17th October 2018

Insight from Samantha Cudby

Time in general practice

18 months

Location

Walton

Qualifications

MRPharmS (Portsmouth), Independent Prescriber (Reading)

Current Role

Practice Pharmacist (for Walton Practice) and Care Home Pharmacist (for North West Surrey CCG)

My life before becoming a pharmacist in GP Practice

I worked in Community Pharmacy (Boots the Chemists) for 26 years. I had many roles but latterly worked mainly in the Care Home section, liaising with care home senior staff to ensure medication was ordered, stored, administered, recorded and returned / destroyed in line with current guidelines. I provided support for writing protocols and policies, completing medication assessments for NVQ training, developing side effect charts for administered medicines and joining multidisciplinary groups to provide information on medication being considered for covert administration. I also provided a range of accredited training courses to care home staff aimed at improving their competence and confidence in all aspects of medication.

As a CCG Care Home Pharmacist my role involves:

  • working in a multidisciplinary team to improve the effective planning, communication and delivery of comprehensive care within care homes to improve patient outcomes
  • completing full clinical medication reviews at individual resident level to optimise medicine use, ensure concordance and promote understanding around medication
  • reducing the likelihood of drug interactions and adverse reactions
  • reviewing systems and processes for the ordering and prescribing of medicines to identify overused, underused and inappropriate medications
  • promoting effective medicine reconciliation to ensure safe and effective care and minimise waste
  • promoting and delivering the recommendations from the NICE SC1 guidelines
  • reducing unnecessary hospital admissions
  • providing education for care home staff and encouraging partnership working between GP practice and care home
  • working with care home staff to ensure compliance with CQC standards.

GP Practice experience

As a GP practice pharmacist, I provide medication reviews for patients over 65 years via clinics and domiciliary and care home visits to improve the quality and safety of patient care and maximise cost-effective prescribing. I also ensure that patient medication records on the practice’s clinical computer system are up to date and accurate, particularly following discharge from hospital or transfer between community settings.

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 everyone understood my role as a practice pharmacist and didn’t expect me to complete tasks beyond my competence, scope of practice and comfort level or book inappropriate patients in to my clinic.

Solution

I worked hard in the areas where I could add distinct value and constantly emphasised the term ‘pharmacist’ and by ensuring I only saw appropriate patients I was able to build my own competence and confidence.

Challenge #2

Ensuring I kept within the 20 minutes per consultation and still complete all I wanted to do in the discussion.

Solution

Focusing on the i2i Network ABCDE change methodology ensured I was prepared for every clinic.

Key Messages

Be proud of being a pharmacist and the skills we bring to the practice.

Maintain the integrity of your key values to ensure patient safety and improved outcomes.

What are your current priorities / key areas of focus?

To improve the quality of care received by our patients through:

  • medication review clinics for the over 65 year olds
  • medicine reconciliation, particularly following discharge from hospital
  • completing audits as identified within the practice, for example Oral Nutritional Supplement, patients at risk of Acute Kidney Injury

How have you demonstrated impact and value in your practice?

  • Working as part of a multidisciplinary team providing regular medicine reviews for patients over 65years
  • Providing leadership on person centred medicines optimisation and quality improvement
  • Providing a link with community pharmacists and other stakeholders in the medicines supply chain to improve dispensing process and manage medication issues
  • Promoting self-management of conditions that are self-limiting in nature or a minor illness
  • Providing expertise in medicines advice considering the different needs of care home residents and community patients

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

I think it is important to keep learning anything and everything but also to embed these new skills into every day practice.

I need further training on Information Technology skills, particularly on how to conduct EMIS searches; currently I rely on other people to do these.

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

  • Empathy
  • Good clinical knowledge
  • Able to work independently with confidence but within a multidisciplinary team
  • Well organised
  • Good time management skills

What has been your perception of the i2i Network?

The i2i Network provides GP Practice Pharmacists with the training, skills and resources they need to do their job, it recognises, develops and celebrates the role of the pharmacist.

I wish someone had told me………

That I would love every aspect of this role so totally and then I would have made the change so much sooner!

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