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28/09/2018 By Deborah Evans Leave a Comment

Saving lives

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.

Filed Under: Viewpoint Tagged With: AKI, Communitypharmacy, HLP, Pharmacist, Pharmacy, Sepsis

22/09/2018 By Michael Holden Leave a Comment

Healthy Living Pharmacy and the NHS Ten Year Plan

It is excellent news that we now have 9436 (88%) pharmacies in England declared as Healthy Living Pharmacies, this represents an additional 5% on the November 2017 declaration. For these pharmacies the key will be ensuring that all the HLP criteria continue to be met in order to maintain the status and thus be able to promote the quality mark.

Becoming an accredited HLP is just the beginning, its what HLPs then do differently, bigger and better that will define and differentiate them. This will then help them realise the benefits of the improved ethos, engagement, capability and activity that comes with doing the right things with the right people.

The next step is building on that capability and activity for a healthier future for their community and their pharmacy. Pharmacy Complete have a range of resources and courses to support this. Developing and demonstrating this capability and commitment should have its own benefits through increased productivity and delivery of both private and commissioned health promotion, prevention and protection services.

What we need to see now is the NHS and Public Health, at both national and local level, recognising the HLP asset to deliver against the Staying Healthy and other objectives within the recent NHS Plan consultation to reduce health inequalities and improve the health of the population. Good to see some early signs of engagement from PSNC and RPS with this consultation which requires new thinking focussed on NHS and public health needs both now and in the future.

Filed Under: Healthy Living Pharmacy News, Viewpoint Tagged With: Community pharmacy, Health Champions, Healthier future, Healthy Living Pharmacy, HLP, Pharmacy, Public Health, QPS, Quality Criteria

08/06/2018 By Michael Holden Leave a Comment

Here and now?

We have expressed our thoughts about the urgency for community pharmacy owners to adapt and take back control of their future in an number of previous Viewpoint articles (see below). To reflect this, we have just updated our much acclaimed Change video and launched our Business Development Programme both of which can be seen here.

Some years ago I wrote an article entitled Back to the Future which examined the future options for community pharmacy – Nirvana and Amazonia I called them at the time – and asked the profession to decide which it wanted.

Well it is here and now with declining funding on medicines supply, a service-based, care-led, quality-driven contract being proposed, growth in prescription volume now plateaued and likely to decline over the next 2 years, and one online pharmacy provider growing its prescription volume at an astounding rate.

So I ask again, do you want to build a healthier future for your pharmacy based on Nirvana principles, or do you plan to do nothing yourself but wait for others to do something for you and meanwhile slip into Amazonia?

Filed Under: Viewpoint Tagged With: Community pharmacy, Healthier future, Healthy Living Pharmacy, Pharmacy

08/01/2018 By Michael Holden Leave a Comment

Hidden value

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.

Filed Under: Viewpoint Tagged With: Healthy Living Pharmacy, HLP, Pharmacist, Pharmacy, Quality Payments

19/01/2017 By Michael Holden Leave a Comment

Community Pharmacy Forward View – Making it happen

We welcome the publication of this ‘roadmap’ for delivering the aspirations of the Community Pharmacy Forward View and the Murray Review. As importantly, we are pleased to see the collaborative leadership between the three pharmacy organisations (Pharmacy Voice, PSNC and RPS). However, we are disappointed to hear of the NPA’s decision to withdraw from Pharmacy Voice which will mean its ultimate disbandment –  unity and engagement, not egos and division, are absolutely critical at this time.

The roadmap identifies six key deliverables:

1. Raising public awareness of what pharmacy does and can do

2. Building partnerships across the care systems

3. Harnessing technology

4. Workforce development and an empowered pharmacy team with the right culture and skills

5. Support for the management and implementation of change in the sector

6. Establishing new ways of working supported by appropriate funding and contractual mechanisms

The pharmacy bodies now seek a constructive response from NHS England, DH and government.

We believe that adopting the full ethos and quality criteria of Healthy Living Pharmacy as an enabler of change will provide a platform for most of the above.

Our summary? –  we need to look it, act it and do it and be enabled to do so.

Filed Under: Viewpoint Tagged With: Community pharmacy, HLP, Pharmacy

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