You recently had an ‘excellent’ rating on your GPhC inspection. Congratulations, what the secret?
How did you prepare for the inspection?
However, like all busy pharmacy owners there is nothing quite like the GPhC letter for inspection notification to “focus the mind” and make sure all the t’s are crossed and the i’s are dotted!
Were there any aspects you had concerns about?
Like all pharmacies, we have our more challenging days, perhaps with staff absence or miscommunication and we know that on these days things are not always as good as we would like them to be, but I think both Leanne and I know that on a good day with the wind blowing in the right direction we are an excellent pharmacy!
Fortunately for us, our inspection was on one of those days. It is important to remember the inspector is trying to give you the best possible score, so be proud of your achievements and shout about them and explain the challenges we all face from time to time as learning opportunities.
What do you spend most of your time doing day-to-day in the pharmacy?
I try to spend most of my time being a clinical pharmacist in the heart of my community. This might include assessing and triaiging minor ailments, discussing complex medication regimens with patients and their carers, administering travel vaccinations in out travel clinic or using clinical skills to help make appropriate referrals. We make full use an ACT which enables the pharmacist to be largely freed from dispensing process. In fact she acts more like a pharmacy manager and is the continuity in our business as both pharmacists only work part time in the pharmacy.
What do you enjoy about pharmacy?
I love the variety community pharmacy throws at you! I have no idea what I will do tomorrow but know it won’t be dull, and it will almost certainly make someone’s day a little better.
I also really like building relationships with my patients. This makes it so much easier when you have to have a difficult conversations down the line (e.g. concerns about memory) when you remember their spouse’s name or what their grandkids are doing. I love that saying “Noone cares how much you know, until they know how much you care” and we see our patients when they are well, which makes it so much easier to tell when someone is poorly.
I am always frustrated by the pace of change in pharmacy. I remember discussing the need for access to patient records and IT solutions to clinical record keeping during BPSA student conferences back in the 1990s! I’m not sure how far we have come in those areas.
You are an independent prescriber, how do you feel about that?
Both Leanne and I are independent prescribers and manage a caseload of polypharmacy patients in our local GP practices. I love having the ability to prescribe, but it is not the ultimate goal. I see it more as one of the tools I use in my clinical role, alongside but not greater than any of my other skills. Pharmacist prescribing just makes sense and I really enjoy this role, as it is multidisciplinary working in primary care at its best. Over the past 20 years this has been the biggest change to my professional work and I think it has really enhanced how other professions see us.
What can be done to encourage or help all pharmacists to become independent prescribers?
All pharmacists should be prescribing and most are under the minor ailments service every day. They see a patient, assess their symptoms clinically and prescribe a product or give advise based on the best available evidence.
Taking this a step further, prescribing evolves and my own practice started out as an asthma clinic following a very small formulary and British Thoracic Society (BTS) guidelines. As my confidence and competence grew I took on chronic obstructive pulmonary disease (COPD) and now polypharmacy clinics using clinical skills. It is important to remember this is an evolutionary process, and not all prescribers will be doing polypharmacy prescribing clinics straight away, but all pharmacists can start somewhere.
I got really excited about Prescription for Excellence as I think it is really aspirational and a great sequel to The Right Medicine. I feel a little bit disappointed about the lack of progress now, two years down the line (but that is probably linked to my general impatience!). Our new chief pharmacist seems keen to move forward and hopefully things will now move forward again and Scotland will lead the way once more!
Sally Arnison is joint owner of Barnton Pharmacy in Edinburgh