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5 minutes with…GP practice pharmacist, Helen Kilminster

Why did you study Pharmacy?

Right place, right time! I asked my local Boots pharmacist for a Saturday job a few weeks before my 16th birthday, he told me to come back after my birthday for an interview. I had no idea he was also the store manager. He offered me a job as a healthcare assistant there and then.


When the dreaded UCAS application deadline approached, I had no real idea what kind of career I wanted. After working with a newly qualified pharmacist called Marianne for a few weekends, she completely sold me on the idea of going to Portsmouth University to become a pharmacist — she even gave me a reading list, so must have seen my potential.


I had left it two weeks before deciding on applying to do a pharmacy degree. I will be forever grateful to her for pushing me to apply, as 18 years on, we are still great friends and we still work together in a mutual supportive manner.


How long have you been qualified?

Twelve years this year! Argh!


Have you always worked in a GP practice?

No, not really. But as a community pharmacist I invested time to get to know the local practices, the GPs and Practice Managers. So within my working locality I’ve known my current practice for about 6-7 years now.


I did my pre-reg at New Cross Hospital, Wolverhampton, then once qualified started out in Hereford County Hospital as a rotational band 6/7 clinical pharmacist. Unfortunately due to family circumstances I then left the hospital world to do community pharmacy with the ambition to bring clinical practice into community pharmacy.


What does your role involve in the GP practice?


Everything and anything! I currently work as a senior clinical pharmacist on wave 1 of the GP Pharmacist NHSE pilot, at Whiteacres Medical Centre in Malvern.


I feel fortunate to be appreciated as part of both the clinical and non-clinical team. As a non-clinical member of the team I help support strategic planning of services, identify priorities and make in-house processes smarter and safer to ultimately improve patient care. I’ve also been involved with their CQC visit in March 2016 as the surgery’s nominated medicines lead.


Within South Worcestershire CCG, we have improving quality and supporting practices (IQSP) meetings every 6 months, which looks at how we can collectively share ideas and drive clinical changes to improve quality of practices. As a result of these visits, I run the necessary audits and review particular patient cohorts that have been highlighted as significant through new clinical evidence or improved working guidelines.


As a valued clinical member of the team, I see patients for minor illnesses, general medication reviews, post-hospital discharge reviews, NHS health checks, management of some long-term conditions and vaccination clinics.


Medicine reviews for me can be anything from oral contraceptive checks, to reissuing of antidepressants. I started my career in hospital where I was trained to take blood, and my practice has allowed me time for a refresher on this too, though it is not expected that I will be required to run phlebotomy clinics. I feel I am treated as an autonomous prescribing clinician and truly integrated into practice.


I am also the named ‘Care Navigator’ for my practice. Social prescribing or active signposting has been fairly topical, but I often feel clinical and social care complement one another. There is a wealth of information; volunteer organisations and charity organisations that can help support our patients. I’ve found myself faced with some challenging social patient cases, which fortunately all have concluded well. Of course, I will continually follow-up these cases to provide support as their care navigator as circumstances change.


I know some people think or see me as a maverick, being a ‘mocktor’ but those who have sat in with me in my clinics or have shadowed me in practice, can see I know my limitations and recognise when it is sensible to refer on — I won’t take any uncalculated risks.


I will always try to provide the best holistic patient care that I can, and I’m hoping my actions help realise the ambitions and potentials of pharmacists in the future. I wouldn’t expect everyone to do what I do, and I don’t see what I do is better than any other healthcare professional, but I do feel there is still hesitation, resistance and acceptance to change our practice in the pharmacy profession.


I hope my achievements give others a chance to reflect on their own practice to build their strengths, and drive innovations, to make a positive change in their own domains.


What is your top tip for pharmacists working in GP practice?

Be patient, open and honest. Before embarking on my current role, I worked for our local GP federation who in turn support all 32 GP practices in the patch. It is important to acknowledge that no two practices are exactly alike, and you need to be self-aware of your attitudes, behaviours and language when meeting practice teams — you never know whose help you might need.


It takes time to develop knowledge and confidence and to be fully integrated into practices. For many, pharmacists in GP surgeries are a completely new concept and only a pharmacist knows what a pharmacist can do.


The foundation of a good working relationship is there to be built, so don’t be afraid to show off your skill and knowledge of medicines. Simple interventions often have the biggest impact. Remember who are you, recognise your limitations — patients really won’t mind if you need to refer on, just keep them informed and explain the next steps. I think as pharmacists, we are protocol driven, abiding by SOPs but in this arena, general medicine is about taking risks, but well calculated, evidence-based ones.


Make friends, and develop a network — not just within your practice, but with community healthcare professionals and providers, your local pharmacy teams and pharmacists in other sectors. The learning opportunities are endless, but as a united profession we can face into the challenges and rise. At every corner of this profession there are pressures, grit and determination are required to succeed, whether the wins are big or small, keep going.


You seem to have a good work/life balance. What’s the secret?


Do I? I think my husband and those closest to me would disagree!


So this is me as a pharmacist:


  1. Work part-time three days a week in a GP practice
  2. Study part-time for MSc in Advance Clinical Practice at Worcester University
  3. I’m currently undertaking the CPPE GPPTP for NHSE GP Pharmacist pilot
  4. I’m a PPG committee member for PCPA
  5. Recently joined a bank team of teacher practitioners at Worcester University to support allied healthcare professionals through their studies


But most importantly I’m a mum to gorgeous children, Noel aged 4 and Neve aged 2.


I love my family, friends and patients. I enjoy life’s simple pleasures and love making people smile and happy. Life can be complicated and sometimes you do need to step away and review what’s important. I know I work hard, but I do try to live a life too. I’ve learnt to be organised, compartmentalise one thing and move on. Having a great supportive family and friends keep me in check so I don’t burn out!


What do you think of the current state of community pharmacy and what is the future for it?


I think we’re at a real pivotal turning point and I am hoping it will evolve for the better. Community pharmacy is under a lot of pressure to deliver a cost efficient patient service but so is the whole NHS infrastructure.


National commissioning could bring on a community pharmacy revolution to become more accountable for improving patient care alongside GPs for minor ailments, urgent care and the management of long-term conditions. Interestingly both the Community Pharmacy Forward View and Murray Report also recognises the clinical potential in community pharmacy to modernise patient care to the demands that is needed.


However, patient needs in primary care aren’t always clinical — social prescribing is needed to ensure a holistic approach to patient-centred care. Unfortunately effective signposting information does not often land in community pharmacies; perhaps we aren’t on people’s radar, and sometimes I do feel our healthcare profession is seen as an after-thought.


Community pharmacies can deliver new innovations, but investment in education and developing skills are needed. Also community pharmacists need to embrace this potential change and ask the question whether they are prepared to face this unknown, this unwritten domain and lead change to provide better care.


Community pharmacy is a unique healthcare setting, available most hours, most days for provision of healthcare advice and knowledge of medicine on the doorstep. No pharmacy sector can work without the other; we as a professional body needs to work together, blur the boundaries and showcase the endless possibilities.


What is your 10-year plan?


My first job is to finish my MSc!


No other real plans. When my youngest starts school I would like to work more hours (if possible!) but so much of my working diary changes last-minute, so having a little bit of flex in my diary allows me to breathe! Perhaps in the future it would good to be influential in the decision-making or help shape the future of the pharmacy profession to fit the modern healthcare system.


Are you a member of any professional organisation and if so why?


I am a committee member of the Practice Pharmacist Group (PPG) at PCPA (Primary Care Pharmacist Association). I love my peers in this organisation! We are all very different people in the committee but we are so passionate about the pharmacy profession and work endlessly to promote innovation & good practice.


It’s been fantastic to see how the organisation has developed over the past few months. We have just set up a Telegram Support Network, which hopes to bring together all pharmacy professionals regardless of role and sector. I am truly very excited about the future of PCPA.


My career has constantly evolved, so in other areas of work I found specific professional organisations useful to network with peers and for CPD. So as a pre-reg, I joined UKCPA; then as an aseptic/oncology hospital pharmacist, BOPA were brilliant, and they still are!


If you could change one thing in pharmacy what would it be?


Commissioned services funded appropriately so that the pharmacy profession can do what it does best – provide excellent patient care and safety in the use of medicines across all healthcare sectors. Wherever medicines are involved in the patient’s journey, there should be a supporting pharmacy team of pharmacists and pharmacy technicians.


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