So someone asked me… Should I still do IP?!?!

Ok so yesterday… a friend of mine asked me… “Should I still do IP??”. She’s been contemplating doing the course for a number of years now and she once again sought my view on whether it is a good idea or not.

This question got me thinking about the topic again… until now I have been quite keen on all Pharmacists undertaking the course but in recent months my view has changed somewhat.

As we all know there has been an NHS pilot aimed at introducing Clinical (IP or non-IP) Pharmacists into GP practice, with a funding arrangement that gradually reduces over a three year period. Demand has been very high amongst the Pharmacist community for these positions within GP practices and in recent months the NHS has announced a further extension of this scheme.

This is all good and well but where theres high demand, economics tends to come into play… driving down the salaries offered. Rumours would suggest the salaries are coming down below what the average Community Pharmacist would earn in a full time store based position. Now off course this is not always the case and many would argue when stepping into a new sector, a certain level of salary sacrifice is to be expected but this is where it comes down to the priorities of the individual.

So going back to the question… Should I still do IP?…. My answer to this was structured in a way that would force the person to think about what their priorities are. I told my friend that if they wished to do IP for personal development, then definitely do complete the course as I personally feel I have greatly benefited from it, but if the aim of completing IP is to gain any financial benefit, then do think again. As described above, there will be no guaranteed pay rise with the move into the world of prescribing but if they do decide to move into this sector, they may have other opportunities and will certainly have a significant amount of development.

Priorities are the key here… I hope this has helped all you readers in making your decisions… weigh up the pros and cons and decide if this is the right choice for you.

What’s the weirdest thing that a patient/customer has asked you?

So today… I was thinking about the weirdest thing someone has asked me…

So here goes….

Many many moons ago… in a distant land ๐Ÿ˜‚๐Ÿ˜‚…

Someone came up to me with a random bag… 

yes sounds shady but keep reading… 

So you’re probably thinking “what was inside the bag ๐Ÿค”?”… I was thinking the same thing at the time…

In the bag was a collection of various mushrooms๐Ÿ„ or fungus if you prefer ๐Ÿ˜‚….

The customer asked me to identity the collection of fungi as apparently pharmacist in their homeland did this sort of work….

Now I know I have had a couple of modules of natural products… way way back in the good old days while doing my MPharm ๐Ÿ˜‚… Can’t say I was particular good at this module and I was out of my depth in this case…

This may seem funny now but that then I felt like I have no idea what to tell the customer… I had to politely decline as I would have no idea where to begin in identifying those mushrooms so I had to advise the customer to speak to a botanist or someone who knew about plants… which unfortunately wasn’t me….

So what’s the weirdest thing anyone’s asked you????

Do I need to buy a Stethoscope???

So guys… those of you who are currently doing your IP training will be asking yourselves this question….

Should I buy a stethoscope or not?

The university that I went to had one session on how to use a stethoscope to do cardiovascular assessments, respiratory assessments and blood pressure monitoring using a sphygmomanometer (yes perhaps the hardest word to say haha).

So when I was doing my training, I had this decision to make… should I buy a stethoscope? This was partly as the GPhCs competency criteria suggest an IP should know how to use one, and a stethoscope may not be the easiest to use, requiring some practice. 

I decided to buy one… I started researching which stethoscopes are the best to buy and went for a Littmann… the Mercedes of stethoscopes ๐Ÿ˜‚๐Ÿ˜‚.

Below is a link to MediSave… the website where I ordered mine from…

https://www.medisave.co.uk/diagnostics-equipment/littmann-stethoscopes/littmann-classic-iii-stethoscopes.html?gclid=Cj0KEQjw5sHHBRDg5IK6k938j_IBEiQARZBJWqTW-J39iRfeL_JVablUc48PNTIgnO3IS57IXyrz5zQaAlo88P8HAQ

So guys if you have any questions… or any feedback… I look forward to hearing from you

Enjoy your new toy ๐Ÿ˜œ

What assessments did I have while training to become an Independent Prescriber?

Now, you are all probably thinking…. “was there a written exam?”

I know the vast majority of people aren’t fans of written exams, and neither am I. Fortunately in this case I was lucky, I didn’t have a written exam. Although the other assessments more than made up for it.

So my first assessment was a case presentation. The challenge was to find a patient, contribute to improving their treatment and present this case at the University in front of a small group. I actually enjoyed this assessment as I like doing presentation…

Next was the terrifying OSCE… Yes I did say terrifying, because thats what it was… for those of you know don’t remember what and OSCE is, its basically a practical exam thats kind of like an assessed role play… The last time I’d done an OSCE was back when I was doing my finals for the MPharm all those million years ago (lol). You get 10 minutes to essentially do a full consultation with the patient with the end result being either to prescribe advice, write a prescription, or to refer…. which would you do?

Then there was the practice based audit… In this assessment you have to set up an audit from scratch… determine a title, set the criteria, complete the data collection, then finally critically analyse the data, and produce some evidence based changes to be implemented if necessary.

Before the last assessment, there is the case discussion. This one is similar the the case presentation but it involved having a discussion with the DMP to essentially give evidence based feedback on the treatment that a specific patient is receiving. This discussion is linked to a short essay summarising what you’ve done.

Lastly you have the never ending reflective portfolio. This is basically a collection of reflective entities from significant events that you may have come across at work or in the practice, along with reflections on additional learning based around your chosen specialism with the aim to ensure that you have met all of the prescribing competences and learning objectives for this course to be signed off.

What are Medicines Management Audits?

In my last post I started off talking about what I did at the GP practice as part of my Independent Prescriber training, time to continue…

Where did I get up to in my last post?…. Yes it was the Medicines Management audits…. Those of you who’ve never worked in GP surgeries are probably thinking what on earth are these?”

So within the CCGs, there are Medicines Management teams… These teams periodically set audits for the GP practices to do, assessing different aspect of prescribing on each occasion. These audits can generally be put into two classes:

1- Clinical – Is Drug A being prescribed for Condition A? If not then what needs to be done to correct this?

2 – Cost-effectiveness – Which test strips are being prescribed to the Diabetes patient’s at the practice? Are these the most cost-effective ones available? Are the quantities appropriate? and are these only prescribed for those who really need them? Following data collection, the prescribing habits would be amended to reflect guidance.

 

 

So what did I do at the practice?

Ok so now that Ive started doing my IP training at the practice, what did I actually do?

As I said I has two days a week available to work at the practice, which I used in the form of two Xย four hour sessions each week, which proved quite effective and I was able to see a range of different activities that took place at the surgery.

I started by shadowing a couple of Doctors. I did this for the first 2-3 weeks and in hindsight, this was too long. Shadowing is something thats good to do in the beginning yes but there is only so much you can learn but sitting and watching….

The next task that I undertook at the practice was to look at patient medication requests and screen them, does the patient need this item? Is there a diagnosed condition listed that warrants this item being prescribed? If so when was the last time this item was reviewed. I was reviewing medication requests this way along with looking at blood tests in certain cases to determine whether it was appropriate to continue this prescribing or if the patient needed to visit the Doctor. After reviewing these requests I would have a discussion with my DMP about my findings.

Once I was comfortable with reviewing these requests, the next job was to do medicines management audits, which aren’t the most interesting but these help you to see how in practice prescribing deviates from how it should be in theory, along with implementing actions to help bring the two together…..

 

More to come in my next post…. ๐Ÿ™‚

The came the fun fitโ€ฆ

So Iโ€™ve had my first day at uniโ€ฆ fortunately there arenโ€™t many of those daysโ€ฆ

Now I started going into the surgery where I had to spend 9hours over this six-month period.

This bit was perhaps the bit that I enjoyed the most during this courseโ€ฆ Sitting in with the Doc during consultations, contributing into discussions, looking at medications histories and essentially reviewing a lot of case studies thereby supplementing both my practical and theoretical skills.

As I said before it can be very difficult store managing and doing the IP course together, this was one of the difficulties of juggling both tasks. I had to ensure I was only at my primary workplace four days a week (including most Saturdays), so that I would have two days free in the middle of the week to be able attend the surgery, fortunately the plan worked… although managing a store while working four days a week… good luck to anyone who does that, its one mission lol.

And so it begins…

I started studying again in the early part of 2016… although I’d completed my diploma not so long ago so it was more like I’d started studying again again lol.

When I went to my first study day, the first thought that came into my mind was “this uni is far ๐Ÿ˜””, in all my concern about the content of the course I’d failed to take into account how far the uni actually was… but hey… you learn something new out of every experience (even if you don’t expect to do so).

I found the study days very good at this uni, although they were a bit intense at times, felt like I was back doing the MPharm again (which feels like a lifetime ago lol).

With all courses that you may be considering doing, when you look at the amount of work involved, it can look scary, and this course was by no means an exception. The Uni had told us that we were expected to do 600hours of work over the next six months as part of this course… this combined with working full time… it’s enough to make you feel as though your brain will melt lol… but don’t worry… there’s always a way ๐Ÿ˜Š.

If I had a pick one word to associate with this course, I’d say REFLECT…. As part of this course you are expected to reflect on literally everything you do for the next six months… take a deep breath… you can do it… just make sure you start working from day one… complete the work in small chunks… and the next six months will fly by…

On the plus side…. student discount is back!!! ๐Ÿ˜‚๐Ÿ˜‚

Time to reflect…

I’ve been working in community pharmacy for the majority of my career… recently I’ve been getting involved with some CCG work as well… but more on that later…

There are several career path options for Pharmacists… although we generally get told about community, hospital, and industry. Yes these are three major options and are quite distinct pathways. Traditionally once you had decided on a path during pre-reg, this would be the sector that you’d remain in for the majority of your career. Yes I agree it can be difficult to move sectors, especially out of community pharmacy and into one of the other major sectors, but it isn’t impossible, many people successfully manage to make this movie.

So tell me… do you think you are in the right sector of pharmacy?

If you are then that’s brilliant and I’m sure you are enjoying your career…

If answer is no then think about the various options that are available to you.

So have you thought about other options, aside from the three traditional sectors? 

There’s Academia, CCG Pharmacist, GP Practice Pharmacist (a new still evolving role), or you can expand your clinical knowledge without moving your job, for example complete a clinical diploma, thereby expanding your options without moving out of your current role.

Think about it and post some comments… I’d love to hear your views ๐Ÿ™‚

Do I think working as a Community Pharmacist has helped me to achieve my goals?

As I previously wrote, I had two goals, becoming an Independent Prescriber (IP) and a Pharmacy owner.

To date I have experienced a variety of different forms of Community Pharmacy, ranging from independent to multiples…. locuming to permanent full time roles. If I am to include my Pre-Registration year then I have had 8 years of full time experience in Community Pharmacy and at least 3 years of part time experience prior to that from back in the Pharmacy Assistant days… Yes makes me sound old I know ๐Ÿ˜›

I think working in a Community Pharmacy has helped to develop the skills that I need for both of my long term goals. As a Community Pharmacist you are exposed to patients of a variety of different personalities and from a variety of different backgrounds, having to manage a variety of patients has taught me that the same approach cannot be used in solving problems relating to various different patients. One important skill is active listen, a skill that was enhanced during my IP course. By practicing active listening techniques the patient can understand that they have been heard and a level of empathy can also be expressed.

In addition to being able better communicate with patients I have provided a fair number of additional services ranging from the bog standard MUR and NMS’…. to services such as Minor Ailments, Smoking Cessation as well as the supply of free EHC. These services have made me feel that there is more that a Pharmacist can do… aside from the daily dispensing-checking job, a Pharmacist can make more of an impact on patients and hopefully I can be one of these Pharmacists.

There is no shortage of pessimistic news in the media such as investigations showing unethical behaviour or stories showing how cuts in funding will cause closures of many Pharmacies. There are also positive stories that perhaps don’t get as much recognition as they should such as the incredible work many Pharmacists have been doing in relation to Flu jabs in recent years… There are many instances where great Community Pharmacies do a brilliant job on a daily basis and work to improve patient safety.

So getting back to the topic… Yes I think Community Pharmacy has helped be gain the skills I need on the road towards both IP (and towards owning a Pharmacy).