Why did you study pharmacy?
My grandfather, who sadly died before I was born, was a community pharmacist in a small village in North Wales. My Grandmother kept the pharmacy going and I have very early memories of it. My uncle was in marketing with Glaxo in Africa, so he too inspired me.
However, I was most influenced by uncle John a very close family friend who was an inspirational community pharmacist and he influenced me the most. Growing up I loved to watch him talking to the people he knew and cared for about heath and social issues as well as their medicines. I will never forget the compassion with which he talked to drug users.
It was pharmacy or marine biology. But, when it came to it, the vocational route was more attractive than the Jacque Cousteau route! I have never regretted it and am still very passionate about the profession. That’s why I stood for the English Pharmacy Board, why I have worked hard for FIP on educational development globally and why I have been passionate about teaching future pharmacists for the last 25 years.
There has been much talk recently about pharmacists in GP practices. Do you endorse this approach?
I was a part time primary care pharmacist in Buckinghamshire FHSA and a part time academic, so had experience of working with GPs in the early 1990s. When I went on to run the postgraduate diploma in community pharmacy at King’s College London, one of the activities the students had to do was to develop a working relationship with their local GPs and work out how they could work together. Some of those students are now partners in GP practices.
I endorse this approach, and recently talked to some of our students in Nottingham who are already aspiring to such roles and would be interested in doing their pre-registration year in GP surgeries and pursing this clinical role. I don’t believe it is a role that’s only for highly experienced specialist pharmacists and that less experienced pharmacist will have many of the competencies required. Prescribing will be important. I also think we need to work as one profession and that more experienced pharmacists can mentor less experienced ones and that we need to work like our medical colleagues and refer difficult patients to expert secondary care pharmacists.
We based prescribing certification on the route the nurses took and I believe that was a mistake and that we now need to ensure that the MPharm and Foundation years prepares students to become prescribers based on competency and not on passing a special university course. Canada has taken such a competency based approach and we might learn from them.
Given the increasing commercialisation of pharmacy, do you think individual pharmacists are free to make unhindered professional decisions with the best interests of patients at the centre?
From what I hear and see, not always and this is totally unacceptable. This seems to be partly due to the target driven contract and partly due to understaffing and having middle managers that are not pharmacists.
I really worry that patients are not receiving the best care because of this. I also think pharmacists are overworked and that we haven’t got the skill mix right. Ideally, if pharmacists are to provide lots of services, there needs to be a second pharmacist as well as technical support. Many pharmacists are also forced to neglect the counter and the sale of P medicines and health promotion advice and leave it to assistants who do not always perform optimally. We do not seem to learn from repeated research from Which? If we can’t get this most public facing role right how can we expect to have greater roles in patient care?
Is the current volume driven community pharmacy contract delivering the best outcomes for patients?
I have long advocated for change in the contract, and believe that a fee per item of service, be it for scripts or MURs, is the enemy of patient care. I would love the contract to change so that pharmacists care for local patients and so that patient 500 gets the same MUR as patient number one and polypharmacy can be tackled without affecting pharmacists incomes.
Do you think pharmacists are adequately supported to deliver the complete pharmaceutical care?
I believe the current students will be very well prepared to do this especially after their foundation year. The five year integrated course will prepare them even better.
However, I believe that a lot of practicing pharmacists are isolated and often don’t have mentors to inspire them. I have been very excited to co-chair the RPS innovators forum and It is great to see new models of care emerging where local pharmacists from across the sectors are working more closely together and with other health care providers to meet the needs of their communities.
I believe that the RPS provides much of the support that pharmacists need to deliver patient care and that the RPS Faculty enables pharmacists to demonstrate to other healthcare professionals and employers that they are practicing at the top of their profession. I am extremely proud to be a first wave Faculty Fellow and take every opportunity to encourage people to join the faculty.
Is it a risk or a benefit to allow every pharmacist in the country to have read/write access to patient records?
Obviously it would be a risk not to! I think it is scandalous that although hospital pharmacists have access to the summary care records as well as patient’s notes, community pharmacists have had to wait so long, even for this. Without access to records, pharmacists are inadequately supported to deliver pharmaceutical care to patients. If elected will continue to campaign hard for this.
Why did you become an RPS English Pharmacy Board member?
The NHS is undergoing unprecedented changes and ALL pharmacists are working under pressure with fewer resources. Pharmacy is on the lips of NHS England, the other Royal Colleges, and in the media more than ever before. We are finally getting the professional recognition we deserve.
However, the English Pharmacy Board must build on our successful leadership work, by further supporting pharmacists in delivering excellence in patient care. My experience at a high level in academia, education, research and health policy allows me to contribute positively at all levels and across all sectors
The next three years are crucial for pharmacy education and as a professor at a leading university which has been the first to pilot the 5 year MPharm I am able to represent the views of and support academics, clinical academics and practicing pharmacists as we change to a five year integrated MPharm moving away from the pre-reg to professional learning placements.
Claire Anderson is Professor of Social Pharmacy at the University of Nottingham, and member of the RPS English Pharmacy Board
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