that this should be a key element of any future workforce strategy. We also want to ensure that patients benefit from advances in medicines and therapies. With growing pressures on workforce, the next government must expand health and wellbeing support to pharmacists and all health professionals delivering NHS services.

Positive signs

The political party manifestos offer some hope in achieving our calls to action and for delivering on key issues that we have long campaigned for. Our call to scrap prescription charges in England in line with Scotland and Wales is being echoed in the current political battles. Recognition of the pharmacy workforce across the NHS and particularly in primary care has emerged as a key health policy issue. Acknowledgement of evidence-based medicines and harnessing the potential of new medicinal products is also featuring in political dialogue in the run up to the election.

For further information about the pledges being made on healthcare by the main political parties, please see our handy summary guide.

Your voice counts

The clock is ticking but there is still time to have your voice heard. Why not encourage election candidates to show their support for pharmacy by using the RPS general election toolkit? Get in touch with your local candidates and invite them to a pharmacy visit to discuss the future role of pharmacy. You could also get involved in the social media conversations about the election, look out for #votepharmacy.

This election is a vitally important one. It is crucial that the main political parties back and support pharmacists and pharmacy services. As a pharmacist, please do make your voice heard and together, lets create a bright future for pharmacy.  

General Election 2019 – The Party Manifestos

by Jonathan Bisby

Like with any general election, the NHS is always a key battleground. Promises on healthcare from the political parties in their recently published manifestos has grabbed headlines as they attempt to secure votes. Here are some of the main manifesto promises that the Conservatives, Labour, Liberal Democrats and other parties have made during this year’s election campaign:

Funding

Conservatives

  • £34 billion extra funding a year for the NHS by 2023-24
  • £750 million a year funding to provide 50,000 more nurses in the next parliament
  • Maintenance grants of between £5,000 and £8,000 a year for student nurses

Labour

  • A pledge to spend £28 for every pound that the Conservatives have pledged
  • Increase expenditure across the health sector by an average of 4.3% a year
  • A promise of a ‘lifetime cap’ on personal contributions towards care costs

Liberal Democrats

  • £7 billion additional funding to the NHS
  • A penny on income tax for the NHS and raise £35bn to spend on the NHS and social care
  • Bursaries for nursing students studying specialties where shortages are most acute

Access to services and medicines

Conservatives

  • Upgrades on six hospitals by 2025 and a commitment to start building new ones over the next decade
  • Free hospital parking in England for NHS staff and some patients
  • A commitment to make the UK the leading global hub for life sciences after Brexit and to work collaboratively internationally and with the EU on scientific research, including Horizon

Labour

  • Abolish prescription charges in England
  • Establish a generic drug company to improve fair prices on medicines
  • They have promised to stabilise overstretched A&E departments and improve stroke, heart disease and cancer survival rates by providing earlier diagnosis and improved screening rates
  • Progress the clinically appropriate prescription of medicinal cannabis

Liberal Democrats

  • £10 billion capital fund to upgrade facilities and equipment in hospitals and NHS buildings
  • A pledge to increase mental health services and provisions and reduce waiting times for these services by reforming the Health and Social Care Act and end what they call automatic tendering of health services
  • They will increase access to medicinal drugs on prescription, such as medicinal cannabis, drawing on international evidence to establish a clear evidence base for research in the UK

Workforce

Conservatives

  • A commitment to increase the number of GP posts from 3,500 to 4,000 from 2021/22 and create an extra 50 million appointments in general practice by 2024/25.
  • NHS Visa for trained nurses and other health professionals coming into the country to make it easier to enter, but no similar pledge to social care
  • Delivery of the NHS People Plan with a commitment to recruit 6,000 more health professionals into primary care, which includes pharmacists, retain skilled workers within the current workforce and improve staff morale

Labour

  • Pledge to ensure that community pharmacy is supported
  • They will increase of 5,000 fully qualifies GPs into the NHS
  • Create an NHS working environment that is ‘safe, flexible and free from harassment, bullying or violence’

Liberal Democrats

  • Retain free movement of workers by preventing the UK from leaving the European Union and supporting the current European GP workforce and attract more GPs to work in this country
  • End the shortfall of GPs by 2025, pharmacy was mentioned as a profession which they will make greater appropriate use of
  • Expand GP training places to 5,000 by the end of the next parliament

The Scottish National Party is calling for the next government to invest significantly in the NHS and have promised to boost Scotland’s budget for the NHS by £4 billion over the course of the next Parliament. They will also introduce the NHS Protection Act, which they say will protect the health service from any future trade deals in Scotland.

In Wales, Plaid Cymru are planning for an overhaul of healthcare and have pledged to provide 1,000 extra doctors, 5,000 nurses and 100 dentists to be trained and integrated into the Welsh NHS. They are also calling for free social care at the point of need for elder people in society, estimating that this will cost the Welsh Government £300 million a year. A 5% increase pledge in mental health spending over the next decade is also a significant announcement.

The Green Party have also announced that they will increase funding to the NHS by at least £6 billion each year until 2030 and ensure that mental health care is put on an equal footing with physical health care. They will add a further £1 billion a year into nursing education, as well as reinstating nursing bursaries for students.

We are calling for the political parties to support pharmacy. Take a look at the RPS General Election Toolkit and our general election blog. This is an opportunity for you to have your say and help make the voice of the profession heard.

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