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Clinical pharmacists keen to make a valuable contribution

By Maureen O'Sullivan, MRPharmS

Looking back over the past few months, Clinical Pharmacist has updated readers on the latest in medicines optimisation, kept them in touch with development of the Royal Pharmaceutical Society Faculty and offered food for thought on the next steps for NHS organisations in the wake of the final Francis report.

These are all high-profile matters that will most certainly impact on the future of pharmacy practice. But what is it that clinical pharmacists are passionate about in their working lives? This month we ask six colleagues to share some thoughts about what it means for them to be a clinical pharmacist.

Direct patient care

“I enjoy being able to provide patients support with their medicines at a time when they feel most vulnerable and scared,” reveals Kate MacNamara, a clinical pharmacist at Morriston Hospital in Swansea. Working in cardiac and stroke services, Ms MacNamara often sees patients who were not taking any medicines before coming to hospital, but who leave taking many. “It’s great when you know they will be leaving hospital using their medicines in a safe and effective way,” she says.

Adam Rathbone, specialist clinical pharmacist at South Tees Hospitals NHS Foundation Trust, agrees that patient education is one of the most satisfying parts of the job. “Seeing that ‘eureka’ moment on a patient’s face when they put two and two together is brilliant,” says Mr Rathbone, referring to the times when he is able to communicate something new to patients about their medicines.

Nevertheless, engaging patients in self-care behaviour can be a challenge, according to Rocco Hadland, heart failure pharmacist at Wrexham Maelor Hospital. He says: “Patients are often given poor, if any, explanation about why medicines are prescribed or changed and this often leads to poor adherence.” He suggests that tailoring information to patients’ needs is one way to overcome this.   

Danielle Wigg, specialist surgical pharmacist at North Bristol NHS Trust, remarks: “The most rewarding part of my job is being asked for advice by clinicians and patients, and using my problem-solving skills to come up with solutions.”

Being proactive

Taking a proactive role in patient care is what Alia Gilani, a health inequalities pharmacist at NHS Greater Glasgow and Clyde, appreciates most about her work.

“I enjoy having the autonomy to prescribe and make clinical decisions,” explains Ms Gilani. “I like pushing the boundaries of the traditional pharmacy model and being able to conduct innovative projects that help to change the face of pharmacy and promote it to other healthcare professionals.”

Contributing proactively to the development of services is also important to Sheena Patel, specialist anticoagulation pharmacist at Chelsea and Westminster Hospital NHS Foundation Trust. Ms Patel was a finalist at this year’s Pharmaceutical Care Awards (London, 14 June 2013) for the hospital venous thromboembolism prevention programme in which she played a key role.

“Being a clinical pharmacist, I feel that I make a valuable contribution in helping to implement and drive changes that enhance patient safety,” says Ms Patel. “I see the direct effect of my recommendations and feel part of the wider hospital team.”

Rising concerns

It is clear that patient-centred care is important to clinical pharmacists. But is there anything preventing them from adding more value to healthcare? Could they be doing better?

Ms Gilani suggests that the lack of permanent financial arrangements and poor support structures for independent pharmacist prescribing clinics are making it difficult to take pharmacy services forward in Scotland.

Mr Hadland, who is an independent prescriber for heart failure, concurs: “There are many pharmacist prescribers who are not using their qualifications — this is missing an opportunity to bring the profession forward.”

Ms Gilani also believes that a lack of support for innovation in pharmacy could be detrimental to the profession. “If we do not support pieces of work that think outside the box then we will have a stagnant profession,” she warns, adding that this could restrict pharmacist engagement in patient care.

However, Ms Gilani does believe that “perseverance pays” and that pharmacists who feel passionate about an aspect of patient care — like health inequalities, in her own case — should still strive to address the issues, irrespective of any lack of support or funding.

Place in healthcare

“I think it is important to raise the profile of pharmacy,” comments Ms Patel. “The role of the clinical pharmacist is expanding and we need to promote our expertise to other healthcare professionals. . . . Pharmacists can provide specialist advice and adopt stewardship responsibilities on clinical ward rounds, for instance.”

But Mr Rathbone is concerned that many people do not understand what a clinical pharmacist is or what one does on a hospital ward. He says: “I feel many other healthcare professionals think that pharmacists just supply medicines and they do not appreciate the knowledge and skills that clinical pharmacists have.”

He believes outdated perceptions of pharmacy stem from the restricted opening hours of pharmacies in secondary care. “How can we ever promote pharmacy as an essential service if we do not reflect that in our opening hours,” he asks.

Indeed, the need for the role of pharmacy to be better understood by other healthcare professionals and the public appears to resonate strongly with clinical pharmacists.

To this end, Ms Gilani suggests that more pharmacy leaders are needed to support the future generation of pharmacists. “We need more proactive pharmacists,” she insists, “to help change the perception of pharmacy in the public, the Government and other healthcare professions.”

 

Citation: Clinical Pharmacist DOI: 10.1211/CP.2013.11123335

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