A day in the life of a PCN pharmacist: challenging clinical work
One of the first primary care network (PCN) pharmacists shares a diary account of a day managing in-depth medicine reviews across three GP surgeries
Since starting my role as one of the first PCN pharmacists in the country, I have been asked countless times what this new role offers compared to my previous position managing a community pharmacy.
7:20: My day starts fairly early. I work across three surgeries in West Sussex with a patient count of over 30,000, so there’s a lot of work to get through. I spend one day a week in two quieter practices and two days a week in a busier surgery. I try and get to work before my morning clinic slots start, to organise my paperwork and log onto the computers.
7:30-8:00: Due to new GP access improvements, I have two 15-minute slots available to patients of the surgeries if they wish to discuss their medicines with me over the phone, or have any other clinical questions. I can log onto any of the three surgeries’ systems remotely via a laptop, allowing me to view patient records wherever I am.
8:00-8:30: I start to think about what clinic appointments I will have for the coming day. One of the surgeries in particular is keen for me to do some face-to-face medicine reviews to ease the appointment workload on the GPs. I normally use this time to look through the pre-booked patients’ records and make notes on points I wish to discuss with them at their review.
8:30-10:30: I hold the medicine review clinic, where I conduct between six and eight 15-minute appointments to go through patients' medications. It can be anything from discussing side effects of medications to making sure all their dosages are in line with their indications. It’s a chance for patients to speak to someone in depth about their medicines.
11:00-12:00: The last part of the morning is a great chance for me to catch up on tasks and discharge summaries for GPs. I systematically work through them, clinically screening each patient and action any medicine changes if necessary. This is much like the day-to-day job of a normal GP pharmacist.
13:00-15:00: The afternoon is dominated by my PCN work. Instead of just using the data of the surgery I’m currently in, I use this time to gather information from all three and form audits on specific topics where I feel I can affect the most positive change.
For example, I’ve just finished an audit on patients taking direct oral anticoagulants (DOACs). It was eye-opening to find that in some surgeries more than half of the patients on DOACs needed an up-to-date blood test or dosage review.
That’s where PCN pharmacists come in. We're focused, medication-centred health professionals who can look at high-risk drugs and initiate protocols to prevent under-monitoring and dosage errors across our whole network.
15:00-16:00: This part of the afternoon is a chance to plan for new audits. I generally meet with the practice managers and the lead prescribers from each surgery to discuss goals to aim towards. We occasionally hold joint meetings to link our individual practice goals to the goals of the PCN.
16:00-17:00: I catch up on my independent prescribing course at the University of Brighton. I’m looking into specialising in care of older patients, a broad topic with a lot of potential.
17:00-17:30: The last part of the day is catching up on emails and networking with other pharmacists both in my locality and nationally. Being one of the first PCN pharmacists since the networks formed [in June], I’m eager to create as big a support network as possible to improve outcomes and share ideas of what works best for these new groups of practices.
Overall, I find it much more clinical than my previous community pharmacy role. Generally this means more challenging work, but seeing the impact I have made in improving patient safety in my surgeries has been incredibly rewarding.
Danny Bartlett is a PCN pharmacist for the Coastal West Sussex Partnership
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