Category Archives: Guest post

Guest Post by @Mrsfinn86 ‘My role as an ACT’

I have worked in pharmacy for ten years now.

To many of you, that won’t seem like a long time. I was only 17 when I joined and I’m 27 now, so basically all of my adult life I have given to pharmacy.

I started off quite by accident in a supermarket pharmacy. I used to work as a shelf stacker in the health and beauty department. One day I’d had enough and handed my notice in. I was SURE I could find a better job elsewhere, two weeks passed and I could find nothing that interested me. Then I was approached by the pharmacy technician Debbie, was I interested in taking a role in their pharmacy?

Now I had spoken to the pharmacy crew a lot, my health and beauty section was built around it so I knew all of them anyway. What I was shocked about was they had been watching me too, liked what they saw and offered me the job!

I was now a counter assistant in a pharmacy. I was ecstatic! I read all those counter pharmacy magazines and completed my level one counter assisted course in super quick time. I was like a sponge just soaking it all up. And the more I learnt, the more I wanted to know.

Pretty soon I was helping my manager put away the POM medicines and tapping out a few labels for her. I also walked back and forth to the local doctors surgeries collecting prescriptions. After nearly a year, I asked if I could go into the dispensary.

There was so much more that side of the counter that I could learn. Sure, I was still learning at the front. You never can know it all (though some think they do!) But I craved to know more, I was told no. They simply did not have enough work to warrant another dispenser. I was crushed.

Then one evening I was working with my absolute favourite locum who told me there was a dispensary assistant position in a large chain pharmacy that she worked in on Sundays. She had told them about me and I needed to go in and have a chat if I was interested.

The very next day I walked the 8 mile trip to the pharmacy and had my interview there and then. What I hadn’t been told, was they were looking for a qualified dispenser. I asked what system they used, she said link. I told her I was not qualified but I had basic knowledge and could I show her? I had never blagged so much in my life, but I so wanted the position!

I showed her I could print labels out, read dosages and stick a label on a box neatly. A massive pet hate of mine is wonky labels!

She offered me the job! I was ecstatic, even though it meant taking a large pay-cut; it’s what I needed to do to progress further. I was to start in a month.

Saying goodbye to my current pharmacy was hard, without them I never would have got to where I am now and I will always be thankful for them taking a chance on me.

A month into my new job I was halfway through my NVQ2 dispensing assistant course. I had also decided I was going to apply for college so i could go on to university to get a pharmacy degree. I left school with no GCSE results due to leaving school at 15 to get a job.

After completing my NVQ2 my manager signed me up for my level 3NVQ technician course. This one was a lot more difficult and took me a little over two years to complete. I did change stores halfway through my course though due to bullying and was unable to find time to study in my new very busy branch!

It was in this new branch that I decided pharmacy wasn’t for me at all. I adored my job, but the daily stresses I see pharmacists go through every single day. The huge amount of paperwork that has to be filled in and it all seemed to be about figures.

Now I’m not stupid, far from it! I understand that pharmacy is a business, but the amount of pressure put on pharmacy managers is crazy. I was told by half a dozen newly qualified pharmacists to look into becoming an ACT. They pretty much all agreed that that’s what they would have done instead had they have known about it. So that’s what I did.

In September 2009 I qualified as an accredited checking technician. This basically meant I could help take the heat off the pharmacist by checking any repeated medications or anything else as long as they had done a clinical check except controlled/toxic and epilepsy medications.

I love my job, no two days were ever the same. Even more so as ACT roles in my company are so few, I would sometimes work in three or four different branches a week! Good job I’m a sociable easy to talk to type 🙂
The hardest thing about my job is definitely working with “old school” locums. I had one want to “test” me before he would “allow” me to do my job. The one that I’m qualified to do. I was outraged! I would never dream of questioning a pharmacists ability’s to do their job. So why is it acceptable for them to question mine?

I do understand that if I did make a mistake then it falls back on the pharmacist in charge at the time, but his whole attitude was awful. I requested to work in another local branch that would appreciate my help and left immediately. That pharmacist never caught up with our huge workload 700+ items normally and apparently was heard saying that girls should not work in pharmacy.

9 times out of 10 I love my job, I am easy to get on with. So if you are a locum about to work in a new pharmacy that has an ACT, please respect that they can do their job and perhaps I will enjoy my job 100% of the time.

Remember, I’m only here to make your job easier!

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Which?

Guest Post

These are the personal opinions of an anonymous pharmacist and do not mean much – apart from them having a rant!

So maths then. Maths that great subject where you can add and subtract, multiply and divide. Where numbers can be manipulated into percentages and fractions. Manipulations that can bring forth great tools such as statistics…and tables and graphs.

Maths is a great tool which informs people as to whats going on within areas of interest.

And – maths can be abused.

In maths the very tools that can be used to express larger numbers as percentages can then also be used to show the effects of smaller numbers and the changes and differences that these smaller numbers can mean as percentages and can be confusing! And (far worse) damaging.

Within the world of pharmacy maths is a great tool. It is used extensively when checking to see if medicine X is better then medicine Y and/or placebo. It can help people check to see if people are prescribing effectively, in audits to find out if SOP’s are being used correctly.

And then maths can be used to make something look shocking.

Recently the Which? consumer people went round a “selection” of pharmacies around the UK and used 1 of 3 scenarios to check on the advice etc given and then compiled a report. I have now read articles in a few magazines which was saying how bad we were in response to the Which? consumer report, well that’s how it felt to me.

The results in the Which? article weren’t good!

In fact, the results showed that whilst multiples had improved, for independants there had either been no change or a worsening in advice given since the previous Which? report a few years earlier.

This doesn’t look good for any profession.

HOWEVER. Which? only visited 122 pharmacies. Out of (in the region of) 13,500.

There are approximately 92 counties in the UK.

So….

122 out of 13,500 = 0.9% of the toal number of pharmacies
122 in 92 counties = Which? visited just over 1 pharmacy per county on average. (1.33 to be exact – assuming 92 counties)

From their 122, they visited multiples, small chains and single independents. They must (surely) have visited some inner city pharmacies and some in the countryside within the 122.

It’s at this point that you have to stop and ask yourself..how relevant a sample size was this. To me the numbers don’t stack up. How can you visit 122 pharmacies and then compile a report that basically says “Pharmacy isn’t doing its job”

I have also heard that academics may have viewed this sample size as “good”..

Which propaganda machine do they work for? The “Ministry of Truth”

What size were the error bars again….

Or am I missing the point?

A less then 1% sample size is enough to tarnish a profession and seek much hand wringing from within the profession. If the sample size was 50% then fair enough. We would have to sit up and take notice. but 1%…

I also note that one of the situations has been challenged by a group of people regarding warfarin interacting with pantoprazole…

If a drugs manufacturer used data from 1% of the available “population” to get a new medicine to market – they would be laughed out of town. Application denied.

This report does highlight one big problem. We are being asked to provide more and more healthy living advice to members of the public, yet regardless of this we are still stuck to the dispensing bench.

More then anything, I am somewhat annoyed by the tone of the magazine’s columns which i believe should have chosen to look at the report more objectively and reported as such with much less bias and more balance – rather then decry against the profession! We are taught (as any good scientist is) to evalute data and then dissect and check to make sure the data and the conclusions are valid.

Any new scientific paper published is open for checking by peer review – quite honestly it feels like no one has done this and taken the Which? report at face value.

The Which? report is nothing more then a tiny snapshot of pharmacy life on a single visit. Pharmacy does a fantastic job at providing excellent healthcare to the general public and this should not be lost in the maelstrom.

Mystery shopping is a very useful tool to provide some information as to what happens. Maybe in future mystery shopping in Pharmacy needs to have a different approach. By all means have your “test the knowledge” questions, but maybe allow the shopper to rate the approach of the staff of how they deal with all their customers – before and after them. ie an all round approach rather then just “narrow focused”.

One off situations do not give the full picture of how all pharmacy works. But if this approach is the only way forward and the sample findings of future reports are deemed to be the same.. what then.. more outcry and more beating and berating.

It’s funny, we have a book in our pharmacy – in fact ALL pharmacies have one – it’s called the “complaints book”. This is indicative of how i feel things are stacked against us. We always focus on the negative – why cant we have a “congratulations book”… The more negative we have, the more feelings of doubt we instill, the more the profession feels apathy.

It’s hard to walk upstream wading through treacle when you feel that the people connected to your profession are diverting more treacle into the mix.

The life of a pharmacy student: Guest Post by @SophieKhatib1

 

Not surprisingly, my drug of choice as a student is caffeine – and I drink coffee almost continuously throughout the day, well, interspersed with diet coke of course!  The majority of my days therefore start with a coffee in hand….nothing to do with a constant hangover of course!!

Once fully woken up, well as much as can be expected for a student, I grab my notes, books, laptop, prescription folder, journals and of course my trusty BNF (the one with the cover that most matches my outfit, of course!).

Lectures flit from x-ray diffraction to legal issues, ethical problem solving to dispensing, drug formulation to clinical pharmacy and genetic biomarkers to drug biochemistry.  Way too much for my brain to handle – more coffee and plenty note taking….in that order.

After a full day of lectures, it’s time to walk home.  Normally in the rain – we are in England after all.  My priorities have massively changed in the last couple of years – I would rather keep my folder of work dry than my hair.  How did I end up in this position??  University is changing me!!!

The best bit of being a pharmacy student is the huge subject diversity we experience and the great wealth of knowledge we pick up on the way.  Having said that, it’s very hard work.  VERY hard work.  I never expected it to be easy but admittedly, never thought it would be quite so intense.  It’ll all be worth it when I graduate and buy myself that gorgeous pair of Jimmy Choos!!

The bit of my education that I most enjoy (apart from going out!!) is having time to do research in my own time.  It’s really enjoyable looking into something that you found particularly interesting.  It’s very rewarding when you realise that you have hit the point where you can print out a journal article on a pharmaceutical subject and actually understand it….well most of it.  You can’t have it all can you – I’m happy with understanding most of it for the time being.  There is only so much that coffee can do – I don’t think its good enough to perk my brain up that much.  It’s a miracle that it manages to do what it does.  I’d be stuck without it!!

Time to go and put the kettle on again….

I Dont Wanna Miss a Thing: Guest Post by Candy Sartan

I could check your script, while you’re standing waiting,
While you’re staring at me frowning,
And impatiently you’re tutting.
I could bag it up, hand it to you right now,
But I won’t know what you’re getting, for certain.
For every time you heckle me, it’s gonna be longer

Don’t want to sign the box, don’t want to give it out
Till I’ve checked it right
Cos I don’t wanna miss a thing.
Cos even when it’s labelled right
The number in the box might not be,
the strength is wrong
And I don’t want to miss a thing

Got an MUR, for a consultation,
And he’s on a dozen items
And they all have interactions.
Then I ask him if,
he knows what he’s taking
And he answers “no, I don’t”
I think I’ll be ages.

I gotta go through each one
To tell him what he’s on them for
And what times to to take.
And I don’t want to miss a thing
Cos even in a medibox
Don’t think he’ll get his head round that
But I need to try
And I don’t want to miss a thing.

I don’t want to miss one dose,
I don’t want to miss one drop
I just want to get it right
The item that you’ve been prescribed
I want you to stand right there
To wait for your turn patiently
Maybe go and read the paper
I’ll have it checked by then
YEAH YEAH YEAH YEAH

I don’t want an error here,
Don’t want you suing me for thousands
You know you would
So I don’t wanna miss a thing.
Cos every time you come back in
You’ll have a little dig at me that your
Hrt was labelled as penicillin

Pharm and Farm: A comparison. Guest post by @lifeonthepharm

 

I have come to realise a similarity, other than pronunciation, of the Farming industry and Pharmacy.

 

  1. Both often have to deal with rather large, uncooperative charges and both the farmer and Pharmacist have to come to deduce meaning from incomprehensible grunts.
  2. Bad smells are part of daily duties, the majority from our respective herds.
  3. Long hours are a common occurrence with the Locum & 100 hour pharmacist often rising early with the farmer and working late beyond nightfall.
  4. Heavy lifting is a characteristic usually associated with the outdoors profession but I have encountered totes containing drinks which could easily slip a disc.
  5. On a more serious note, both professions are facing squeezing of reimbursements …
  6. …and diversification of business is one way to stay in the black whether this is through farm shops, ice-cream and cheese, or through MURs, NMS and EHC.
  7. In modern times both sectors are facing ever increasing beurocracy and paperwork, putting a squeeze on that most valuable resource: time.
  8. The overuse of medicine seems to be an issue solely centred on healthcare, but the overuse of antibiotics in animals is a problem which is front and centre in many people’s minds.
  9. A degree of autonomy is a shared characteristic, with the treating of minor ailments dealt with internally within our respective fields, although we often have to answer to a higher power whether this is the supermarkets (which profession?) or targets from head office.
  10. I’m sure many pharmacists have been asked to look into their crystal ball to answer those unanswerable questions (how long will I have the squits? When can I stop my citalopram?) and I have heard farmers being called upon themselves (is it going to be a hot summer? When should I pick my strawberries from the garden?)
  11. Last but not least, the universal trait among Pharmacists and Farmers is the ability to deal with huge amounts of bullshit and keep going everyday.

 

Psychologist seeks pharmacist’s brains! Guest Post by @errorgirlblog

 

Hannah Family ~ Twitter: @errorgirlblog ~ blog: http://errorgirl.com

Hannah is a psychologist working with the pharmacy practice research group in the Department of Pharmacy & Pharmacology at the University of Bath. She is currently in her final year of her PhD research programme which is looking at whether pharmacists may be experiencing mental overload when they are at work, and if so if this may be related to dispensing errors.

Last week on BBC news 24 the tennis player Andy Murray was talking about his success in the Olympics and the US Open and how in part his success can be attributed to the work he has been doing with a sports psychologist (the interview can be found here: http://www.bbc.co.uk/sport/0/tennis/19921333). During this interview he talked about how he had worked with many sports psychologists in the past and hadn’t found them that helpful because they only concentrated on tennis and how to stay calm during the match. However, when his new coach Ivan Lendl suggested he worked with a sports psychologist and recommended the one he had worked with during his own tennis career, he agreed to give it another go. Happily, he explains that this psychologist has had a positive impact on his game this year because instead of focusing solely on the game (like all the other sports psychologists had) she has been helping him “deal with all the stuff that comes into your head from outside.” Andy Murray is a superb example of how reducing your mental workload can mean the difference between success and failure.

Mental workload very simply relates to how much of your mental resources you are using at any one moment. The reason psychologists like me measure mental workload is because we know that humans have a finite amount of mental resource (at any one moment our brain can only do/think about as much as you can fit on one post-it note). This means that when thoughts from outside pop into your head (that are irrelevant to the task at hand / the tennis match) we know those thoughts are using up valuable mental space which could be used to help you carry out the task. Annoyingly we tend to be fairly good at knowing how much we can physically do at any one moment, but probably because we can’t see what is going on in our brain, we often aren’t aware of how much we can mentally do and so it is easy for us to overload our brains either through taking on tasks that are simply too demanding, or through giving our brains extra work to do by trying to think about too many things at once.

Why do we care if people are overloading their brains? We care because in other industries (e.g. aerospace, manufacturing) low mental workload (when our brains aren’t doing enough) and high mental workload (a.k.a mental overload) has been related to the occurrence of errors and safety incidents. We also know that sometimes the way tasks are designed, or required to be carried out can add unnecessary workload to a person’s mental processes or indeed overload them.  Human factors experts look at tasks in great detail to make sure this doesn’t happen. Similarly the environment we work in can add extra mental workload so it is important to consider not just the task, but where you are carrying it out. For example, consider the difference you might feel carrying out your pharmacy work in a busy pharmacy compared to doing the same work in a quiet office (one might feel a bit more mentally draining than the other). We also know that mental workload is linked to how much you enjoy or derive satisfaction from your work, and that it is one factor linked to burnout, job turnover and absenteeism. There is of course you and your life outside work too. You will have an impact on the amount of mental workload you experience at work too because it varies in relation to our mood and energy levels. This means we need to be aware of how much we are having an impact on our own mental workload, as well as the work and the environment we work in.  Of course mental workload is only one factor that will affect your experience at work and your ability to carry out your work safely and accurately.

The reason why I have been so interested in exploring mental workload in pharmacy is because of the documented workload pressures in pharmacy workplaces at the moment, especially within community pharmacies as the balance between healthcare and business priorities becomes harder to juggle in the current financial climate. In the last 5-10 years the profession has seen a very large increase in workload through greater dispensing activity and new roles that pharmacists are taking on which hasn’t been matched by increases in staffing levels.

So the aim of my research is simply to find out the levels of mental workload involved in routine community pharmacy tasks (e.g. dispensing activities) and how this changes when we alter the parameters of the environment the task is carried out in, and also how the task is carried out. We also measure how these task and environment manipulations impact on errors on the tasks so that we can find out if these factors are linked to safety incidents in pharmacies. This past year I have been inviting community pharmacists to come and take part in a simulated pharmacy study which takes about 1hr 30minutes to 2hours to complete. I ask my participants to complete 2 sets of routine pharmacy tasks and complete some questionnaires at the beginning, in between and at the end of the tasks. I ask all our participants to come to the University of Bath to take part because that way I can ensure that all our participants complete the tasks under the same conditions (knowing as we do that the characteristics of the environment you carry out a task in can affect your mental workload). Due to the time and travel involved, we are able to offer funds to employ locum cover a day to pharmacies whilst their pharmacists come and take part, or if pharmacists take part on a day off or are a locum we offer them  equivalent of a days locum fee for taking part and we reimburse all participant’s travel expenses.

The study is a lot of fun and all the pharmacists I’ve met have been the most amazing people and I hope I bump into them again in the future if I am lucky enough to continue my career in pharmacy practice.

I would like to tell you more about the theory of the study and what we hope to find, but we haven’t finished recruiting and meeting participants yet, and until this is complete I cannot share the finer details until all my participants have taken part. I promise I will write another post for Mr Dispenser, when the data collection is complete to tell you a little more about the theory behind the study.

To date over 80 community pharmacists have taken part in our study but we need more to reach our targets, if you are a community pharmacist and you would like to take part – there is still time (until December 2012!) please contact me on h.e.family@bath.ac.uk if you would like to know more. *I am particularly looking for lots more community pharmacists who work in independent pharmacies to take part!*

 

Considering Academia? Guest Post by a PhD student

Considering Academia?

So you’ve worked in community or hospital pharmacy (or both) and fancy a bit of a change. How about a PhD to add to your list of achievements? Why not? Hmm, maybe consider the pros and cons below…

Pro:        You set your own working hours             

Great! You’ve worked 9-6 five days a week in a job where you can’t even leave your place of work during your shift. It doesn’t leave much time for the practicalities like doctor/dentist appointments. Or a lunch break where you get to sit down uninterrupted for more than 10 minutes. With a PhD if you can pop out when you like, turn up when you like and go home when you like. Awesome!

Con:       You set your own working hours

The onus is entirely on you to manage your time. Which means if you spend too much time during the day on Daily Mail/BBC News/Guardian/Facebook/Twitter/Mr Dispenser’s blog/*insert procrastination website of choice* you will go home feeling incredibly guilty so you feel you have to compensate for time lost by doing work in your supposed ‘free’ time. And then feel guilty if you don’t. Which turns into a continuous cycle of guilt that you can’t get out of. Which will eventually drive you mad.

 

Pro:        Your PhD may make a difference

You could discover that gene that is responsible for a type of cancer. Or you could implement an intervention that improves patient adherence to their medication.  Or find that pharmacoepidemiological link between a common drug and a common condition or side effect. Something you work on during your PhD could potentially save lives or change pharmacy practice in the future. Plus you get the pleasure of calling yourself Dr.

Con:       Your PhD may make a difference…but you couldn’t care less

Your thesis instead can just become a means to an end to get the PhD out of your life. It’s very easy to become disillusioned with your research when you suffer setback after setback, whether it be lab equipment on the blink, agonizingly slow recruitment of patients or the long, ridiculous process of ethical approval just to be allowed to have a chat with some pharmacists. Because when you reach the end of three funded years without having submitted you don’t care about your results and just want the thing out of your life so you can get a proper job and start earning actual money.

 

Pro:        You get to work closely with lecturers you admired (or were scared of) during your undergrad

I returned to my alma mater to do my PhD in the same department that I did my undergrad pharmacy degree. My supervisors are well respected in their field so I know the skills and knowledge that are rubbing off on me will be invaluable to me. And they really aren’t that scary. Plus you get to call them by their first names.

Con:       You get to work a bit too closely with former lecturers

When both your supervisors are pharmacists they can be a bit matter of fact about health issues. Being quizzed by one of them about my bowel movements when I was ill last year was quite possibly the most cringeworthy meeting I’ve ever had to sit through. Maybe this is too much information in itself. Aaanyway…

 

Pro:        You get paid quite generously for demonstrating the modules you hated

Taking undergraduate tutorials in the dispensing and OTC practice modules for the past 3 years makes me forever grateful that I have that stage of my pharmacy education long behind me.  You’d almost feel sorry for the poor wee lambs. And breathe a sigh of relief that it’s not you in their place.

Con:       You may get paid generously but the marking is mind numbing…zzzzz

Whether it’s marking the same extemp product 20-30 times for nearly four hours straight or the 35+ tutorials and homeworks every week, being a demonstrator can try the patience of a saint. And I’m no saint.

 

Pro:        Your PhD can open the door to alternative career paths

Industry, teaching, further research, back to community or hospital. The world is your oyster!

Con:       Your PhD can open the door but might not be enough to let you in

Like any area, academia is a competitive, fickle and slightly ruthless place. You must be prepared to dedicate a large proportion of your life to your job in order to make progress up the ranks. I did this in first year and by the end of second year I was burnt out with a very negative view of everything academia is about. Don’t make the same mistake. Work life balance is something that must not be taken for granted.

 

Pro:        You get student discount again

Speaks for itself!

Con:       You are a student again in your mid to late twenties

While the friends you went to school with are growing up, getting married, buying houses and being sensible and settling down in general, you’re static or going backwards. Still renting, still single, still living in a student area, stuck in a general rut. (This is just me being bitter though, several of my PhD friends are married and/or own their own home).

 

So have a good long think before you jump feet first into academia. Might be worth dipping a toe in with a diploma or masters first to get a taste of things to come.

 

Disclaimer: This was written by a very disillusioned PhD student who really doesn’t like their PhD. It is not intended in any way to be representative of all PhDs. Other (far more positive) PhD views are available. I think.

 

J

 

Thoughts of a diabetic patient: Guest post by @ninjabetic1

One of the things that worries me about my diabetes is that people don’t need to help me, they don’t need to look after me. I have to do it for myself to survive, but others do it because it’s their job.

 

Putting my diabetes in the hands of others and learning to trust them has always been tough for me. I’ve had a lot of bad experiences when it comes to my health due to my own choices, but now I’m turning a corner and I need others to help me do that.

 

Over the last few months I haven’t had good experiences when it comes to getting the diabetes supplies that I need. Since March this year on 9 occasions I’ve popped into my pharmacy to pick up insulin, test strips and needles to find that my prescriptions either haven’t been brought over from my doctors surgery, haven’t been signed for by my GP or have been queried by my GP.

 

This means that on 9 occasions I’ve had a plummeting feeling in my stomach as I’m told that my life lines aren’t available to me like they should be. On 9 occasions the pharmacy staff have taken charge and gone out of their way to help me get those supplies which I depend on every day.

 

I cannot fault the service that I receive from the pharmacy, and I really feel for the staff when I ask for my prescription only to be told that there has been another error made from the surgeries end. They see my face fall and panic set in as I’m told that the medication which keeps me alive is being withheld. They saw me burst into tears when I was told yet again that my insulin wasn’t there and had to ask if I had enough to keep me going me over the weekend. They’ve given me emergency supplies, made phone calls, given me advice and support whenever these errors have been made.

 

I’ve started to dread going to pick up my treatment because I never know if it will be there for me or not. I’ve complained to my surgery every time that it has happened and these mistakes are still being repeated again and again. I’ve been left feeling that having diabetes is too much work for others, that the reason there are errors with my prescriptions is because others simply don’t need to help me. I feel that I’m trying so hard to turn a corner but I’m constantly hitting a brick wall and being let down. I’m starting to lose any trust that I’ve built up in those people who are paid to help me. The only suggestion that I can think to make is that more communication is needed between the pharmacy and the doctors surgery, however the pharmacy staff have made this clear to them on a number of occasions.

 

I know that I’m very lucky to have great support from the pharmacy staff… if I didn’t have them then I hate to think where I would be. I’m grateful that they don’t just see their work as a job, and that they truly want to help me turn the corner

 

 

A Change of Heart: Guest Post by @aptaim

 

I’m taking advantage of being a guest blogger to do something that doesn’t always come naturally, and that’s to admit that I’m wrong. Actually more than that, I’m confessing that I’ve been exactly wrong for more than the last year.

 

A couple of weeks back I was at an intimate strokey-beard meeting on commissioning with various representatives from the DH, NHS Commissioning Board and such, and it was there I realised just how wrong I’ve been.  The meeting was tabled as a discussion on the place in the new NHS of Local Professional Networks – designed in principle to be pools of subject experts that could be pulled upon by the NHS CB for input into the commissioning process – but it transpired that for various reasons they no longer exist in the new NHS framework:  a three-in-the-morning decision if ever there was one.  This, and the recent news that pharmacy commissioning representation in the Local Area Teams of the same Board is absent, made me realise my folly.

 

Because right now, who will commissioners go to for pharmaceutical advice?  More importantly, who will champion the role of pharmacists so that commissioners even know that they are a viable option?  Some may seek support from their emerging CSU, others will house some expertise in their CCG. But how many of them fully understand the breadth of pharmacist’s potential and the services that can be offered by pharmacists, and more so in the easily accessible sites that are retail pharmacies?

Perhaps some of you will suggest our governing body the GPhC. Well personally I’m not so sure, after they responded to my P-medicine self-selection query.  So what about Pharmacy Voice? The PSNC perhaps? The AIMp? The legendary Chemist and Druggist Senate? The NPA then? The CCA? The PDA? The UKPCA? No? OK, surely the PCPA? The GHP?  The PPRT?

And herein lays my concern: there are too many organisations that ‘represent’ parts of pharmacy, and too few that represent ‘pharmacists’.

 

In 2010 I decided that the Royal Pharmaceutical Society wasn’t worth my money, mainly after hearing a local (then) RPSGB branch member say that the cleaving of professional and regulatory functions wouldn’t actually change anything other than their logo.  But now in late 2012 I know that was the wrong decision based on someone else’s flawed attitude.

From my experience so far the RPS has changed. It is not always the speediest or responsive of organisations (their statement on 3-for-2 offers was praise-worthy, but I think we’re still waiting to hear their position on salbutamol by PGD?) and their coverage doesn’t extend fully to all sectors including my own speciality in community services, but that’s down to individual members, and the pharmacy ‘representatives’ above, to influence.  But what they do deliver on is media engagement, and this is important for three reasons.

 

Firstly, it cements pharmacists into the mid of the general public as a healthcare professional. I know that more people visit a pharmacy than any other healthcare setting, but this weekend I watched a couple agonise over which two pharmacy-only medicines to buy so they could get a third free, only to suffer their backlash when I intervened to say three boxes of Nurofen Plus – whilst not illegal – was not something I was prepared to let out of the front door.  Retail pharmacy is our most often visited sector, but it is most often seen as a shop not a centre for healthcare.

 

Secondly, increasing general public opinion of pharmacists as a healthcare professional increases the support the profession gets from patients. In the NHS, old or new, patients aren’t the same as the public, but certainly in the new NHS patients have a greater voice, if not a greater influence on decision making.  The more patients regard us as professionals, and talk about us as such, then the more this message will drip-feed, or directly feed, into commissioning intentions.

 

Thirdly, being an expert pharmacist is good for business: predominantly retail, but this will extend further as more roles and opportunities in primary care emerge.

 

Throw into the mix their extended joint-working initiatives over the old RPSGB such as the RCGP Joint Statement,  Transfer of Care initiative and the standards for in-patient prescription charts, and the RPS is emerging as a strong leadership body for pharmacists.   Things are currently moving rapidly and uncertainly in English healthcare, and I envisage the ‘pharmacist trilema’ becoming more relevant to our every working practice: you can deliver any balance of quality, time or return on investment, but if you want more of one, at least one of the others must be sacrificed.  I sacrificed return on investment for my employer (and my own ear-drum) on Sunday when I put quality first and denied the Nurofen Plus sale, but this individual action can only go so far.

 

It appears the current government remains committed to reviewing the principles of remote supervision, and the only certain outcome of this passing will be a squeezing of posts or remuneration for retail pharmacists.  The GPhC seems not to worry unduly about the requirements of the individual pharmacists they regulate, so it will be organisations like the RPS who must – and I now think can – deliver the right message to policy makers and healthcare commissioners that pharmacists are, and must remain, the universally accessible frontline clinical provider of all aspects of pharmaceutical care.

 

So my change of heart? Well the first thing I’ll do with next month’s wages is join the RPS.

 

I can only hope that other non-members will do the same.

 

Is it just me? Guest Post by @helenroot

 

I have a confession – I think I’m a Pharmacy geek. There is something that has been bugging me for a while, but I have been trying to ignore it. I’ve been in denial, but I can hide my secret no longer.

 

This week on my Twitter feed was news of a new app that can identify drugs. It was only a matter of time I guess, and it didn’t make me question my career choice. No, that was just the trigger for my secret to rear its ugly head again. That evening a Twitter conversation began with “guess the tablet?” and equivalent Pharmacy related paraphernalia as the topic. The enthusiasm for this was immense, and whilst I missed the event (It was the Great British Bake Off Semi-final!), that conversation was the trigger for my imminent confession.

 

I’ll set the scene. You’re watching your favourite soap opera and Janice, the new blonde young interest, has been having a run of bad luck, you know the kind of thing. Broken hair straighteners, chipped nail varnish, burnt toast….. life is tough. So, she books an appointment with Dr.Dish who tells her she’s depressed. Cut to scene with Janice in the pub, opening her prescription and telling the lippy barmaid all about her tough life. Well, this is my gripe. Janice always produces a brown (often unlabelled) tablet bottle, and tips out some pink tablets, “these are the antidepressants he gave me”. Cut back to me shouting at the TV, “that’s Ibuprofen! When did you last see an SSRI out of a calendar pack……” and here is my point.

 

It drives me insane when so much time is spent on continuity in TV and films and yet there is a total disregard for continuity of medicines. I’ve seen it in Hollywood blockbusters. A scene of crime search, diazepam, they must have used this to sedate the victim, cut to shot of random white tablets the size of horse pills, and quite obviously to our trained eye, not diazepam.

 

Also, in movies, the hero or the villain gets shot and then breaks into a pharmacy or house. Then they grab some aspirin or opioid painkillers and take the whole bottle. No GI bleeds or respiratory depression ensues.

 

My secret goes further though. Does anyone else get annoyed by the pathetic pictures used in glossy celebrity magazines (that’s a whole other confessional) or pictures used to illustrate online medical stories? It that just me too?

 

“New research shows the contraceptive pill can make your hair curly” – Headline picture of either an ancient HRT products (I’d spot Trisequins anywhere) or a worried looking woman about to take a tablet from a non cyclical calendar pack, you just know that isn’t a contraceptive.

 

“Flu Jab linked with hiccups” time to dig out that picture of a man sneezing and a glass hypodermic syringe circa 1970/1980 that is now sitting in some museum for Pharmacy.

 

Well, I could no longer live with not knowing whether or not I am alone in my annoyance. I have just a sneaky suspicion I am not alone. Now I have planted the seed you won’t be able to escape it. You’ll find yourself looking for this everywhere. Or, is it just me?