by the Directors of Pharmacy and in a CPS newsletter and an NHS circular. In this way, we hoped that all community pharmacies would know about the initiative.
‘The fact that video consultations are of prime importance at the moment is obviously a major positive factor of Near Me,’ Clare continues, ‘but it can be used by pharmacists however they decide is clinically appropriate, for example, within Pharmacy First to provide consultations. If all pharmacies had Near Me ready to go, it could save patients having to go to the pharmacy. Even if it’s totally necessary for a patient to go into the pharmacy, for example to collect a medicine, having the consultation by video first reduces the amount of time they need to spend there.
‘Near Me isn’t suitable for every consultation, but it is a tool which provides community pharmacists with the ability to decide if further referral etc is necessary. The service is, of course, open to every healthcare professional in NHS Scotland and so in addition to assisting patients, it also promotes collaboration between primary and secondary care, for example by enabling three- way consultations with a multidisciplinary team.
‘It is, however, very much up to pharmacists to decide how to use the service and we’re envisaging that how Near Me is utilised will differ from pharmacy to pharmacy. In some cases it may reduce physical distances for patients, who may live in remote areas, but it can also be useful for those with mobility issues, those suffering from anxiety who do not wish to enter healthcare premises and those who simply find it difficult to attend for appointments due to work commitments. There’s no doubt that Near Me could be a lifesaver for many patients during these challenging times – and those yet to come.’ Fiona McElrea from Whithorn Pharmacy in NHS Dumfries & Galloway was one of the first pharmacists to become involved in the scheme prior to its procurement by the Scottish Government.
‘We actually started with the scheme – which was then called ‘Attend Anywhere’ in August 2018,’ Fiona told SP. ‘We were approached by the Dumfries & Galloway Health Board to take part in the pilot and were
provided with a laptop and software. We then produced patient leaflets to tell our patients about the scheme.
‘At that time the initiative was designed to provide pharmaceutical care in remote and rural areas and was particularly for patients who were normally seen at dispensing GP surgeries where they would often not see a doctor. Also, there were many patients who were taking up GP appointments for minor ailments or queries about medication such as antibiotics, so Attend Anywhere not only provided pharmaceutical care and advice for patients, but also relieved pressure on GPs with regard to issues such as minor ailments. ‘Initially the scheme wasn’t very popular. Many patients would still come in or would phone and the main advantage seemed to be that it improved our lines of communication with the GP, who began to refer patients to the pharmacy.
‘Obviously there was trial and error involved in finding the most advantageous ways of working. At first, we would leave the ‘virtual’ waiting room open all day and patients would just log in, but we discovered very quickly that the process worked better if we made an appointment with the patient.
‘Now that COVID-19 is here, Near Me as it is now is proving more popular. We had a farmer, for example, who had a rash on his chest. He didn’t want to go to the hassle of having a shower, travelling to the pharmacy, driving back etc, and so we arranged a time for an appointment. He had his shower at home and then I was able to see the rash online.
‘To date, we’ve used the remote consultations for services such as smoking cessation and EHC, but we also thought they would work well for medicines use reviews. One elderly patient, who was quite computer savvy, for example, was concerned that there was an issue with his high dose of morphine. He set up his laptop and placed all of his medication on the kitchen table. I was then able to go through each item individually with him and produce a chart of what he should be taking.
‘The uptake on Near Me is still not as high as I would have hoped by now, but I would envisage that this may change as the challenges posed by
SCOTTISH PHARMACIST - 9
COVID-19 continue. People are definitely becoming more accustomed to the online and virtual world as time goes on and are more used to the technology involved. Near Me isn’t suitable for every consultation – it’s a matter of working out sometimes which issues are more suited to Near Me than to a phone call, but I think this is just a starting point and that the scheme will grow organically.’ Jonathan Burton was one of the early adopters of Near Me in his Stirling pharmacy.
‘Near Me enables us, as pharmacists, to keep in touch with vulnerable people in our community,’ Jonathan told SP. ‘Near Me allows us to have face-to-face consultations without the need for patients to travel long distances or be physically present in the pharmacy – aspects which make video consultations particularly useful given the continued need for social distancing.
‘We have been using Near Me alongside a mix of other forms of communication including telephone and e-mail, and we’re finding that we are using a different skill set than we are accustomed to. We’ve had plenty of help from organisations such as NES, for example, who ran a webinar that provided us with plenty of hints and tips on how to facilitate this new type of consultation. CPS have advice and information on their website and RPS members can also access a comprehensive remote consultations advice and links page on the RPS website. I think it’s particularly important that we have access to the Near Me resource given the fact that Pharmacy First has been launched and
we’re now able to provide a minor ailment service to the entire population. Near Me will have a vital role to play in this, given the fact that there is no end in sight to the coronavirus pandemic.
‘I also think t's really positive that we've been able to move forward so quickly with this in Scotland. Pharmacists in community, hospital and GP practice settings have shown a willingness to adopt new ways of communicating with patients through the COVID-19 crisis and Near Me supports them in developing their practice. I'd encourage pharmacists to use the guidance document to help smoothly introduce video consultations into their daily work routine where they feel it would be helpful for themselves and the patients they care for.’
What is needed for a
Near Me consultation? To make a Near Me call, both pharmacist and patient need: 1. A device for making a video call, such as a smartphone, tablet or computer with a webcam and speaker (often built into laptops) 2. A reliable internet connection – wired or WiFi or mobile data. If you can watch a video online, your connection should be good enough for a video call 3. The Chrome Google chrome browser or Safari Apple web browser 4. A private, well-lit area for your consultation
For more information, visit
nearme.scot
‘Near Me isn’t suitable for every consultation, but it is a tool which provides community pharmacists with the ability to decide if further referral etc is necessary’
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