Edward Frank Harrison – a pharmacy war hero

by Matthew Johnston, RPS Museum

If asked to list influential figures in the history of the First World War, few would probably know the name of Edward Frank Harrison. But it was Harrison who was responsible for saving the lives of thousands of Allied soldiers thanks to his work to combat the threat of chemical warfare.

Born in 1869, Harrison began his career as an apprentice pharmacist in North London aged 14. He was awarded the Pharmaceutical Society’s Jacob Bell Scholarship and won prizes in the subjects of chemistry, botany, and materia medica. He passed both the Minor and Major examinations at the Society’s School of Pharmacy and registered as a pharmacist in 1891. Read more Edward Frank Harrison – a pharmacy war hero

Pharmacy breakthroughs in mental health treatment

By Julie Wakefield, RPS Museum volunteer

From the 1950s onwards there have been significant breakthroughs in the medicines used to treat mental health problems.

In the early 1900s the drugs used in psychiatry were the ‘chemical straightjackets’ such as opiates, bromides, and barbiturates that simply sedated patients.

This all changed in the 1950s with the introduction of chlorpromazine for psychosis, lithium for bipolar disorder, and imipramine for depression.

It began a pharmacological revolution because it demonstrated that drugs, not just psychotherapy, could restore mental health.

Antidepressants

Imipramine was the first of a class of drugs called ‘tricyclic’ antidepressants. In 1955, researchers gave it to 40 depressed patients. The results were dramatically successful. The pharmaceutical firm Geigy had produced the first drug in the history of psychiatry that acted specifically against depression.

Since then many more of these drugs have been developed, with varying side effects. However, imipramine is still considered by many psychiatrists to be the gold standard of antidepressant therapy.

Antipsychotics for Schizophrenia

Many pharmacy historians have regarded chlorpromazine as the single most important drug in the history of psychiatry. Chlorpromazine treated the symptoms of schizophrenic psychosis with less sedation than previous drugs.

A trial on 38 psychotic patients in the early 1950s showed that it could not only calm the patient but also treat a whole range of their symptoms. These included hallucination, delusions, confusion, anxiety states and insomnia.

Chlorpromazine was the first of a class of drugs called ‘typical’ antipsychotics for schizophrenia. A dopamine antagonist, it works by blocking the uptake in the brain of excessive levels of the neurotransmitter (a chemical that helps transmit signals in the brain) dopamine, believed to partly cause the symptoms of schizophrenic psychosis.

Bipolar Disorder

Just as chlorpromazine brought relief to sufferers of schizophrenia, lithium carbonate, launched in 1954, became the ‘gold standard’ treatment for bipolar disorder. Lithium is a mood stabiliser used in the prevention and treatment of mania associated with bipolar disorder (manic depression).It is still the most common treatment today as it both treats and prevents mood disorders.

The pharmaceutical treatment of mental health in 2018

However despite the significant developments in psychiatric medication over the last 70 years, many patients with mental health problems are still not receiving a high enough standard of care.

As part of its mental health campaign, the Royal Pharmaceutical Society is exploring how pharmacy teams can help improve the physical health of people with mental health problems.  People with mental health problems often have more difficulty accessing healthcare than others and the life expectancy of those with a serious mental illness is 15-20 years less than average.

A key part of improving this is ensuring patients get the best outcomes from their medicines, so reducing adverse events, minimising avoidable harm and unplanned admissions to hospital, while using resources more efficiently to deliver the standard of care that people with mental health problems deserve.

Heads down or heads up?

by Nicola Gray, RPS Regional Liaison Pharmacist

One of the privileges of being a Regional Liaison Pharmacist for RPS is having the opportunity to go and speak to pharmacists working across different sectors of care about their current work and their aspirations.

One common theme across all sectors for me has been the difficulty so many of us have in imagining a different practice scenario to the one we currently work in. The very real and constant pressure of daily work means that pharmacists often have to concentrate on traditional tasks to meet the needs of an increasing – and more complex – patient caseload. It might be the community pharmacist chasing yet another medicine in short supply; the chief pharmacist considering how to cover their on-call responsibilities; the academic pharmacist running the same lab 5 times to accommodate student numbers; or the GP practice pharmacist team leader covering several practices themselves because of the churn in their team. The common feature is ceaseless demand, which restricts our capacity to think and act strategically and to connect with the wider system.

Tied to the wheel

I’ve come to call it the ‘heads down’ phenomenon, but another pharmacist recently described it to me as being like ‘hamsters on wheels’. Those of us who are not caught in this cycle might become frustrated by a disappointing pharmacist response to funded offers of training, or worry that opportunities for strategic development will be missed because system leaders do not see demands from the profession for their ‘place at the table’. I believe that the ‘heads down’ phenomenon gives us a very reasonable explanation for why this might be – and a way to consider what we really have to do to facilitate change.

Looking up

Each of the four Regional Liaison Pharmacists has many stories of the innovators and local and national pharmacy leaders who are determined to look beyond the daily grind. For example, I attended the Greater Manchester Pharmacy LPN conference in the summer and awards were given there to pharmacists, pharmacy teams and multidisciplinary initiatives to celebrate solid innovation rooted in the needs of local populations. These awards showcased pharmacy-led improvements in patient safety and equitable access to services, which need acknowledging in a national healthcare system where both seem to be an increasing daily challenge.

Becoming part of a movement

The future of pharmacy has to be a system-wide movement united by a common cause and guided by shared values. Where I live in Greater Manchester, a recent meeting about workforce strategy – involving representatives from all patient-facing sectors – showed strong consensus around moves to affirm our shared identity there and use it as a basis to market pharmacy to patients, the public and other professions. This isn’t window dressing – it is fundamental to creating an effective movement.

As a representative of pharmacists in different roles in my past, and in the role that I perform for RPS now, my greatest nightmare is that promises will be made to local system leaders about pharmacy without the certainty that everyone else is committed to that cause. Conversely, the critical mass of pharmacists needed to give that support can only be created if they too feel part of a movement that is not just about another plan, or pilot, but that has the capacity to actually get us from where we are to where we really want to be.

In order to encourage more pharmacists to raise their heads, they will have to start to see small but meaningful positive changes in their daily work. Nothing less will do. This may be facilitated by shifts in commissioning to align incentives for pharmacists with value for patients. It may also be linked to better retention of pharmacists in localities and roles so that the work becomes more proactive than reactive. This will promote trusting personal relationships between pharmacists working in different sectors and with the wider healthcare team. The right approach will be decided at an increasingly local level, but support for these ‘local pharmacy movements’ from RPS and other national bodies and employers will help to sustain pharmacy leaders, and raise more heads up.

Medical exemption fines: could they be better spent?

by RPS England Board Chair Sandra Gidley

The Government have announced plans to strengthen checks at pharmacies for entitlement to free prescriptions in England.  Whilst we all want to see fraud stopped, I have to ask – is really the right approach?

Only patients in England can be judged to have committed prescription fraud because prescriptions are free in Scotland, Wales and Northern Ireland.

Many patients who fall foul of the medical exemption fine have simply forgotten to renew it. They only need to do this every five years, so it’s a diary date that is easy to miss. We shouldn’t label people with a serious long term condition who have forgotten to renew their medical exemption certificate as fraudsters because they have made a genuine mistake. Read more Medical exemption fines: could they be better spent?

Supporting System Leadership

by Amandeep Doll, RPS Regional Liaison Pharmacist

I’m one of four Regional Liaison Pharmacists at the RPS, working on system leadership for pharmacy and medicines optimisation in England, delivering national strategy at a local/regional level.

We know there is a need to bridge the gap between the strategic and operational levels of healthcare and mobilise the profession to get involved with system leadership to improve health outcomes for patients. It’s vital to ensure that medicines optimisation and pharmacy services are considered core criteria when planning and implementing healthcare services.  Read more Supporting System Leadership

Pride in Practice

by Sarah Steel MRPharmS, RPS Wales Policy and Practice Co-ordinator

Sarah Steel MRPharmS, Policy and Practice Coordinator

With August being the month we in Wales choose to celebrate Pride, what better time for the RPS Wales team to join the ongoing campaign for unity, equality, acceptance and embracement. To show our solidarity, some of our RPS staff members will be sharing their experiences in pharmacy as members of the LBGT community, and on the 24th of August, the eve of Pride Cymru, in the office we will be donning our brightest colours, eating rainbow cakes and flying the flag in support of Pride.

Why we still need to worry about equality

I’ve found myself thinking recently – if last year marked the 50th anniversary of the 1967 Sexual Offences Act and the “de-criminalisation of homosexuality”, why are members of the LGBT community still being tormented, isolated and discriminated against? It turns out, my ignorance was distorting my understanding. In 1967 homosexuality was in fact only partially de-criminalised; many anti-gay laws remained, and criminalisation did not in fact toally end in the United Kingdom until 2013. That’s only five years ago!

Five years ago, I was in my second year of University. Through my time at University and my career to date, I have been a proud member of the LGBT community. For the majority of the time, I have felt accepted and embraced, but I can’t say I have always felt that I am, or would always be, treated the same. My sexuality is something I am conscious of in interviews, when starting new jobs or working in new teams. I am still, in 2018, worried how people will react when, for example, I correct he to she when talking about my personal life. And I am sad to hear from colleagues and friends that they have had much worse experiences, including homophobic slurs and discrimination.

Join us and show your Pride in Practice

What stands out to me clearly is that LGBT rights and support is not a moot point, and there’s still a long way to go. The celebration of the campaign and the achievements so far is as important as ever, and we hope that through our blogs and  photos, we can be a part of the campaign for unity, equality, acceptance and embracement for all of our members. We’d love it for members to join us by sharing photos of your involvement this weekend, either at home or in the work place. Be sure to tag your social posts with #RPSPrideInPractice so we can share!

Improving mental and physical health – parkrun

By Chrissie Wellington, Global Head of Health and Wellbeing, parkrun

We all know that exercise is one way to improve physical and mental health, but it can be very hard to get started and motivate yourself to continue exercising.

I work for a brilliant organisation called parkrun which provides a fantastic way for anyone to improve their physical and mental health in a fun and supportive environment.

As a non-profit organisation, parkrun organises free 5k runs which take place every Saturday at 9am (9:30am in Scotland and Northern Ireland). There are currently over 770 parkrun events across the UK with approximately 140,000 weekly participants supported by around 14,000 volunteers.  Read more Improving mental and physical health – parkrun

The Hanbury Memorial Medal – open to scientists of all nations

By Karen Horn, RPS Librarian

Daniel Hanbury, renowned British pharmacologist and botanist, died of typhoid fever on 24 March 1875.  He was 49 years old.  He is buried in Wandsworth, in the Society of Friends’ burial ground.

Shortly after Daniel Hanbury’s death, his friends and colleagues resolved to honour a life dedicated to science by awarding a medal in his memory –  for ‘high excellence in the prosecution or promotion of original research in the Natural History and Chemistry of Drugs.’ Read more The Hanbury Memorial Medal – open to scientists of all nations

It’s time to make the most of pharmacy in mental health

By Sandra Gidley, Chair of RPS England

People with a serious mental illness die 15-20 years earlier than on average.

They are three times as likely to lose all their teeth.

More than 16 million people in England are diagnosed with a long-term physical health condition, and more than five million of them will experience a mental health problem.

These are just some of the shocking figures that underline just how much further we have to go on the issue of mental health and the reason I was delighted to join with members, patient groups and the other health professions to mark the launch of the Royal Pharmaceutical Society’s new campaign on mental health in Parliament last week. Read more It’s time to make the most of pharmacy in mental health

What you must know about sunscreen

by Colin Cable, RPS Assistant Chief Scientist

Summer is coming. But when the sun comes out do we all know how to protect ourselves from its damaging rays?

To try and get a feel for the public’s understanding of sun protection the Royal Pharmaceutical Society carried out a survey – and about the types of damaging ultraviolet (UV) radiation, sunscreen labelling and how to use sunscreens effectively. Read more What you must know about sunscreen