Q&A
pharmacists within the community and hospital sectors. It is not just for cancer patients but includes non- malignant illnesses such as dementia, copD, heart failure, parkinson’s and any other progressive, non-curative illness. of the 15,000 people die who in Northern Ireland annually, it is estimated that approximately two thirds would benefit from some level of palliative care during the last year of life.
IN YoUR ExpERIENcE, whAt ARE thE mAJoR chAllENgES oR BARRIERS to commUNItY phARmAcIStS to pRoVIDINg optImUm pAllIAtIVE cARE foR pAtIENtS AND SUppoRt foR thEIR cARERS?
the biggest barrier for community pharmacists can be a lack of information about patients. greater numbers of increasingly complex palliative patients are being treated in their own homes and community pharmacists often lack basic information about diagnosis, medication changes, especially after discharge, plans for treatment or who to contact for any medication queries. hopefully the planned Electronic healthcare Record for Northern Ireland (Encompass) will join community pharmacy to the wider healthcare team, providing more information on patients and improving health outcomes.
community pharmacists often lack opportunities for protected training time that are afforded to other healthcare professionals, making it difficult to gain new skills, keep them updated in the multitude of clinical areas and learn from peers. we will be using the innovative Echo videoconferencing technology to build knowledge and confidence among the cppcN through teaching, case presentations and discussions. this system will connect palliative care experts in a hub in Belfast with the cppcN pharmacists all around Northern Ireland, providing a forum for learning from experts and each other. If successful, this method could be utilised for other areas.
from our initial scoping we know that some community pharmacists maybe only see a small number of palliative patients annually and so maintaining knowledge and skills can be difficult.
we plan to combat this by issuing palliative care resource packs to community pharmacists and utilising online and ‘app’ resources to give pharmacists more options of where to go to find reliable information on palliative medicines. the hScB recently provided a copy of the palliative Adult Network guidelines book to all pharmacies, which are our adopted guidelines for general palliative care. the accompanying website is
www.book.pallcare.info and is a great resource for pharmacists.
the All Ireland Institute for hospice and palliative care website
www.aiihpc.org is a location I would direct pharmacists to as it contains all the information on upcoming palliative care conferences and training. Sometimes pharmacists can be left out of the loop for wider training opportunities such as these, but they are an essential way we can build our knowledge by interacting with and learning from other healthcare professionals and they provide excellent networking
medicines used in palliative care and who your local cppcN pharmacy is if medication is needed urgently and you are having difficulty accessing it. finding a pharmacy which stocks palliative medicines can be a frustrating experience for carers, especially at the end of life, when they should be spending that time with loved ones.
BEINg INVolVED IN pAllIAtIVE cARE IS A VERY poSItIVE ExpERIENcE. wE focUS StRoNglY oN QUAlItY of lIfE foR pAtIENtS AND thEIR loVED oNES, whEthER thEIR pRogNoSIS IS DAYS, wEEKS, moNthS oR EVEN YEARS. If I cAN plAY A pARt IN hElpINg pAtIENtS mANAgE thEIR mEDIcINES to ENABlE thEm to AttAIN thEIR goAlS, thEN thAt IS A VERY REwARDINg ExpERIENcE
oNgoINg tRAININg comES Up REpEAtEDlY. ARE YoU AwARE of ANY locAl tRAININg EVENtS foR hEAlth pRofESSIoNAlS INtEREStED IN ImpRoVINg thEIR KNowlEDgE of pAllIAtIVE cARE?
As a macmillan professional I have been able to avail of some of the fantastic learning opportunities provided by the charity. macmillan also works with the health trusts to provide palliative care masterclasses, and all pharmacists and other health professionals can access online learning through
www.learnzone.org.uk.
opportunities. the NIcplD pharmacist in palliative care course also provides a wealth of background knowledge in the area.
whAt ADVIcE woUlD YoU gIVE to commUNItY phARmAcIStS to ENSURE thAt thEY ARE wEll EQUIppED AND pREpARED foR mANAgINg pAllIAtIVE cARE pAtIENtS?
I think the first thing is awareness of what is important to patients. An awareness of the basic principles of palliative care will enable pharmacists to deal with most of the issues that may arise. Be aware of the range of
one way to help with this is by anticipating issues that may occur. NIcE guidelines advocate ‘anticipatory prescribing’ where medications for any likely symptoms at the end of life are prescribed before they occur, so reducing the situation where an urgent prescription for a palliative medicine, which many pharmacies may not stock, needs dispensed. community pharmacists can advise on this and we will be issuing regional guidance on end of life care to all pharmacies.
finally, I would also recommend awareness of the wider services available to patients and carers. In addition to expert information and advice on cancer, macmillan NI provides practical and emotional support to people affected by cancer, and their carers through the community helpers scheme. You can find out more about services available locally at
www.macmillan.org.uk
AND oN A lIghtER NotE...
whAt IS YoUR fAVoURItE plAcE YoU hAVE tRAVEllED to AND whY?
while working in Australia I had the chance to spend some time scuba diving on the great Barrier Reef, so that would definitely be it. It was such a fantastic experience surrounded by spectacular sights such as colourful coral, fish, turtles and even sharks. You feel like you are living in your very own David Attenborough documentary!
whAt woUlD YoU chooSE foR YoUR fAVoURItE mEAl AND who woUlD YoU ShARE It wIth?
having recently got married, I should definitely say I would share any meal with my wife gillian! we spend a lot of time on the North coast and when we go to the mermaid restaurant in portrush, I always go for the scallops and then the monkfish; followed by dessert obviously.
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