Superintendent pharmacist — understanding new areas in public health
 Tricia Kennerley is superintendent pharmacist and NHS services director
for Moss Pharmacy. In her spare time Miss Kennerley spends her time renovating
her cottage. She also enjoys golf and skiing.
Reflection Last year, I identified the need to develop my understanding
of the role of pharmacists in public health. This need was identified from
increases in media coverage of public health (particularly weight-related
issues) and the release of the Department of Health’s
consultation paper “Choosing health”, which highlighted possibilities
for pharmacists in new areas of public health. I decided that I needed
a better understanding of these new areas in order to influence senior
management
colleagues to invest in them and to work with my team to develop the Moss
Pharmacy healthy heart campaign.
Plan I identified several action points:
· Read fully the “Choosing health” document
· Search the internet for recent articles about public health (primarily
pharmacy and medical journals from the UK, US and Australia)
· Have discussions with members of my team
who are experts in this area
Action These actions took around 10 hours
overall.
Evaluation Completing these action points allowed me to have strategic
input into Moss Pharmacy’s public health campaign. As a result of
this, our healthy heart campaign gained wide backing from the senior management.
This CPD record relates to competencies G17 (effect of lifestyle on health)
and G18 (health education and promotion respectively), as well as G14 (evaluation
and use of reference sources in support of evidence-based practice) in “Plan
and record”. Many of the articles found on the internet contained
useful evidence on the relative effectiveness of various public health
interventions.
Recording Moss Pharmacy introduced its own CPD portfolio for use by its
pharmacists in 2001; this follows the same format as the one used by the
Society. Over the past few years, Moss Pharmacy has been encouraging and
rewarding participation in CPD through its staff bonus scheme.
The prospect of doing CPD is much worse than the reality. Once you have
broken the barrier of completing a couple of recording forms, it becomes
much easier. You quickly learn to recognise your learning needs and how
you have applied what
you have learnt. I am pleased I took the plunge early and would recommend
any pharmacist to give it a go before it becomes mandatory.
Hospital pharmacist — taking action following an incident
 Laura Cameron joined the register in 1997. She is the chemotherapy preparative
service manager at a large teaching hospital, managing five pharmacists
and 10 technicians in a satellite pharmacy that makes intravenous chemotherapy
doses. In her spare time,
Miss Cameron goes to art exhibitions.
Her favourite exhibition so far this year has been Tamara de Lempicka at
the Royal Academy.
Part of my job is to meet research associates to set up clinical trials in
terms of reviewing the protocols and agreeing a pharmacy financial contract.
This example of my CPD came from an incident during a phase I trial of a brand
new compound.
Our unit normally prepares prescription proformas for each dose cohort,
stating the dose level, the infusion fluid and anti-emetics, so the prescriber
is only required to enter the dose. In this case, one doctor accidentally
used the wrong cohort prescription proforma. When a member of my team clinically
screened this prescription, this was not identified. Consequently, the patient’s
dose was from the wrong cohort and, therefore, not in accordance with the
trial procedure (but in this case no harm came to the patient and the trial
was not compromised).
Dose cohorts have to be filled consecutively. If a trial is run across
several centres, cohorts will be filled sequentially with patients from these
centres. However, in this case, we were the only centre running the trial.
On reflection, in the initial trial set-up meeting, I had failed to realise
that we were the only centre and to communicate this to my team. If I had
done so, the fact that a patient was being placed in a second cohort before
the first had been filled would have been unusual and the mistake would not
have occurred.
I identified issues regarding my communication skills, the process I use
to set up trials and the design of the proforma used. I talked these through
with the head of pharmaceutical quality assurance at the hospital and discussed
ways to prevent this kind of incident from reoccurring. I also spoke to the
doctor involved, the trial’s research nurse and the pharmacy team.
I am reviewing how I introduce new clinical trials to the unit and how
information relating to each trial is recorded. One of the outcomes of this
event is that we now have a notice in trial folders stating the number of
patients per cohort and that each cohort must be full before moving to the
next.
I think this example shows that the action taken following reflection of
an event may not necessarily involve a structured plan or attendance on a
course.
I received the “Plan and record” folder a couple of months ago
and I have not had a chance to look at it properly, but I am familiar with
the CPD cycle because of the diploma in pharmacy practice I did at the London
School of Pharmacy. I used to make CPD records, but I have not made any records
lately because of the time it takes.
Things come up during my working day that are more urgent so although I
do CPD, recording it is not a priority. I do keep a note of the things I have
done.
I am practising and keep up to date with clinical advances and technology
by reading and attending conferences, but I need to find time to record my
CPD outside working hours.
Primary care pharmacist — learning from a weight management project
 Samixa
Shah is practice support pharmacist for Barnet Primary Care Trust. She
was formerly a Centre for Pharmacy Postgraduate Education tutor for
North London and North Middlesex. Mrs Shah is a volunteer class
representative at her son’s school and has
recently completed an eight-week course on meditation.
Reflection In September 2003, the PCT asked me to manage a six-month weight
management project. Each pharmacist involved was to screen and recruit 15
potential clients by measuring waist circumference and blood pressure and
calculating body mass index. These clients would meet the pharmacist once
a month to check their progress and to obtain advice and tailored information
(eg, on food fat content).
I had to write objectives for each month. Thinking through each stage of
the project led me to identify areas for my own development and plan for them.
For example, although I have managed professionals in CPPE workshops, I had
never done so in a long-term team project. I also thought that I needed to
brush up on my computer skills (in order to generate the necessary paperwork
efficiently) and my mentoring skills because the project presented a development
opportunity for the six pharmacists taking part.
Plan and action Fortunately, my PCT offers in house training and details
are e-mailed to us regularly. I could have looked at other courses, but the
PCT ones were convenient in that I could attend during working hours. I chose
a course on computer skills, learning how to use programs such as Word and
Excel.
Revising things I had learnt already also helped. For example, I had previously
worked through a CPPE workshop on time management and my diploma in community
clinical practice (completed in 2002) required me to interview health care
professionals. I took time to refresh my memory in these areas.
My CPD for this project covered many of the “Plan and record” competencies,
including G18, G23, G27 and G28.
Evaluation One pharmacy helped 50 per cent of its clients achieve continual
weight loss while the others had varying degrees of success. However, I was
really satisfied with how I managed to write up the project (eg, I put results
on spreadsheets) and to design user-friendly forms. Time management skills
helped me keep on top of things over the six months. In terms of managing
people in such a project, one of the things I have learnt is that it would
be useful to find out what people’s ideas and motivations are before
recruiting them. Some of the participants did not realise how much work would
be involved and those who were not well motivated did not achieve good results.
As a result of being involved in this project, I have been asked to participate
in the obesity forum group for Barnet PCT.
Recording I used to make my CPD records on paper but in January I started
using the on-line records. I prefer this because it is easy to amend what
I have written.
Although I have always tried to look at what I need to learn in all instances,
I think that CPD has made me more reflective. I
believe that all pharmacists are learning all the time but often do not
recognise this as CPD.
Clinical governance pharmacist — crystal ball gazing
 Tim Root is a specialist pharmacist for clinical governance and technical
services, with London, Eastern and South East Pharmacy Services, based
at Chelsea and Westminster Hospital. Outside work he enjoys DIY, cooking,
reading historical novels and making model sailing ships from kits. Mr
Root is particularly interested in 18th and 19th century naval history
and is a “late convert to the gym”.
Reflection A major element of my role is strategic planning for cancer
chemotherapy service provision at both local and national levels. One of
the many factors that is
likely to influence trends in chemotherapy
in the next five to 10 years is pharmacogenetics.
I realised recently, however, that I knew
almost nothing about the science involved and, therefore, did not really
understand
exactly what impact to expect or when.
Plan and action While wondering how to fill my knowledge gap (without having
to admit publicly that I needed to do so!), I was serendipitously invited
to a sponsored meeting on exactly this topic, run by the University of Cambridge.
I have no idea why I was invited, but can only suppose that someone had spotted
the puzzled look on my face whenever pharmacogenetics came up. The meeting
took one and a half days and I had to fit this into my normal work schedule.
Evaluation I came out of the meeting not only knowing much more about genetics
itself but being much more aware of its implications for the future use of
medicines in general and in cancer chemotherapy. In particular, the meeting
also introduced me to areas, such as the possible commercial implications,
that I had not previously thought of at all.
As a consequence of my own improved understanding I felt (just) confident
enough to start to introduce pharmacogenetics and its implications into discussions
with others and to start considering its impact on some of the strategic planning
and horizon scanning (all too often perhaps more accurately described as “crystal
ball gazing”) with which I am involved.
Recording Now I am supposed to say something about writing it down but of
course I cannot, because I have not yet started to do this properly. I suppose,
though, this summarises what I think about CPD. I know it makes sense and
that I have to do it. I know I do it pretty much every day. What I do not
do (and where, I hope, I am not way out of step with many of my peers) is
formalise the process by writing it down. This is the bit I now have to discipline
myself to do.
I have read and, with the support of a facilitator, tried the Society’s “Plan
and record” format. As an introduction and guide to formalising the
CPD cycle I found the content helpful but it did not always reflect my own
way of thinking. That may well change with regular use but I think I still
prefer a less rigidly structured approach, like this article, for instance.
Council member — getting to grips with new roles
 John Jolley worked in industry for 35 years until 1999, when he left his
job as technical director for Boehringer Ingelheim to take up various roles,
which include medicines
management pharmacist for South Norfolk Primary Care Trust, setting up
a national drugs distribution for Prime Care services and freelance consultant
to the health service and industry. However, he is still a Qualified Person.
This year, he was elected to the Council of the Royal Pharmaceutical Society.
When he has spare time, Mr Jolley enjoys sailing and golf.
My CPD is diverse. I run a number of training courses for people who wish
to become Qualified Persons. This requires a considerable amount of CPD
because I need to
attend regular meetings and keep up to date with new legislation. I have
just completed writing a code of practice for the European Industrial Pharmacist
group.
Since leaving industry in 1999, I have done different CPD because I needed
to
become competent in my new roles. For
example, in order to become a medicines management pharmacist, I attended
courses organised by the National Prescribing Centre. These were mainly
clinical. Although I was familiar with aspects of drugs I was
responsible for producing in industry (eg, respiratory and cardiovascular
medicines) there were other areas (eg, diabetes) that I needed to improve
on.
This year, I have continued with my medicines management development but
I have not done quite so much in view of my duties on Council. Some of
my CPD is now council-related. On being elected, the Society
advised me to attend various induction courses, covering subjects such
as strategic management training, statutory requirements and how the infringement
committee works. It helped me to identify where I needed to develop. I
found these courses valuable and they helped me familiarise myself with
what is going on in Council.
Admittedly, I have been remiss with making records so far, but I shall
be doing so by the time we go “active” in 2005. You can still
do CPD without making records. Records are only necessary to get recognition
from the Society. I have received “Plan and record”. The format
is good, once you get into it. I think I favour written records rather
than the electronic ones though — with paper I feel more in control,
as do many of my age group who are not totally at ease with online activities.
As an industrial pharmacist, I undertook CPD for many years. I always worked
out a personal development programme, defined career objectives and organised
the training and practice experience. Activity from previous years was
always reviewed and effectiveness of the learning agreed. When I left Boehringer
and started as a consultant, CPD became more difficult because I no longer
had annual appraisals. Here I found “Plan and record” useful
in helping me to plan my CPD. My message for pharmacists in industry is
that if you have annual assessments and a development programme, there
is really nothing additional you need to do except enter the information
from your appraisal into the CPD format the Society requires. |
The
Pharmaceutical Journal