My aspirations for the NHS Community Pharmacist Consultation Service

As the new Community Pharmacist Consultation Service goes live, English Pharmacy Board member Andre Yeung, a key developer of the earlier Digital Minor Illness Referral Service, offers his thoughts on how to make it a success.

How did the Community Pharmacist Consultation Service develop?

My good friend and colleague Mike Maguire and I actually started talking about this right back in the summer of 2014. Back then NHS 111 wasn’t really referring to community pharmacy – they mainly sent patients to GP services, walk-in centres or A&E departments. It got us thinking that community pharmacy could do so much more in this space if we only just connected the network up with NHS 111.

After our NHS Pharmacy Integration-funded pilot in December 2017 we’re now presented with a national roll-out this October. It’s taken some time to get to this point, and it took a little bit of convincing about pharmacists’ role, but I believe the future delivery of this service is really important for community pharmacy and the NHS. We’ve had over 28,000 patients referred into community pharmacies as part of our pilot and community pharmacists have done an absolutely astounding job of clinically assessing, advising, treating, managing and escalating patients within an integrated primary care system. 100% – we’re now the first port of call for minor illnesses here in the North East.

Why do you think the CPCS is so important?

My belief is that Community pharmacy developing a role in acute out of hospital care is more important than the sum of all other commission services that have been commissioned through community pharmacy.

Why? Firstly, because acute care is needed and appreciated by patients! Secondly, it doesn’t just disappear if pharmacy doesn’t do it so it’s needed by the NHS too. Thirdly, the size and scale of this is massive.  It seems to me a ‘no brainer’ that if pharmacy helps out our GP and nurse colleagues they too would start to argue that the right place for managing patients with minor illnesses is within community pharmacy. Pharmacy can provide patients with excellent access to services and because of our scale can take pressure off NHS colleagues as we head into the busy winter season.

What are the considerations that are needed to enable around a national roll-out?

It’s a big task to get the best out of this service. In some respects, this is business as usual for pharmacists, in others it’s completely different. I don’t think there’s been a more challenging service launch in the history of community pharmacy.  As of October 29th we’ll be connected to the NHS in a way that we haven’t been in the past. People will be monitoring and counting on our clinical interventions so we need to ensure the quality of what we deliver is of a really high standard across the board. If we can do that, and I believe we can, then this could be a seminal moment for our profession – a really positive turning point that leads to further developmental opportunities in the clinical arena. How great would it be to achieve amazing results with the spotlight on us like never before?

What message would you give to front-line pharmacists?

These are a few of my top things to remember about CPCS:

  • CPCS about YOUR clinical assessment in the pharmacy. Get the info you need and make your own professional clinical judgement as NHS 111 have only done a triage based on what the patient has reported on the phone. A great clinical assessment keeps the patient safe, is rewarding for the pharmacist and importantly helps patients get well as they have the right plan in place.
  • Three most likely outcomes of your assessment will be a) you can help the patient, b) you need to escalate the patient or c) you can’t help the patient but you don’t need to escalate.
  • Safety net every patient: advice on when to act and how to act if things don’t improve or get worse.
  • Keep decent clinical notes in the IT system, for patient benefit and yours.
  • When you escalate in hours, most times you’ll need to speak to the GP not the receptionist. You’ll be escalating because you have a clinical concern so it’s only natural you’ll want to communicate this to the receiving GP – it’s both helpful and courteous to do so! Out of hours you’ll be going back to NHS 111 via the healthcare professional line so be prepared to request a referral or support from the clinical assessment service.
  • Reflect on your practice. If you need some additional training then sort this out as part of your CPD.

What are my aspirations for the future of the service?

Initially, this is about community pharmacy the sector maximising this opportunity. It’s about us ‘knocking this out of the ballpark’ so to speak. That’s my main aspiration!

If we achieve this then the NHS have already outlined an opportunity to work with GP referrals into community pharmacy for minor illnesses.

In the future, what would be good would be some additional training, access to some POMs and some basic equipment (oximeters, BP monitors, thermometers etc.).  This will allow us to see other types of patients as our functionality increases. Why not see patients with suspected UTIs, with impetigo etc? I know my colleagues at the Royal Pharmaceutical Society will be pleased to hear me say that I think the roll out of Pharmacist Prescribers will eventually come on the back of all of this work. We’ll need them as we do more and more in this domain.

It’s all very exciting! Caveat to all of the above? We MUST deliver this first phase of the service well.  Organisations need to support our front line pharmacists and pharmacy teams to deliver quality. They absolutely have the capability to do it, they’re amazing, but they will need our help and support to make it happen!

Our Mental Health and Wellbeing Campaign

By Jonathan Burton MBE FRPharmS, Chair of the Scottish Pharmacy Board

I think we can all agree that being a pharmacist can often be stressful and demanding. My personal experience of managing my wellbeing, in the context of my work as a community pharmacist, has been a journey.

Early in my career (I’m 20 years qualified now) I often struggled to control stress & anxiety when workload was high in the pharmacy, I could be irritable and looking back I’m sure this was noticed by and affected my work colleagues and patients alike. I co-own the company I work for and this had the added effect of causing me to feel a lot of guilt, even in situations in the pharmacy that I couldn’t really exert any control over, as I inherently felt it was always in part my fault if my team and I were struggling. I seemed to carry this with me all the time. 

Further on in my career now I feel I manage these emotions better, but I still notice the negative impact that busy and stressful days and experiences have on my life & general wellbeing. I can control it at work better, but at home sometimes it’s still a struggle. If you ask my wife and children they’ll tell you, I often find it difficult to switch off from work and it sometimes takes me some time after arriving home before I feel I’m the husband to my wife and father to my boys I think I should be. If it’s a tough week at work I often stop looking after myself, my diet worsens and exercise stops. 

I consider myself lucky, I enjoy my job and have always felt fortunate to be a part of a profession that cares for others. But as health professionals we need to look after ourselves and each other as well as the public and patients we care for. We are human, and we will have our struggles with our wellbeing and mental health, but this does not mean we don’t deserve help to manage these challenges. 

If you are a pharmacist reading this, and haven’t done so already, please help the RPS and Pharmacist Support fight for better access for pharmacists to help with their wellbeing and mental health issues by completing our survey. It really will make a difference, thank you.

My first week as an RPS intern

Simi Aguda, Second year pharmacy student

I’m Simi Aguda, a second year Pharmacy student at the University of Portsmouth. I recently had the opportunity to work within the Royal Pharmaceutical Society in Education and Professional Development.

My first week began with an introduction to the different teams at the RPS by Aamir Shaikh, a Professional Development Pharmacist who supports early career pharmacists.

I met with the different departments and organisations within the Royal Pharmaceutical Society, including the BNF, Pharmaceutical Journal, Education, Team England, Events, Marketing and Professional Support. I was immediately welcomed and was excited to see what the professional body of Pharmacists got up to ‘behind the scenes.’

My first project was to review the RPS website from a student perspective, suggest improvements and present my findings to the Marketing Team. I needed to be analytical and precise and further develop my presentation skills, as well as evaluate whether the content of the website matched the needs of Pharmacy students like myself. After the presentation the changes were made to the website and my feedback was taken on board. I noticed how the RPS valued giving and receiving feedback, and that as a student my opinion and thoughts mattered. This has been an integral part of my experience and demystified my preconceptions of the RPS and their culture.

My second project was analysing data collected from Pharmacy students and Pre-Registration trainees and identifying changes and patterns from the data set and how this could improve RPS membership. In addition, I had the opportunity to work with Gareth Kitson, Professional Engagement Lead, whose role is to promote pharmacy across England, as well as liaise with the media and Government to champion and speak up for Pharmacy. This broadened my perception of potential pharmacy careers.

Next, I had the opportunity to meet with the head of Marketing, Neal Patel. I was invited to discuss how the RPS can engage with students like myself, this was an incredibly informative meeting and provided me with insight into how dedicated the RPS is to helping Students, Pre-Registration trainees and qualified pharmacists. The focus was always on how the RPS can support its members. As a student I was unaware of the resources available for me. I have since met other interns who were placed within the Pharmaceutical Journal, and we have worked together to create content for the RPS digital channels.

Primary care networks: getting started

by Stephanie West, RPS Regional Liaison Pharmacist

One of the things that excites me as a Regional Liaison Pharmacist for RPS is seeing examples of how local primary care professionals are coming together to discuss good patient care, provided by the right practitioner, close to home. So it was fantastic to see clear recognition of the key roles pharmacists play  Read more Primary care networks: getting started

How pharmacists can support older people with mental health issues: a personal view

By Dr Amanda Thompsell, Chair of the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists

Having met with members of the Royal Pharmaceutical Society to talk about their mental health campaign it made me reflect on the many ways that pharmacists support older people with mental health issues.

Not only do pharmacists give helpful advice around reducing unnecessary medications, on side effects and potential drug interactions and ways to improve adherence, but pharmacists help in so many other ways that can go unnoticed. Read more How pharmacists can support older people with mental health issues: a personal view

The Hanbury Botanical Garden: a pharmacist’s holiday destination in 1906

By Karen Horn, RPS Librarian

The Hanbury Botanical Garden is situated on the La Mortola promontory overlooking the Mediterranean. A glance at TripAdvisor  tells us that it is ‘spectacular,’ ‘a real gem,’ and ‘a beautiful, calm place with stunning views.’

What we are not told, though, is the garden’s connection to the Hanbury family and pharmacy.

Thomas, Daniel and the making of a garden

Daniel Hanbury was an enthusiastic traveller, taking every opportunity to further his research on materia medica. It was he who brought La Mortola to the attention of his brother, Thomas.  In March 1867, Thomas, a merchant in Shanghai, visited the area and found the ruined Palazzo Orengo with its neglected grounds and olive groves. Read more The Hanbury Botanical Garden: a pharmacist’s holiday destination in 1906

Creating a profession where you feel comfortable to be yourselves

by Robbie Turner, RPS Director for England

Recently I wrote a blog about  LGBTQ Pride celebrations describing how upset I was that LGBTQ young people were still suffering high levels of abuse, discrimination and mental health issues as a result of their identity. I promised to reflect on what more the RPS could do to support pharmacists to help young LGBTQ people and we are exploring how our future RPS campaigns can deliver this. Read more Creating a profession where you feel comfortable to be yourselves

My week at RPS

Roshnee Patel, MPharms Student at King’s College London

What’s happening behind the scenes? As a pharmacy student it is very difficult to understand and know what is being done for us outside the four walls of our university. My week at RPS demonstrated to me how much support there is available after we graduate but also during our studies. Fortunately, I was able to spend some time within the marketing team and I got to see it all.

From just about knowing how to use Google calendar to now being able to structure, format and schedule social media posts, my time at RPS has enabled me to develop a wide range of my skill sets. In the RPS, opportunities are always knocking on your door. I was given the opportunity to write an email to students in Birmingham. Having had no previous experience in writing emails to such a large number of recipients, I was taught the do’s and don’ts and how to template my email. Within the marketing team, I also got to witness the amount of hard work which goes into planning and preparing for anything to be sent out to the public and making sure that whatever is being sent out is for the correct audience with the most useful information. Before anything is sent to the public it is prepared and checked way in advance. The FIP World Congress next year is being held in Glasgow and is being hosted by the RPS. Even though the event is over a year away, a tremendous amount of work is currently being done to make sure the event is the best. Having also got the chance to sit in on a meeting, I saw how the RPS have and are still developing programmes to help pharmacy students from their first day till their last and beyond that as well. When we’ve just finished our pre-reg year or we’re over 10 years into our career it is comforting to know that the RPS will be there to support and guide us if we need them. It was also great to see how the RPS are always highlighting the importance of pharmacists in the community and are continuously changing themselves to make our journeys easier.

Read more My week at RPS

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

How pharmacy can raise public awareness of health issues

by Tricia Armstrong

Community pharmacists have historically been the most accessible healthcare professionals and have successfully taken part in many public health campaigns, such as stop smoking services. In recent years the role of the pharmacist has become more diverse with pharmacists offering more services, such as flu vaccinations. Patients are looking for convenience and accessibility and pharmacists often meet these needs by providing services in the evenings and at weekends. In an article by Anderson and Thornley (2012), the authors discuss the reasons why patients, who are entitled to free NHS flu vaccinations, are prepared to pay for vaccinations because the service is more easily accessible in pharmacies. Read more How pharmacy can raise public awareness of health issues