IN a quiet unassuming community in Glenrothes, Cadham, is one of the epicentres of a quiet community pharmacy revolution.
One woman, her family and her team are making a long-held dream into a reality. Talk to Bernadette Brown about pharmacy and you’ll see her passion and enthusiasm is infectious, her drive to get things done palpable.
“This has been a dream of mine for years”, she told me in voice that seemed to convey a mixture of relief and a quiet sense of achievement.
She recently ripped up her beloved pharmacy where she has worked for many years, pulled the guts out of it and installed an automated dispensing robot – no mean feat in a very busy pharmacy. Now, robots themselves aren’t going to transform pharmacy practice, they are an enabler to free up time for the team, and really a better pilot site (one of six) for the Scottish Government’s test of technology in pharmacy couldn’t have been chosen.
Cadham pharmacy was recently transformed into Cadham Pharmacy Health Centre and it’s easy to understand the change in nomenclature. When I visited the pharmacy on relaunch day, I honestly thought I was in the wrong place. There was nothing to identify it as a traditional community pharmacy — there was no retail space which normally clearly demarcates areas within almost all pharmacies.
It was like walking into a cross between a high-end boutique, a GP practice reception area and hospital pharmacy dispensary. Behind the scenes some finishing touches had still to take place.
Sitting proudly in a glass display case is a glut of awards for excellence and innovation, testament to the effort and dedication of the team. On the wall on the right hand side is a mission statement, a list of awards the team has won (note the space for more to be added…) and details of services the pharmacy provides.
Behind the reception counter, which is hosted by a lady wearing a bluetooth device (I’m assuming connected to the phone) are four multifunctional touch screens which replace the traditional shelves of P and GSL medicines, enabling customer to choose products (which pop out of the robot), or watch health information videos.
There are two consultation rooms, a private area for methadone, and another room where Mr MAC lives – the pouch dispensing robot.
Bernadette really has developed a local health centre, and you can see the pride as the team all go busily about their work. More than that though, the people who use the pharmacy have also benefitted as they see have seen their pharmacy transformed, and know that it’s all for them, so you can sense the pride and emotional investment they also have in the pharmacy.
Bernadette was already pushing boundaries and delivering measurable health benefits before the robot was installed, so what they can achieve now will be fascinating to watch.
So what aspects of the pharmacy make it so different?
- All pharmacists are enrolled on clinical diplomas or independent prescribing courses.
- By 2018 the pharmacy will have four independent prescribers and an additional two accuracy dispensing checkers.
- Independent prescribing is incorporated into both acute and long-term conditions consultations and all outcomes and prescribing are fully audited with robust safety and communications to all GP.
- An enhanced common clinical conditions clinic has been established.
- There has been significant investment in technology (in addition to robots) to maximise the time all pharmacists have to offer minor illness consultations and chronic medication service (CMS) reviews.
- There are two custom-built private large consultation and treatment rooms.
- Two nurses assist with clinics: one for respiratory, and one for common clinical conditions.
- Only self-care medicines are available “to create healthcare transaction, not a retail one”, which says Bernadette is influencing how the public use them for clinical care and services.
Individual practitioners, like Bernadette, are developing their practice, learning new skills, growing in professional confidence and making real differences to the people they help. They really are blazing a trail — we need to celebrate these people, spread the news, and drive the ambition of other community pharmacists who may still be mainly involved in the dispensing process.
One of the keys to Bernadette’s development was undertaking the NHS Education for Health (NES) Clinical Skills course with Robert Gordon University (RGU) and Ninewells Hospital, which she says has provided valuable learning as an independent prescriber. “It has changed the way I am prescribing, using these new skills for more detailed assessments and using the SBAR [situation, background, assessment and recommendation] tool to communicate all prescribing with GP practices.”
Bernadette’s goal is to undertake consultations all day in her pharmacy and support the NHS by reducing the number of minor illness consultations going to GP practice, out of hours, or A&E, as well as helping those with long-term medical issues, such as pain and respiratory conditions.
She wants to provide an enhanced minor illness triage walk in clinic to include prescribing in urinary tract infections (UTIs), skin, eyes, ear, nose, throat as well as acute exacerbations of chronic obstructive pulmonary disease (COPD) and asthma.
This is what community pharmacy is all about, and Cadham Pharmacy is a great example of community pharmacy at its best: providing excellent care in the heart of a community.
In fact, it’s more than that, like most community pharmacies, Cadham Pharmacy isn’t just located within the community, it is part of the community.
Ross Ferguson attended the recent relaunch of Cadham Pharmacy Health Centre