Life as a practice pharmacist: getting to know my team
Building bridges with other healthcare professionals helps, explains Vivek Kuvelker
When I started working as a practice pharmacist, there was quite a steep learning curve.
I was part of the Clinical Pharmacists in General Practice pilot – arranged by a federation of GP practices in North Yorkshire – which began in September last year and eventually recruited 14 pharmacists. Our role is to add specialist clinical pharmacist knowledge to decisions being made about patients’ treatments.
Once I started working with my primary care colleagues at the Stokesley Health Centre, I realised I needed to become accustomed with the different types of work that went on in the practice, and the various healthcare professionals who worked there.
I planned meetings with GPs, and learned about their clinical systems. To understand the team’s roles in more depth, I began shadowing them.
Prescriptions and patients
The start of the shadowing period was a slightly worrying time for me, but everyone was very approachable and understanding, despite their busy schedules. For example, the practice nurses showed me how they run chronic disease management clinics for patients with asthma and angina.
On another occasion, the staff that oversee prescriptions showed me the kinds of problems they face on a typical day. Through having my input while I was shadowing them, they gradually realised that having me there helped to sort out a lot of patient and pharmacy-related queries.
Facing similar problems
I met with the other pharmacists in the pilot on a monthly basis. Most, including myself, hadn’t previously worked in a GP practice, and so we were understandably nervous about what we’d need to do and how we’d do it. It was a relief to be able to speak to those who had prior experience, and we realised that although each surgery was different, their clinical needs were similar.
We used a range of key performance indicators (KPIs) to record how effectively the pharmacists in the pilot were carrying out our different activities. These related to: reducing GP workload and saving them time; reducing hospital admissions; minimising medication wastage; improving the timeliness of hospital discharge medication reviews; and maintaining an effective medicines optimisation process.
“Anger got the better of me”
Trying to meet these KPIs was, at times, frustrating. Although I’m usually quite calm and collected, anger got the better of me on occasions – for example, when creating an appropriate recording template on SystmOne (the clinical IT system used in the surgery) and EMIS. I couldn’t understand why some of the pharmacists in the pilot just didn’t see that ‘one size doesn’t fit all’. Using one template to record everything we did just wasn’t going to work – it was certainly a learning experience for me.
But learning is always an ongoing process and this pilot is no exception. Due to an imminent Care Quality Commission (CQC) inspection at the practice, we were trained to meet different clinical governance requirements, and we were all provided with vulnerable adult, child protection and lone worker training. I was also trained to set up the electronic prescription service’s (EPS) repeat dispensing facility at the surgery. Coming from a community pharmacy background, it was interesting to see how EPS worked from the surgery’s point of view.
Primary care training
Overall, I felt very lucky because despite the frustrations, I had more positive experiences than negative, thanks to the excellent support I was given by everyone at the Stokesley Health Centre. I was trained to provide flu vaccinations by following the surgery’s patient group direction, and trained to take part in clinical practice research.
I was also offered independent prescriber training at Keele University. This consisted of a six-month course, with distance learning elements and monthly study days at the university, which I attended with two other pilot pharmacists. I’m proud to say that we’ve all passed the course and will soon become registered prescribers. I’d like to thank GP Mark Duggleby, nurse practitioner Michelle Parker and all of the other doctors at the Stokesley practice, for their help.
Finding time to smile
I get on well with the other staff (pictured), including the long-term conditions nurses, who do a great job visiting patients at home and helping with a lot of clinical and practical problems in the surgery. They’ve shadowed me too, and are now very comfortable asking me to support them to help patients.
The nurses, GPs and I have all learned a lot from each other – and still do. Through our teamwork, we have minimised drug wastage, while improving adherence and patient outcomes. I’ve grown to understand their problems and they’re aware of how I can help them to solve theirs. They’ve made me smile many times and I’ve been known to make them giggle occasionally. It’s a good relationship between us.
Read Vivek's first impression of life as a practice pharmacist here.