What triggered your interest in diabetes?
The disease is a very interesting one that has multiple risk factors and linked to different other preventive and curative health issues, therefore for me, it presented itself a very rich specialist subject that would always keep me engaged, satisfied, and leave no room for boredom. But I would suggest the interest was sown long before in my thoughts during a period where I lost a couple of close family links to preventable diabetes complications.
What needs to change in this area?
A lot needs to change, for one we need a unified professional body that has the mandate of the majority of active pharmacists and focuses on building the brand by standing for all pharmacists and not neglecting non-members. I think the RPS is well placed and able to achieve the latter if it makes it a number one priority above all others. The sad reality is the profession can’t grow without unity but it can’t be united without growing far from its past and rebrand. With regards to diabetes, we do need a better structure of development for those interested in the specialist area but most importantly find more job posts and hands-on training opportunities for inspiring specialists. Pharmacists in specialist areas need to realise simply ticking competences isn’t good enough as a specialist training model. There has to be an effort made to understand the specialist area beyond medicines use, management and optimisation, even though these are our cornerstones as pharmacists. As a consultant pharmacist in infection once suggested, if you are going to specialise you might as well study it right which often would require a form of academic certified assessment alongside hands-on practical training opportunities to gain specialist experience. There also needs to be a clear distinction between being a diabetes specialist pharmacist, a pharmacist with a special interest in diabetes, and generalist pharmacist providing diabetes medicine reviews. Competencies and training requirements can’t be the same for all three categories, just as a consultant diabetologist training differs from a GPWSI in diabetes so also I would expect to see the same variation in pharmacy so the subject becomes more inclusive than exclusive.
Is there a significant role for pharmacists in the care of patients with diabetes?
Diabetes is everyone’s concern. There is an integral role for pharmacists as we are the only profession found within every stage of care delivery from formulary development, prescribing, and dispensing to end service users. Pharmacists are often the last and frequent healthcare professional people with diabetes encounter so most definitely pharmacists have an active role to play in diabetes care delivery. However, there are many issues that need to be addressed, for example, we need NHSE and local commissioners to officially recognise pharmacists. Especially community pharmacists, as part of national and local diabetes care service delivery and referral pathways. There has to also be more commissioned primary care specific pharmacy diabetes services to encourage the development and spread of good practices. Most importantly there has to be an increase in access to people with diabetes records to allow continuity of care and follow-on care from where prescribing services are provided to where dispensing services are delivered. This needs to become the new culture and model of diabetes care. Only pharmacists can make the latter a reality to the benefit of people with diabetes. This will reduce NHS expenditure and human cost of diabetes.
How can community pharmacists help?
I remember sitting in a lecture while in Pharmacy School and the lecturer talked about how the community pharmacist role evolved. Since then I have always felt there is a capacity for community pharmacists to do more to improve the delivery of long-term condition prevention and management services. Pharmacists would become part of an integrated, patient-centred system of healthcare and be proactive in taking up clinical and biopsychosocial disease monitoring and management roles.
What do you love about your job?
I love a lot of things about my job. The chance to have face to face consultations, develop policies for good practice, improve patient clinical and biopsychosocial outcomes, and support other HCPs with medicines and diabetes-related queries leads to the rewarding job satisfaction I presently enjoy. The autonomy is priceless.
Any aspects you dislike?
I have been fortunate to work in a GP surgery with forward-thinking GPs that respect and value pharmacists, however, I would say the increased workload can often lead to physical and emotional burnouts.
What was the toughest lesson you had to learn as a pharmacist?
There have been numerous lessons learnt; too many to count. However, I believe one that sticks like glue is that I have to constantly remind myself that often it is a lonely road, one with very few exemplary mentors.