Sophie Blow is pushing the boundaries on how patients are cared for before surgery.
After noticing a lack of guidance on how to manage the risk of stopping or changing medicines in perioperative patients, surgical pharmacist Blow decided to do something about it.
“The next thing I know, I was setting up an engagement group and we had over 50 pharmacists writing monographs, and eventually have a published document,” says Blow.
That document was the Handbook of Perioperative Medicines. Blow initiated, project-managed and edited the project, which was published in 2016 and has gained endorsement from the Royal College of Physicians and Surgeons, the Preoperative Association and the Royal Pharmaceutical Society. The handbook is now in its third edition.
Her influence has not stopped there. In the summer before the COVID-19 pandemic hit, Sophie became a Clinical Leadership Fellow in Perioperative Medicine – a role not traditionally held by a pharmacist.
As her nominator says: “It was so refreshing to see a female pharmacist driving this forward in a field dominated by medics and males.” In this role, she is already setting up new services and surgical pathways to improve care.
For instance, after identifying that preoperative iron deficiency anaemia increases complications and the cost of care, she has led a team of anaesthetists, blood transfusion practitioners, haematologists and data analysts to fix the problem.
A subsequent pilot has shown that by identifying and treating patients before admission, preoperative cancellations, bed days and the need for transfusions are reduced. In the first year, the initiative reduced bed days by 560 at one site.
Blow says: “I discovered skills I didn’t know I had.”
The pandemic radically changed priorities. Blow was tasked with setting up a temporary pharmacy service from scratch, from purchasing to supply chain to storage, in an emergency COVID-19 ‘Nightingale hospital’ based in a conference centre in Harrogate. Thankfully, the hospital was never needed.
Returning back to her fellowship, she then was appointed the first clinical lead for perioperative optimisation at Leeds Teaching Hospitals NHS Trust in August 2020, stepping outside of her traditional pharmacy roots and aiming to improve perioperative care for all.
In colorectal surgery, she has worked with the nursing and surgical teams to identify patients with frailty who would benefit from geriatrician input. In five months, 21% of all patients seen by the colorectal service have been identified as frail, referred and reviewed by a geriatrician, with 64% choosing not to proceed with surgery and opting instead for conservative treatment. Blow is now leading plans for a trust-wide service for older people undergoing surgery.
Her most recent project is a website that prepares patients for surgery, called Shape Up 4 Surgery. It provides information and signposts to free exercise classes and stop smoking services.
“We know, particularly now there’s significant waits [for surgery], that people are becoming deconditioned while they’re waiting and they haven’t got the information so it’s a challenging time.”
After a radio and social media campaign, in its first three months Shape Up 4 Surgery has reached more than 1.3 million people living within two hours’ drive of Leeds and it had 2,000 website hits in one month.
Blow admits that she constantly feels like she has to prove herself: “I am young, I’m female, and I’m not in that profession, so when I go to meetings I have to triple check everything.”
However, this is not how one anaesthetist saw it, when they pointed out that her power came from the fact that she was bringing a different perspective: “I learned that what I know is the whole pathway — the surgeons, pharmacists, anaesthetists, nurses and how they all interconnect.
“Looking back I [would] tell younger me to be open and talk to people and introduce yourself because you feel really shy when you start. I just I think I would love to have been able to publicise more what we do as pharmacists and celebrate it a bit more.”
“A really exceptional pharmacist and boundary-breaker, who has introduced major local and national initiatives.”
“Sophie’s initiative to encourage collaboration on a national guide for her area of speciality demonstrates that direct impact she will have had both on the work of other clinicians and most importantly positive outcomes for patients.”
Meet the rest of The Pharmaceutical Journal’s Women to Watch 2021 here