Jonathan Burton
Congratulations on being awarded the accolade of ‘Pharmacist of the year in Scotland’ at the Scottish Pharmacist Awards 2016. How does it feel to be recognised in this way?
It’s obviously a great feeling. It’s slightly bitter-sweet though as I know that there are a great many community pharmacists out there who work exceptionally hard and are not fortunate to have received the recognition I have through my career. I am very lucky, and thankful.
Can you explain a bit about what you do that contributed towards your win?
I think I was nominated because of the work I’ve done with our local Pharmacy First service in NHS Forth Valley, which has enabled community pharmacists to assess & treat urinary tract infections (UTIs) and minor skin infections as a walk-in service.
It’s really been a team effort, but I drafted up the concept & argued for the service to be developed & funded, and helped piloted the service initially, so it’s all my fault really! I’ve also started running a walk-in independent prescriber (IP) clinic in my pharmacy, assessing & treating a range of common clinical conditions.
What common clinical conditions do you see most in your pharmacy and how do you manage them?
I see lots of sore throats, lots and lots of sore throats! As you can imagine the student population mix quite closely, so common viral infections spread easily, this can include glandular fever too. Ear problems (wax, outer & middle ear infections) are also common, along with skin presentations. We see quite a large number of scabies infestations, again due to students living together, sports & sexual contact too.
Do you manage to make use of your independent prescribing qualification to the fullest extent?
I feel I do. I use it within the NHS services to treat a wider range of ear, nose and throat (ENT) presentations in particular e.g. topical steroids & antibiotics for more severe Otitis Externa. I also use it privately to prescribe a wide range of vaccines etc in our pharmacy travel clinic. I’m interested in acute presentations and public health, and I feel my IP qualification enables me to really practice autonomously at the top of my licence in these areas.
Could you deliver these services without being an IP?
Some, but not all. I will say, though, that in my opinion enhanced clinical & physical assessment skills are more valuable than a prescribing qualification when it comes to managing common clinical conditions.
What is your next move in terms of applying the IP skills in your pharmacy?
Simply to do more of the same, but better.
I feel I’m offering the right kinds of consultation to my patients, but I need to fully evaluate what I’m doing with my walk-in common clinical conditions service and continually improve, update & refine my skills. There may be some conditions currently just beyond the scope of my competency that I may start to manage more autonomously, but first I’ll continue to work hard on my current practice. I’d like to access more of the NES clinical skills training in the coming months, it’s been incredibly helpful for me.
If you qualified again would you choose community pharmacy, hospital pharmacy or GP practice pharmacy?
I can confidently say that I am glad to practice in the community, I love my job & would do it all again. But, I am fortunate that I have a certain amount of control over my professional life, co-owning the pharmacy group I work in.
Community pharmacy is to a certain extent what you make it, you have to make every patient contact count, but it can be very demanding. I can fully understand why so many new entrants to the professional consider GP practice pharmacy or hospital practice more attractive options to make best use of their knowledge & skills.
Quite frankly, community pharmacy leaders and owners need to understand this too, or we will lose a generation of our most talented & committed pharmacists. The sad and bitter irony of this situation is that, in my opinion, community practice potentially offers pharmacists some of the most clinically challenging and interesting opportunities to closely interact with patients. Trust me, I live part of that dream and it’s awesome.
Public health interventions, vaccination, clinical & physical assessment, prescribing, management of chronic conditions — community pharmacy could be the natural home for so much of these vital activities, but in reality we hold ourselves back in many ways. That might be difficult for some to hear, but I believe it is the truth.
What is your 10-year plan?
To be honest I don’t have one! I do have certain goals though. I’d like to serve again on the RPS Scottish Pharmacy Board. I’d also like to continue my postgraduate studies I’m currently doing via Keele University through to diploma level, & possibly go on from there to do an MSc, and even a professional doctorate in the future if I’m capable.
I’m aiming to resubmit my RPS Faculty portfolio every 3-5 years, I want to maintain my membership & one day achieve fellowship level. I rediscovered my love for learning 2-3 years ago and it’s really changed my outlook on my practice. Aside from that, just to have a happy family & work life. I’ve started swimming again after a long break and that feels good, I used to compete & would like to do so again in the masters age groups.
What would you like the RPS in Scotland to focus on in the coming year?
I think we need to see a much clearer strategy on member engagement with the Foundation and Faculty programmes in Scotland, to build more formal support networks. Aside from that, to continue the vital lobbying work for pharmacist access to patient records.
How healthy is community pharmacy in Scotland right now?
Comparatively healthy, when compared to other parts of the UK. It’s a big question though. We have stability, but we don’t want stagnation, new ways of working & services need to develop. It’s a difficult balance.
What changes need to be implemented to help community pharmacy reach its potential?
If we can further integrate ourselves into the fabric of NHS Scotland via vaccination services, expanded walk-in clinic activity and make our premises more fit for purpose I think we’ll be in a much safer place.
I’ve touched on it earlier, but there are some uncomfortable truths that community pharmacy leaders and owners need to confront if we are to truly progress. We’re not playing games here, community pharmacy is becoming more complex and patient focused, and the demands placed on community pharmacists need to be taken into consideration when planning the environment we work in and the staff teams supporting us.
Of course, there are key statutory and NHS contractual changes that will help drive progress, I understand this, but we need to drive change from within too, and show we are serious about our role in NHS. This will take a certain amount of collective bravery.