• I have a good understanding of a wide variety of pharmacy roles – I worked as a locum in community pharmacy, I have worked in the hospital setting on admissions wards, ran pre-op assessment clinics and have had the joy of working as part of the out of hours service in hospital on the on-call rota!
• I was excited by the new role split between general practice and secondary care. This split role has the benefit of having a foot in both camps that is used to streamline care for my patients.
• I now work as a specialist heart failure (HF) pharmacist which I have been doing for the last 8 years, and work within the multi-disciplinary heart failure team in an interface service delivering clinics between primary and secondary care.

• The two disease areas that I have been focussing on in some GP practices are HF and anti-coagulation
• I have been reviewing HF patients in general practice and take responsibility for this HF workload as a Quality Outcome Framework (QOF) domain in one of my practices since April 2014. This allows me to optimise treatments and includes reviewing patients following hospital admission to ensure that any treatments that are withheld e.g. in acute kidney injury, are safely and appropriately re-commenced.
• I have been reviewing anti-coagulation in other practices that I work in, with the aim to identify patients anti-coagulated with warfarin who are inadequately controlled and make clinical decisions on changing or considering alternative forms of anti-coagulation therapies for these patients. I am developing a register of patients that are anti-coagulated on Direct Oral Anti-Coagulants (DOACs) and review this group to ensure the necessary monitoring is done and that patients are reviewed.

A particular area that I am focussing on at the moment is how I can make the repeat medication re-authorisation process more efficient, by forging close working relationships with the prescription clerks in practices. As pharmacist our skills are well suited to support this process whether dealing with queries and subsequently identifying patients that need to come in for a review. These activities will ultimately improve patient safety, outcomes and reduce workload on GPs.

I have been recording all activities that I have been involved with that require medication optimisation that will generate revenue for the practice such local enhanced services and QOF work. Additionally I record the medication related queries that I deal with as GP time freed.

I have come to realise that that Type II diabetes is a condition that some of the practices could benefit from further support in optimising patient’s treatment. I am aiming to upskill in this field through attending training events and spending time with the specialist endocrinology pharmacist and the diabetic specialist nurses.

It is important to identify opportunities to improve patient safety and to maximise treatments in long term condition management. Build confidence in a particular disease area and this will lead to further projects.

I have been very impressed with the i2i methodology where workshops are presented by experts in the field who understand the challenges of general practice. Delegates leave the event equipped with online tools and the knowledge to develop a clinic or service, which is what adds the most value to the delegates to enable them to implement their learning back in their practices. I have not seen this in any other training event that I have attended.

… the intricacies of the GP QOF when I first started!