INNOVATION


maximise the time her pharmacists can spend instead in offering minor illness consultations and chronic medication service reviews.


‘my ultimate goal in pharmacy,’ says bernadette, ‘has always been to develop services, and so I made the decision to have not one but two treatment rooms. as a result, the retail area had to go.’


It’s the fact that there is no ‘front of shop’ that makes cadham Pharmacy health centre particularly striking. Where ‘traditional’ community pharmacies have a wide range of otc products on display, cadham certainly looks more akin to a gP surgery. Instead of the traditional retail display, patients are met by a reception area, with seating for patients who are waiting to be triaged. Instead of walls taken up with otc products and retail offering, cadham’s walls feature five digital screens with displays for smoking cessation, otc products and the pharmacy’s travel clinic.


If, for example, a patient or customer wishes to purchase an otc product, they simply pull down the touchscreen, touch the appropriate product button (which also tells them how many are currently in stock) and order accordingly. With three clicks of a button, the robot will dispense the required product.


‘anything that any patient wants to order on an otc basis,’ bernadette continues, ‘is available from the robot as long as it fits into a robot-size box. anything that doesn’t fit – for example wheelchairs or walking sticks – is available on a next-day delivery basis. despite the fact that we have removed all otc items from view in the pharmacy, ironically we will, ironically, eventually actually increase our retail offering!’


the time that has been freed up with the introduction of a second robot is certainly being put to good use! In addition to the pain clinics and medication review clinics that she has been running for some time now, bernadette has now employed two nhS nurses to assist her with clinics: one for respiratory conditions and one for common clinical conditions.


‘my respiratory nurse,’ bernadette continues, ‘majors in coPd and asthma and so she now assesses a


‘mY ULtImatE goaL In PharmacY haS aLWaYS bEEn to dEvELoP SErvIcES, and So I madE thE dEcISIon to havE not onE bUt tWo trEatmEnt roomS. aS a rESULt, thE rEtaIL arEa had to go’


patient’s condition and I, as an independent prescriber, write the prescription. We’re clearly showing how upskilling in community pharmacy can be of benefit to both primary care in general and to patients in particular!


‘I am so proud of how this collaboration is enhancing what we can offer patients from our Pharmacy health centre. our enhanced common clinical conditions clinic will hopefully encourage the public to use the pharmacy first. as prescribers, we can assess patients, advise and/or treat appropriately, and work with local gP practices, referring - when necessary - to further care. this is intended to improve access to healthcare and could reduce pressures on our gPs, out-of-hours services and a&E.’


IndEPEndEnt PrEScrIbIng Prescription for Excellence states that, by 2020, every community pharmacist in Scotland is to be an independent prescriber (IP). that’s because PfE acknowledges that, going forward, clinical pharmacist independent prescribers will be delivering medication and polypharmacy reviews.


as an independent prescribing pharmacist, alasdair Shearer currently runs a very effective chronic pain clinic at Loch Leven health centre in Kinross. Working with the gP partners and the locality pharmacist


within the practice, alasdair, from davidsons chemist in milnathort, works to identify patients whose pain needs are not being met. through the clinic, he responds to both direct referrals from the gPs and also searches for patients whose medication is overdue for review, or who are not taking the most efficacious medication.


alasdair has set up his clinics with 30- minute appointment slots. this gives him adequate time to approach each patient holistically and to take time to understand their complex pain symptoms, look at treatments that have been tried, and engage them in choosing the correct treatment.


holding his clinics every two weeks allows him to closely monitor patients and respond quickly to patients who are struggling with their medication. Improvements in patient outcomes have already been demonstrated in a number of ways including pain reduction scores. over the course of the last year, alasdair saw 24 new patients; 21 of whom have seen their pain score improve.


IntEgratEd PharmacEUtIcaL carE the minor ailments Service in Inverclyde was recently extended, with access now granted to any patients, who are registered with a gP in the Inverclyde area. In addition to minor ailments, pharmacists are now also able to assess and provide


treatment for some of the most common, uncomplicated conditions that generally require a prescription from the gP. this has created an extra, ‘added value’ element to the initiative in not only freeing up gP time, but also in promoting the idea that the individual can self manage and seek self care for such conditions.


‘We’ve already got a lot of patients registered on maS,’ says John mcanerney from Pettigrews Pharmacy in gourock, ‘but we’re definitely seeing more coming in now that this extended scheme is up and running. I think it’s the fact that we’re easily accessible and that people can simply pop in to see us without having to have an appointment that’s probably making it very popular, although we are getting gPs referring patients to us for things like uncomplicated UtI. We’ve mainly been prescribing items such as antibiotics and trimethoprim. this scheme is giving us, as pharmacists, more opportunity to use our clinical skills in practice, which is great for us and equally good for patients, who don’t have to wait for gP appointments.’


SUmmarY With terms such as ‘gP workload’ and ‘crisis at a & E’ becoming mantras for the state of healthcare in nI, isn’t it tragic that the province’s community pharmacists aren’t given the same recognition – or funding – as their Scottish counterparts? •


PharmacY In focUS - 13


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