Francisco Alvarez, Isle of Wight: pharmacy manager at Regent Pharmacy
Francisco Alvarez has been a champion of the Pharmacy First service since it was introduced to the Isle of Wight in 2014. It allows patients with certain minor ailments and conditions, including earache, coughs and colds, skin rashes, eye infections and diarrhoea, to go straight to their pharmacist for a consultation without having to go to the GP first.
All of my patients have access to my clinical expertise through medicines supply, lifestyle advice, managing long-term conditions and Pharmacy First
When Pharmacy First was introduced, Alvarez worked with the clinical leads at GP practices to see how they could better communicate the scheme to patients, such as through leaflets, posters and hand-out cards. Already 335 of the patients Alvarez has seen under Pharmacy First were referred by a GP.
Alvarez has also presented at local voluntary groups and met with local councillors to discuss the benefits of the service. Over 5,000 Isle of Wight residents have been treated under Pharmacy First since 2014.
“All of my patients have access to my clinical expertise through medicines supply, lifestyle advice, managing long-term conditions and Pharmacy First, which is a concept I would like to see developed further to include more conditions that can be effectively managed by a pharmacist,” says Alvarez.
Margaret Hook, North Somerset: community pharmacist and owner of Banwell Village Pharmacy
Margaret Hook has piloted a new service to help with the early identification of dementia. This involved identifying customers who were having memory problems and then offering them a memory assessment and the chance to take part in a mini cognitive test to screen for changes in memory. Hook adapted the service to involve the whole pharmacy team to ensure the service was available all day.
Our patients can come in anytime to see us, they don’t need to make an appointment and they can speak to us in confidence
Over a quarter of the 64 people assessed said they noticed a significant change in their memory. By speaking to them their conditions were identified early and they were referred to other health services for further support, or to have their medicines altered.
Piloting this service motivated Hook to continue with her dementia work. All of her staff have been trained as Dementia Friends so they know what signs to look out for.
“Pharmacists are ideally placed to help identify dementia as we see our patients on a regular basis and can often spot changes in their memory. Our patients can come in anytime to see us, they don’t need to make an appointment and they can speak to us in confidence,” she says.
Paul Scott-Harris, Buxted, East Sussex: community pharmacist, Buxted Pharmacy
Since 2014, Paul Scott-Harris has been the only pharmacist in the area to have full access to patients’ health records, with their permission. With this access Scott-Harris is able to make up to 40 life-changing medicines interventions every month for patients, without them having to be referred to their GP, saving time for both the GP and the patient, as well as NHS money.
Access to patient records should be available to all pharmacists, enabling them to make timely and effective clinical interventions based on primary data from the GP surgery
Changes he has made include adjusting doses of blood pressure tablets or changing diabetes or heart medication. Warfarin doses are also checked routinely against blood results.
Scott-Harris’s pharmacy is integrated with the village GP practice meaning he can assist with triaging patients. He also supports dementia patients in the GP surgery by reviewing their medicines.
“I believe strongly that access to patient records should be available to all pharmacists, enabling them to make timely and effective clinical interventions based on primary data from the GP surgery,” he explains. “The obvious benefits to patients’ are time saving, reduction of stress, no need to make GP appointments or take time off work.”
Leela Terry, Gloucestershire: gastroenterology pharmacist prescriber at Cheltenham General and Gloucestershire Royal Hospitals
Leela Terry has been shortlisted for her work with patients with inflammatory bowel disease. Terry has been leading medication counselling clinics for over a year, having developed the role with the inflammatory bowel disease team.
Having a pharmacist on the gastroenterology team is a real benefit to our patients and demonstrates how important it is that pharmacists are part of the multidisciplinary team
Her work involves carrying out full assessments of patients, including measuring disease activity, to make sure they are prescribed the right medicine for their condition and guiding them through their medication options.
By increasing clinic availability through a more effective skill mix Terry has reduced waiting times and saved nursing time. As a direct result the team is now able to offer an additional 36 appointments each month. Over the first year, Terry saved more than £50,000 in medicine costs through optimising the use of expensive biologic medicines, identifying medicines adherence issues and increasing the use of homecare services for inflammatory bowel disease patients. Patients have said how much they value seeing a pharmacist in this setting.
“Having a pharmacist on the gastroenterology team is a real benefit to our patients and demonstrates how important it is that pharmacists are part of the multidisciplinary team in hospitals and community. I am proud of how much has been achieved so far,” she says.