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Thinking outside the box: The pharmacist on a public health mission

Community pharmacist Viral Doshi talks to C+D about how his innovative public health work during COVID-19 lead to him being recognised with a coveted British Citizen Award (BCA)

While COVID-19 lockdowns saw many businesses owners working from behind their doors, community pharmacies stepped up and kept theirs firmly open.

Then when COVID-19 vaccinations started to be rolled out, many community pharmacies offered up their services.

Read more: Podcast: The pharmacist battling long-COVID

Mr Doshi, who is lead pharmacist for public health in the London  Borough of Hillingdon, was among one of the community pharmacists who led the charge in vaccinations.

He spoke to C+D about his COVID-19 efforts, which have seen him win a prestigious award, and what lies ahead for him in the post-pandemic world of community pharmacy.


Tell us a bit about you


I was born in Mombasa in Kenya and came to the UK in 1974.

While my father wanted me to become a dental surgeon because [that's what] he was, I had my heart set on becoming an international cricket superstar. Of course, this did not happen. Despite this, I enjoyed playing league cricket and was considered an all rounder at university.

I got very interested in the medical profession very early on because a lot of family members worked in it as physiotherapists, dentists, pharmacists and so on.

Read more: 'I've always loved to read': The pharmacist with a passion for writing romantic fiction

I decided I wanted to become a pharmacist when I was 16 after working in my brother-in-law's pharmacy during the summer holidays. I was fascinated with the fact that helping people live longer and healthier lives depended on the safe use of medicines and excellent healthcare advice.

I was equally fascinated that pharmacists' unique expertise and knowledge made them essential members of the healthcare team. Indeed, it continues to do so.

Earlier this year (January 26), I was awarded a prestigious BCA for services to healthcare.


Tell us about your award win


I was presented with a BCA Medal of Honour for my COVID-19 work.

At the height of COVID-19, I obtained approval to transform my local community centre into a vaccination hub. This hub was located in the heart of a multi-ethnic population with social deprivation. It was surrounded by wards experiencing high COVID-19 rates.

My determination to increase uptake and reduce vaccination hesitancy, saw 80,000 vaccinations administered. This was the highest vaccination uptake in north west London overall.

Read more: How Northern Ireland's pharmacies vaccinated a nation

I am a passionate advocate for the role community pharmacies and GP practices can play in supporting the health agenda. My goal to provide better choice and community access have been fully met and appreciated by patients.

My initiatives have been recognised as leading to a dramatic increase in the clinical skills, knowledge and services offered by local community pharmacies around various health topics. This has enabled pharmacies to adopt a holistic health approach to working with their communities.

I have been at the forefront of multiple local initiatives improving the lives of the people in their community.

For example, I identified that many local authority colleagues were unable to visit a GP or pharmacy because of their work commitments so I set up an on-site drop-in clinic and gave free health checks. I have identified high blood pressure and risk factors and referred them directly onward as necessary. 


What have your career highs been?


There have been many highs during my career.

I believe I have made a significant difference to the provision of healthcare, [both] in my local community and nationally and have demonstrated award-winning leadership as well as imaginative and innovative solutions to improving patient healthcare and safety.

I am convinced this has influenced numerous positive clinical outcomes and shown measurable improvements in patient care and sustainability.

My objectives have been to improve pharmacy services, professionalism and to provide better choice and access for the community. I believe these have been fully met and well appreciated by patients and fellow primary and secondary care colleagues.

These pharmacy services include sexual health, weight management and smoking cessation.

Read more: Pharmacy smoking cessation service set for slow start, PSNC anticipates

It is my smoking cessation work that I am proudest of. I tried to think outside of the box in my work in this area.

We were seeing a patient on a weekly basis for smoking cessation so I thought to myself,  how could we improve our service offering for them?

I launched a chronic obstructive pulmonary disease (COPD) screening programme to help with this. It not only allowed us to measure the patient’s lung health, but also motivated the patient to actually come to the smoking cessation clinic.

They saw first hand that their lung age was higher than their actual age. So, for example, the patient might have an actual age of 35 but a lung age of 90.

This approach also improved the interprofessional relationship between the pharmacist and GP.

GP practices were really happy pharmacists were doing the COPD screening because they were taking the burden off them and were identifying the patient's condition as early on as possible, meaning it could be managed as early on as possible.

Read more: Pharmacy smoking cessation services hailed as DH rumoured to ditch tobacco plan

Another highlight has been receiving a fellowship from the Royal Pharmaceutical Society (RPS). I believe this demonstrated the high regard colleagues had for me as a leader and role model for the profession. Being appointed an RPS Fellow is one of the highest honours that can be bestowed. 


And the lows?


While there have been many highs during my career, there have also been lows. One of these came early in my career when I was identified as a pharmacist on the street.

I was surrounded by some unsavoury characters, who demanded I provide them with various medications. However, this did not happen as there were some community officers nearby who assisted and dispersed them for me.

This experience left me very worried and scared. However, it also highlighted for me how pharmacists are always in a community setting and when we walk out of our pharmacies or even when we are in the pharmacy, we are always under that spotlight.

Fortunately for our profession I believe we are in a much better position now and are much more respected. I think COVID-19 has played a big part in that.


What advice do you have for today’s trainee pharmacists?


Firstly, I congratulate today's trainee community pharmacists for embarking on their pharmacy careers. I think it's a wonderful profession that's so multi-faceted. Community pharmacies are centres of healthcare, which are well acknowledged and whose clinical profile over the years has gone from strength to strength. This is a fantastic thing.

Read more: HEE to fund exam support for trainee pharmacists for first time

In terms of advice, I would urge them to improve their knowledge of public health and public health skills so they can develop and deliver targeted healthcare interventions within their communities.


What do you like to do in your spare time?


With the bit of spare time I get, the key to balance in my life is to spend quality time with my family. I also enjoy reading, watching sci-fi films and spending my wife’s hard earned money on gadgets.

My charitable activities are also very important to me.

I like to think that my dedication to helping people live a better life has reversed the misfortunes of many deprived people. 


What's next for you?


I want to continue my journey in public health and continue to think outside the box about how I can improve the expertise of the pharmacy profession through health improvements and tackling health inequalities.

Read more: ‘How can community pharmacy teams improve their inclusive practice?’

One of the things I am doing is focusing on NHS England’s (NHSE) Core20PLUS5 approach to reducing healthcare inequalities, which concentrates on the most deprived 20% of the national population. 


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