What does your current role involve?
My remit is very wide. In my role as an advanced clinical practitioner, diabetes and prescribing lead, I have urgent and routine appointments, order and review blood tests, undertake LTC reviews, management of the diabetes caseload, management of repeat medicines re-issue and re-authorisation, medication reconciliation and synchronisation. I am part of the senior management team. I occasionally review clinical post and online letters. I am in charge of delivering on the CCG MOT prescribing quality scheme for my GP Practice, medicine information contact for other staff and I deliver 1 to 1 education and support professional development plans for other staff members especially in the area of diabetes care delivery.
When did you qualify as an independent prescriber?
I gained my IP in July 2015
What was the therapeutic area that you covered as part of the prescribing course?
My designated medical practitioner (DMP) was an acute admission and diabetologist consultant, so I got the opportunity to cover two therapeutic areas; anticoagulation and diabetes. For my assessments, I focused on NOACs as the course required a narrower scope for assessment purposes.
How have you developed as a prescriber?
Going through the clinical diploma training and building a specialist interest made my development as a prescriber natural. I was able to quickly understand the difference between generalist and specialist prescribing, and the different levels of knowledge and competency. Thankfully I haven’t had a prescription error that has brought harm to a patient or put a patient in harm’s way so I will endeavour to keep it so. I think the key is remaining reflective and aware of my unconscious incompetence.
Do you think all pharmacists should be independent prescribers?
I think the right question to ask is if I think IP is essential for all pharmacists, to that end the answer is no. Independent prescribing isn’t a position or title but rather a tool, therefore like every other tool one should only obtain it if one is clear about what one wants to do with it. Knowledge of prescribing is essential for all pharmacists but having an IP certificate isn’t.
What clinics have you set up over the years and what do they involve?
In my present job role as a diabetes clinical lead for my GP Practice, I had to set up diabetes, pre-diabetes, obesity, and gestational diabetes review system and service. Also as part of ensuring my patients with diabetes get all their diabetes care processes completed annually, I set up an in-house review system to meet this need. This included creating a new post for one member of admin staff; a diabetes care processes coordinator. In my clinics, I provide weight loss and maintenance guidance, BP and lipid optimisation, foot checks, diabetes retinopathy aftercare, urine albumin-creatinine ratio (UACR) management, biopsychosocial support and assessment, diagnose and manage diabetes and it’s complications. I also support the patient to self-manage diabetes emergency complications(e.g. DKA and Hypos), initiate oral and injectable therapies including insulin. I run a clinic for urgent/routine/walk-in/on the day appointments, dealing with a range of issues and queries such as medicines queries, long-term condition reviews, blood test reviews and minor ailments. I also have a bi-annual diabetes virtual clinic where people with diabetes with a Hba1c >75mmol/mol are reviewed with the community consultant diabetologist.