Lucia Castagnetti is a community pharmacy branch manager and independent prescriber. She works at a branch of Well pharmacy in Lochgelly, Fife. She took time out to chat with me. I found it really inspiring to chat with her because she is one of the new generation of community pharmacy independent prescribers. She explains, in a very modest unassuming way, how she is doing life-changing work by using her professional skills.
Where do you work?
I work in the Lochgelly branch of Well pharmacy
How long have you been a pharmacist?
Why did you study pharmacy?
Pure chance. I had no idea what I wanted to study until Professor Furman from Strathclyde university spoke about the pharmacy course at my school’s careers week. Even at that point, it was the forensic science elective that grabbed my attention but after spending a week in a health centre pharmacy for work experience I found I quite enjoyed it. After that my fate was sealed.
What does your current role involve?
First and foremost I’m a community pharmacist and have the day to day management of my branch and providing all the services that entail. In addition to that, I go into a GP surgery once a week for my prescribing clinic where I see patients for anything from asthma and hypertension management to minor ailments/ acute conditions that aren’t covered by the electronic minor ailments service (EMAS). I’m also undertaking training on warfarin management with a view to starting an anticoagulant clinic with local surgeries.
When did you qualify as an independent prescriber?
I initially qualified as a supplementary prescriber around 2007 and did the independent prescribing (IP) conversion course a year or two later.
What was the therapeutic area that you covered as part of the prescribing course?
I chose respiratory as my area of interest. It was the area that interested me most and conveniently has quite straightforward guidelines.
How have you developed as a prescriber?
Over the years I have had to cover clinics in different therapeutic areas and this has involved spending time with other health care professionals to find out what skills and clinical knowledge I needed to work on to make sure I could do this. I’ve attended some of the NHE Education for Scotland (NES) courses such as core clinical assessment skills and consultation skills. A recent scoping exercise at NHS Fife out of hours service proved useful for adding in a minor ailments element to my prescribing clinic after seeing the algorithms and PGDs the non-prescribing nurses used to treat clinical conditions such as cellulitis and ear infections.
Do you think all community pharmacist should be independent prescribers?
At the moment I don’t think so. Community pharmacy is a busy and stressful environment as it is. The coursework itself is quite a shock to the system if you have been away from study for a few years and I remember my horror when I realised I had several essays to write before the week at university. I think the introduction of more patient group directives (PGDs) recently is a good stepping stone for community pharmacists to provide more patient care in a structured manner. I do think more pharmacists should do the training and eventually it will become the norm. That will be an exciting time for community pharmacy as prescribing can become integrated with day to day pharmacy rather than a handful of niche clinical areas.