Throughout my university days, I worked every Saturday at a local Boots store. Of course, the prime reason I did this was to earn money, but the unintentional consequence was that I learned to connect academia and the practice of pharmacy.
For example, the drug of choice for blood pressure in those days was Aldomet (methydopa), which was available in bulk packs of 500 tablets, with a single leaflet inside addressed to doctors and pharmacists only. I used to collect leaflets from this and other products and tie in the information I found in them with my university lecture notes.
Forty years later, I’ve been employed, run my own business and am now back in full-time employment at Avicenna. I suppose I am in a hybrid position now, where my weekday job puts me in touch with more than a thousand independent pharmacists and various stakeholders such as local pharmaceutical committees, the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee, the General Pharmaceutical Council and the Royal Pharmaceutical Society.
My Saturday job is working in my own busy pharmacy in Lewisham.
Why work six days?
The most common question I get asked is: why work six days? The truth is that it keeps me in touch with the real, fast-evolving world of pharmacy. Working Saturdays puts me back on the frontline, and gives me a weekly reality check of what it’s like to be a community pharmacist in one of London’s diverse boroughs.
I am accredited in all services: flu; yellow fever; smoking cessation; medicines use reviews (MURs); the new medicine service; emergency hormonal contraception (EHC); health checks; and whatever else is available. My role is much more exciting than it ever was, and at the same time very stressful – with increasing regulations and reduced margins.
The word “family” has been dropped across many healthcare services – from family practitioner committees (which evolved into clinical commissioning groups) and family doctors (now called GPs), to family businesses (now multiples). The innovation that used to be bottom-up is confined to history.
We now have young managers across the NHS who hardly visit GPs, let alone pharmacies. We have academics who do a good job in innovating and designing service packages, but have never worked in a pharmacy. We have pharmacy leaders – who once upon a time worked in a pharmacy – and finally we have coal-face pharmacists, who deal with real-life situations, and get everything thrown at them.
MURs still have their uses
There were some adverse reports about the MUR service last year. The concept has very much been designed to help patients, only to be let down in some instances by poor implementation. It’s the latter that needs attention.
My experiences during delivering MURs on a Saturday include: dealing with a patient who regularly ordered statins to please his GP, but never took them; an uncontrolled diabetic patient who followed the advice of an internet article; and many with poor inhaler techniques.
I also give lifestyle advice on blood pressure, smoking and obesity – the consequence of all these could have huge cost implications to NHS. Pressure on public health has led to the withdrawal of stop smoking and EHC services – a short-sighted strategy in my view that will generate short-term savings, followed by huge corrective costs later.
So that’s why working Saturdays is important to me – it’s about the connection with the patients, and an effort to see pharmacy through the eyes of Avicenna members. I am in a fortunate position to be able to work on both sides, and try to connect them.
In an attempt to put this learning into practice, all Avicenna head office staff – from the chairman to our apprentices – have to work in an independent pharmacy, to get a taste of what it’s like to walk in our members’ shoes. To quote Confucius: “I hear and I forget, I see and I remember, I do and I understand.”
Salim Jetha is chief executive of independent community pharmacy group Avicenna