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How I kept our pharmacy's services running – even without a pharmacist

Ms Fairweather trained as a smoking cessation advisor – and trains colleagues to offer the service
Ms Fairweather trained as a smoking cessation advisor – and trains colleagues to offer the service

Dispenser Dawn Fairweather stepped in when a busy Well branch was without a full-time pharmacist for six months. She tells C+D how she got the pharmacy's services back on track

In a financial climate where local authorities are cutting back on smoking cessation funding, it is reassuring to see pharmacy staff are still willing to go out of their way to keep the service on track, even in challenging staffing situations.

Well Pharmacy’s Bollin House branch in Macclesfield managed to continue to offer a smoking cessation service, even during a six-month period when the branch was operating without a full-time pharmacist.

It was left to dispenser Dawn Fairweather, who qualified as a stop smoking practitioner in 2016, to become the pharmacy’s smoking cessation lead. 

Offering “mini-therapy sessions”

Ms Fairweather stepped up to run the smoking cessation service when local commissioners “changed the way it was going to be funded” – meaning a local GP surgery, which was due to offer the service, could no longer afford to provide it.

“The branch didn’t offer the service initially, so I put myself forward,” she explains. After winning a bid, the Well branch implemented the scheme, which offers patients a twelve-week course. Ms Fairweather says the in-depth nature of the course – which includes her technique of giving patients “mini-therapy sessions” – is her secret to success.

“We delve into their history and look at exactly why they smoke. [Smoking] is not so much a nicotine addiction…as it is [an addiction of] behaviour,” she tells C+D.

After achieving a “fantastic success rate” and earning several referrals from neighbouring GP surgeries, Ms Fairweather became a trainer for the specialist service provider Kickstart, based in Macclesfield Hospital. Since then she has trained another staff member, her colleague Darren – using a unique sporting analogy.

“I used to smoke myself many years ago, whereas Darren has never smoked, so [I needed] to get him to understand what it’s like to quit. Darren is a die-hard Manchester City fan, so we started talking about the psychology of that. He just couldn’t imagine putting another [team’s] shirt on, and couldn’t imagine going to their game.

“So I said: ‘Right, from tomorrow you support Liverpool’. [Stopping smoking] is that sort of change in somebody’s lifestyle; it’s a huge change to somebody to no longer smoke, especially if they’ve been doing it for many years.”

“I helped [him] do his online National Centre for Smoking Cessation and Training (NCSCT) qualification, and then supported him through on-the-job training,” she recalls.

Taking pressure off GPs

In addition to the smoking cessation scheme, the branch also provides a weight management service, flu vaccinations, blood pressure testing, and advice on alcohol abuse.

“We have six surgeries across the road in a medical centre [with] 56 doctors,” Ms Fairweather explains. Offering patients these services in the pharmacy helps to take the workload off the GPs, she says. “There is so much [pharmacy] can deal with that people aren’t necessarily aware of.”

For example, during last year’s flu vaccination season, “we did hundreds [of flu jabs] on behalf of GPs”. The blood pressure testing also means the pharmacy is sent patients from the GP, as “they’re stretched and don’t have the facilities to offer it there”.

Minor ailments service “back on track”

In April this year, the pharmacy was finally able to reduce its reliance on locums, after branch pharmacist Chelsea Taylor, who joined in October 2017, became accredited to offer a minor ailments service commissioned by Eastern Cheshire clinical commissioning group (CCG).

Ms Fairweather says it was “quite frustrating” not to be able to offer a minor ailments service, but Well tells C+D it is now “picking up pace”, with the branch receiving an average of two inquiries a day since Ms Taylor received her accreditation.

Ms Fairweather says she is pleased to see the pharmacy “back on track” with this offering, as it is “really beneficial” for patients.

Looking to the future

While her name badge says 'dispenser', Ms Fairweather says she has “been working as a pharmacy technician for at least 10 years” – but has not yet been able to complete her technician qualification after taking career breaks to have two children.  

But working in community pharmacy has inspired her, and she also says her six-year-old daughter wants to become a community pharmacist. “It’s certainly a nice sector to be in,” Ms Fairweather says.

“I think there’s a lot more future prospects for me to work towards in my pharmacy career, so I’m happy.”

Do you know of a dispenser who has expanded their role in the pharmacy?

A LOCUM, Community pharmacist

are we going to get an answer on  how the branch continued the NRT service without a pharmacist or not ???????????????????????????

Leon The Apothecary, Student

Smoking Cessation doesn't require a Pharmacist, except for Champix via PGD, at least in my neck of the woods.

Interleukin -2, Community pharmacist

The mess that is todays pharmacy........i suspect a few laws have been broken here and we re busy applauding....I vaguely remember a pharmacist being disciplined for providing "MURS" and not having "accreditation" ..but with six years of uni/training and many years of practice experience. Whats going on!?

Easier in Wales! Has to be an accredited Pharmacist or accredited, registered  technician!

Sue Per, Locum pharmacist

Ms Fairweather says it was “quite frustrating” not to be able to offer a minor ailments service, but Well tells C+D it is now “picking up pace”, with the branch receiving an average of two inquiries a day since Ms Taylor received her accreditation.

Does the article imply that she is providing MAS - with accredition??????.

She is not even qualified as a technician, therefore have the qualification requirements been derogated, generally, or for this particular branch???

I think you need to read the article again. In October last year a permanent pharmacist joined (Ms Taylor) who then gained the accreditation to provide MAS. The branch wasn't providing MAS without an accredited pharmacist. The only service they were providing before was smoking cessation where you don't need an accredited pharmacist unless you intend to provide champix via a PGD.

A LOCUM, Community pharmacist

i think you need to speak to your local stop smoking cessation clinical lead , you do HAVE to be accredited , i've had to do all the training ie cppe and workshops and up dates , so how come these rules dont apply to ms taylor ? and have myself and all other PHARMACISTS been doing unecessary training when ms taylor has a 'free' hand to do anything she wants unlike the rest of us ????????????

Not in the area I work. You can become a stop smoking advisor and provide NRT (except champix) without pharmacist supervision. Then claim for payments using the blue vouchers or possibly using pharmaoutcomes depending on how the account is set up. On pharmaoutcomes you only need to enter pharmacist registration details when supplying champix. Again, I'm only referring to the area I work and can't speak for other areas of the country. 

Also, I think you are confusing the 2 people in the article. Ms Taylor is a pharmacist who started in OCT 2017 who received accreditation to provide MAS. Ms Fairweather is the lady who was providing the stop smoking service.

You could always phone the branch and ask the for more details about the services if it incences you that much.

A LOCUM, Community pharmacist

ms fairweather is not a pharmacist , she cannot sign the pharmacists box on any blue, green, purple voucher nor complete the DoC on pharmaoutcomes to claim payment , the locums who they used in the 6 month period when ms taylor was not appointed cannot do these two tasks unless they . complete NCSCT online programme 1 or 2 or equivalent CPPE training , request a level 2 local implementation briefing , knowledge and skill training completed, arrange mininum 2 shadowing sessions with a mentor , complete competency assessment .

Apologies, I didn't exaplin myself very well regarding the blue vouchers. She might have been using the ones used by non-pharmacy stop smoking advisors (I get these all the time). I know this would  be unlikely given the advisors are normally based in community clinics.

I'm not disputing anything you are saying, I know the stop smoking scheme well having run a one for the last 8 years. The point I was making was it would be possible for someone to run a smoking cessation clinic without a regular pharmacist. I don't think there would be a large write up about someone providing an illegal service who has gone on to become a trainer for a specialist service provider as detailed in the article.

Again, if you wanted to know exactly how they got around the lack of a regular pharmacist you'd be best to contact the Well branch itself.  They must have been doing something different to the norm.

A LOCUM, Community pharmacist

pleased we are getting somewhere now, i'm fully aware ms fairweather is a SSSA , its the accredidation of the locums in that 6 month period i'm questioning , for them to clinincally check , dispense and sign her vouchers and claim payment on pharmaoutcomes after signing the DoC or using a direct electronical system after undergoing relevent training and passwords , they must have had some calibre of locums unheard of anywhere else in the UK. my understanding is when the permanent accredited pharmacist leaves the service must stop 

A LOCUM, Community pharmacist

sorry for being a killjoy ,during the 6 months when the business was run on locums , as i understand all these services require a locally trained accredited pharmacist to sign off vouchers and complete relevent CPPE modules and complete Declaration of Competence to claim money on sites like Pharmaoutcomes , strings of different locums on different days are rarely accredited and many are out of the local area anyway , so how have these services been signed off and claimed for ?

Well done Ms Fairweather. Proud of you and the hard work done by you and thousands of pharmacy staff every single day. 

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