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Working in community pharmacy was rewarding, but there were limits to how much I could actually ‘do’ for the patient.
6th July 2017
Written by Naeem Ditta
“The only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle” - Steve Jobs.
I started my career in 2006 as a community pharmacist. I felt there was so much more I could, and should do to improve patient care and access to healthcare services. I genuinely wanted to do more for my patients.
Daily I faced customers who needed advice on how to deal with minor ailments. However, while the pharmacist can deal with most of these ailments, on many occasions my response was, “I’m sorry you will need to see your GP”.
I was curious. What will their GP say? Will there be investigations? How would a GP go about the consultation? After all, curiosity is the engine of achievement.
I spent my first 8 years between the community and hospital pharmacy, and then decided to start my journey to end this curiosity. I returned to university to become an independent prescriber in 2014. During classes, surrounded by mostly nurses, I often wondered if I was making the right career move as a pharmacist. Soon after qualification, I used my new skills as a clinical pharmacist at the ISSA Centre (one which I currently work in).
A year later, I returned to university for further studies. So here I was again, sat in a class, being taught more skills by exceptionally well trained nurses, and surrounded by more nurse students! I was impressed with the skills the nurses already possessed, and realized how far behind pharmacists are in term of skills attainable as HCPs.
Since 2006 only a handful of community pharmacists have taken up the opportunity to become independent prescribers. Patient consultations carried out by nurses and other clinicians have increased over the years. In 1995, 75% of consultations were done by GPs, 21% by nurses and 2% by other healthcare professionals. In 2006, approximately 62% of consultations were done by GPs, 34% by nurses and 4% by other clinicians.
By becoming a non-medical prescriber (NMP), and obtaining further qualification from university, I have maximized the use of my skills and with new ones, I am making improved impact on patient care within a multidisciplinary team (MDT).
Patients with conditions that require long term management (e.g. hypertension, diabetes and arthritis) benefit most from MDT care.
I now work in a health centre with a patient population of more than 10,000. My role from clinical pharmacist has evolved into pharmacist practitioner.
I provide face to face consultations for ‘on the day’ medical appointments (acute and chronic ailments) and prescribe appropriately using local/national guidelines. This includes history taking, undifferentiated/differentiated diagnosis, investigation, treatment and referral as appropriate. I monitor the health centre repeat and acute prescribing, and carry out medical reviews for patients with long-term/chronic conditions. I also oversee medicine optimisation and cost effective prescribing in our practice, by supporting/mentoring our medicines co-ordinators.
As well as having input with medicines management, I deal with general/clinical queries originating from either the surgery reception or local pharmacies. My role/duties are always expanding.
There is yet so much more to achieve and as long as we are curious we will learn and do more.
The future is bright and opportunities plenty, to improve patient care and maximise use of NHS recourses.
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