How were your early years of practice?
After completing my preregistration training I started the “structured training and experience for pharmacists” programme in south-east London. I was initially based at a district general hospital and this was followed by rotations at a larger teaching hospital. The programme allowed me to gain experience across different clinical rotations across multiple acute trusts. This experience equipped me with the confidence, skills and clinical knowledge required for future practice.
I progressed to take up a medicines information post at Guy’s and St Thomas’ NHS Foundation Trust. It was a regional centre and the work was varied and intense.
Have you undertaken any postgraduate qualifications or other types of professional development that are specific to what you do now?
I have completed the postgraduate diploma in general pharmacy practice. In doing this qualification I acquired the clinical and strategic knowledge that I needed for moving on to more advanced practice.
I have also attended several training courses run by East and South East England Specialist Pharmacy Services. Some of these have been aimed specifically at pharmacists working in elderly care medicine and focused on topics such as: antipsychotics in dementia; anticholinergic prescribing; and practical approaches to reducing polypharmacy.
In any advisory role such as mine, where you are communicating and advising on changes to therapy, it is absolutely imperative to keep up to date with the latest evidence. I have been trained in online literature searching and critical appraisal. I use these skills to search for and appraise the evidence for new medicines and treatments.
I read various journals and subscribe to email news alerts and bulletins to stay informed.
What is your current role and how did you get there?
I am a care home pharmacist and prescribing adviser for Enfield Clinical Commissioning Group. I started this dual post in October 2012, at a time when there was only a handful of care home pharmacists nationwide. Taking up a post that was still a fairly new concept for pharmacy presented me with a challenge, but plenty to look forward to, too.
Having no predecessor meant that in many ways I had a blank canvas to start with; my chief pharmacist and I were able to sit down and carve out the direction we wanted the role to progress towards and decide on the areas we wanted to focus on.
As a care home pharmacist I look after 55 care homes in the borough and I am responsible for promoting high-quality, safe and cost-effective prescribing. I have placed a strong emphasis on addressing polypharmacy and medicines wastage, and I lead on all clinical governance issues — formulating policies and monitoring any resulting action plans.
In many ways, my role as a care home pharmacist complements my role as a prescribing adviser. I build close working relationships with GPs and offer advice with respect to medicine optimisation, cost-effective prescribing and all aspects of medicines information.
What do you enjoy most about your work and of which achievement are you most proud?
Without a doubt, one of the most rewarding and satisfying parts of my role is having a direct input into prescribing — being able to make positive changes to patients’ therapy and seeing the results.
Many of the elderly patients that I review can be on many different medicines and, most of the time, many of these medicines can be stopped without any problems. Tackling polypharmacy with the aim of improving quality of life for patients and reducing unplanned hospital admissions is a rewarding outcome of my work.
My role was piloted as a new initiative within the medicines management team in collaboration with the local authority. It was an exceptionally proud moment for me to have my efforts acknowledged in the recent “Commission on Future Models of Care report”, published by the Royal Pharmaceutical Society.
What do you hope to achieve in the future?
Personally, I plan to undertake an independent prescribing qualification and use it to develop my role further and enhance my practice.
For the profession, I am keen on promoting the public profile of pharmacy. I would like to see pharmacy move forward and continue to be at the forefront of research, innovation and clinical care.
What is the best piece of advice you have for other pharmacists who might like to follow in your footsteps?
A career in pharmacy is what you make of it. The more you put in to your job, the more you will get out of it. Do not be afraid to step out of your comfort zone and grasp any opportunities that come your way. If you are unsure of what direction you wish to go [in], then you should try to experience as many areas of pharmacy as possible — you will only ever benefit from the exposure.
Zeshan Ahmed, PGDipGPP, MRPharmS, is prescribing advisor and care home medicines management pharmacist at NHS Enfield Clinical Commissioning Group
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