By Michael Holden Leave a Comment
In her latest blog for Bio-Oil, Deborah Evans, Co-founder of Pharmacy Complete, explains what is behind the dry skin that so many people experience and offers her advice for pharmacy staff on how best to support patients.
Read Deborah’s blog here to better understand:
By Deborah Evans Leave a Comment
A patient came into the pharmacy to thank me. Nothing unusual in that although infrequent, our customers are generally very grateful for the support we give them across a range of issues – their medicines, general health and wellbeing. On this occasion though, the thank you will be remembered for the rest of my career. The gentleman came in specifically to thank me for saving his father’s life.
I remembered him clearly – he had come in on a Saturday morning wanting to speak to the pharmacist. He was in a quandary – he was concerned about his 84 year old father, who had developed cellulitis and despite being on antibiotics, wan’t improving. An hour and a half away, the son was managing the issue remotely and was being fobbed off by his dad who didn’t want to leave his caring role for his wife with dementia. A familiar story. Many questions later, I was concerned. This could likely deteriorate into either a sepsis or acute kidney injury. I advised strongly for him to call 111, not to leave it, not to feel ’embarrassed’ about ‘making a fuss’ (his words) and get to see his dad as soon as he could. He committed to this action and left.
So what happened? He came in to tell me that he followed my direction; 111 immediately called out an ambulance and his dad was admitted into hospital. Despite IV antibiotics he developed a sepsis three days later and was put into intensive care. They almost lost him but I’m pleased to say he survived and at the point of discussion, was in a ward and eager to get home and back to his wife.
What made me have this insight? The same situation played out with my late mother several years earlier. I had recently undertaken some CPD on Sepsis and I’m passionate about reducing the risk of AKI. More so, I asked questions. And listened. Aside from the intellectual assessment, I followed my instinct.
Stories like this will be happening up and down the Country. Community pharmacists and their teams make a real difference. And sometimes we save lives.
By Michael Holden Leave a Comment
I was in Practice on Saturday – working for an independent community pharmacy owned by the adjacent GP practice. As frequently happens, we received a call from a young woman (late 20′s) who wanted to speak to the pharmacist.
This case highlights just how much value pharmacists add to the health system but goes completely unnoticed by those who hold the purse-strings.
She explained she had Lupus and had been late requesting a flu vaccination. She was visiting her mother from the North West and with the increased press noise about flu she was keen to have a number of queries answered before having the vaccination. Was the flu jab appropriate for her and if so, what could she expect? Would she be able to have it as she had recently been prescribed a course of steroids by her consultant and she had heard that she should not have ‘live’ vaccinations? She then went on to add that she thought the Prednisilone tablets were causing her bad stomach symptoms as she believed herself to be lactose intolerant and she had read that the tablets contained lactose – could this be the tablets and if so, what alternatives could she have?
One thing at a time – I explained that she should have the flu vaccination, it was inactivated so fine with her Prednisilone although she might expect a flare up of her Lupus symptoms as a side effect. I also explained the availability of the vaccination (we don’t provide it at the pharmacy I work in as adjacent to the GP practice and this is a decision they have made) and that she was eligible on the NHS – meeting our Healthy Living Pharmacy (HLP) requirement of signposting someone to the flu vaccination service. I encouraged her to find a pharmacy that provided the vaccine and gave her some local examples.
I then asked a few questions about her symptoms and whether she was on any other tablets – she was. Sertraline (confirmed by access to the SCR following her explicit permission) could cause an increased risk of bleeds/stomach problems combined with the steroids. She had previously been prescribed Omeprazole (but not taking) and so I explained that whilst it could be lactose intolerance (difficult to determine) but (perhaps more likely) could be the combination of both medicines causing her tummy to be upset. I advised she reinstate her Omeprazole (explaining that this may initially upset her tummy) and encouraged her to speak to her consultant/GP when back in the North West, monitoring her symptoms to see whether the PPI helped. I reiterated my recommendation to have her flu vaccination as soon as practical.
We finished the call with her very satisfied with the level of service she had received and with me having a glow of professional fulfilment. I had made a difference. From a system perspective, the contribution undoubtedly added value – here’s a patient who could have ignored the recommendation for a flu vaccination, fearful of having it and potentially had problems with her stomach and a bleed. Instead she felt empowered, informed and motivated to put in place what she needed to continue her treatment.
So, what’s the issue? This call took around 20 minutes of my time, some research and a call-back. From a sustainability perspective none of this was remunerated; this call actually cost the pharmacy money. With the focus on funding supply, our current reality is that the time spent on supporting and caring for patients is becoming increasingly difficult to justify. There was no ‘footfall’ within the pharmacy which would result in a sale, we did not benefit from a Rx nor an additional service or vaccination. None of this directly impacts my role or my desire to help, however phone calls for professional advice are an increasing trend in our pharmacy and I worry that we cannot continue offering ‘free’, easily accessible advice as a sector. I can only think this trend is going to increase further as patients want to speak to a healthcare professional but cannot get a GP appointment. This is fabulous for the profession but for it to be sustainable, the NHS must wake up to the hidden value that pharmacy offers.
What’s the answer? More of us MUST highlight stories such as these and help our local MPs, Commissioners and our negotiating body to understand what we really do. We need more evidence and research to persuade those who define policy and payment. We require a new contract which reflects the care package we provide in our communities and perhaps a Quality Payment which recognises interventions made.
One thing is for sure, with pharmacies closing and finding it increasingly difficult to operate, we need to have our professional contributions properly recognised. I don’t know anyone who would turn a patient away and not help so please, NHS, properly recognise the difference we make and fully integrate us into the system.