12th February 2019

Insight from Clare Murray

Time in general practice

Started with GP Federations November 2016

Location

East Belfast, Northern Ireland

Qualifications

Masters Degree in Pharmacy, Postgraduate Certificate in Independent Prescribing, working towards Postgraduate Masters in Advanced Clinical Practice.

Current Role

Lead Practice Based Pharmacist.

My life before becoming a pharmacist in GP Practice

  • I worked for ten years in community prior to moving across to General Practice full time. I have managed teams of up to 20 in the past. I was a passionate Community Pharmacist keen to push the boundaries for what patients could expect in terms of care when they visited my stores.
  • I worked with the local community delivering Building the Community-Pharmacy Partnership (BCPP) initiatives with local charity partners to help empower women with mental health issues.
  • I was recognised for contribution to Pharmacy Service delivery winning the accolade of Young Community Pharmacist of the Year and an award for Education and Self Development within the Pharmacy Profession.
  • I have also held local commissioning roles, working with the Department of Health (DOH) to help deliver key priorities and transformation of the patient journey in Primary Care.

GP Practice experience

I have recently moved into a Lead Role within East Belfast, helping deliver the DOH key priorities for action within my locality and enhancing the role of Practice Pharmacists in Primary Care

As a Practice Pharmacist I have undertaken work in the following areas:

  • Diabetes, hypertension and asthma clinics
  • Travel clinics
  • Flu vaccines
  • Medicines reconciliation post hospital discharge
  • Medication review
  • Acute/Repeat Prescribing administration
  • Clinical Governance Audits and implementation of change to promote evidence based best practice.
  • The go-to medicines expert within the practice for queries
  • Medical Student Training with regard to prescribing
  • Training of non-clinical staff on new initiatives such as Minor Ailments or Pharmacy First Scheme
  • Increasing GP capacity within general practice
  • Enhancing communication between Primary and Secondary Care to improve patient outcomes.
  • Presentation at local University career events to encourage Pharmacy students to consider the role.

Key examples of personal challenges of practice pharmacy – what were they and how did you overcome them? (including skills, knowledge and training)

Challenge #1

Ensuring GPs are aware of my own personal scope of practice and not expecting me to undertake work that is outside my level of competence.

Solution

Effective communication right from the beginning reflecting the skills I can bring to the table as a medicines expert. Adoption of the ABCDE model from i2i helps with this. It allows me to formulate conversations prior to meetings with the GP’s to ensure the message I wish to convey is succinct, clear and not diluted by other agendas. This needs to be an ongoing reflective process, with open lines of communication and an ability to say no or ask for help when appropriate.

Challenge #2

Ensuring my skills are used optimally and complement the skills already present in the practice.

Solution

With regards to Diabetes, the Practice Nurses and I have an efficient way of working that plays to each-other’s strengths. The nurses undertake the physical assessments necessary for QOF and then refer patients who require their medicines optimised to me. The patients’ love this approach as they can have the key messages reaffirmed twice ensuring they understand. The GPs love it as they are no-longer being interrupted during clinics to make changes to therapy. The nurses love it as they can spend longer on lifestyle interventions knowing that I will deliver the key messages regarding medicines and re-inforce the lifestyle advice.

Key Messages

The most important message I would give to anyone embarking on this career path is develop effective relationships early on, speak up when you have concerns, never be afraid of asking questions and continuously reflect on your scope of practice.

What are your current priorities / key areas of focus?

My key priorities for the coming year are:

  • Enhance and maintain the role of Practice Pharmacists as an integral member of the Primary Care model in Northern Ireland.
  • Develop those Pharmacists new to role, to ensure their skill set is maximised and they are enhancing their scope of practice. It is vital to ensure the effective use of the Pharmacist resource so people feel valued members of the team
  • Promote and ensure consistency across the practices I manage with regards to the implementation of Evidence Based Medicines Optimisation.

How have you demonstrated impact and value in your practice?

I have demonstrated impact in a number of ways; I am now an integral member of the LTC management within my practice. I contribute to QOF meetings and ensuring patients are reviewed robustly.

I feel I am an integral part of the team within which I work, colleagues ask me for advice and help with regards to patient management.

I have now developed relationships with patients in the practice and they will routinely book into see me and value my clinical opinion with regard to their clinical management.

The fact that GP colleagues miss me when I go off on a week’s leave and Pharmacist holidays impacts on resource allocation demonstrates how much Practice Pharmacists contribute to enhancing GP capacity.

What development do I need / am I undertaking at this point in my journey?

I am enhancing my ability to manage LTC through the completion of diploma modules in diabetes and cardiovascular risk

I am also keen to develop my personal ability to coach and mentor to enhance my leadership role.

What skills or competencies do you feel are important to have in your role as a practice pharmacist?

  • Relationship Building
  • Effective communication skills
  • Time management skills
  • Problem solving
  • Efficiency
  • Ability to ask questions

What has been your perception of the i2i Network?

I love the focused approach targeting LTC management, playing to the skills of Pharmacists. Bringing like-minded people, keen to learn from experts in the field into one venue allows you to develop a network of peer support to promote and foster continuous personal development.

I wish someone had told me………

Its ok not to know the answer to everything, but rather learn where to go to find the correct answer!

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