As a result of an exciting trip embarked on by one Scottish pharmacist, the sector’s sphere of influence has experienced a new global reach. Owner of Cadham Pharmacy Health Centre & Travel Clinic in Glenrothes, Bernadette Brown, reflects on her visit to New Zealand to meet with the board and members of the Canterbury Community Pharmacy Group for liaising and learning.
I was honoured and proud to have been invited by the Canterbury Community Pharmacy Group to New Zealand in July 2019. I met Aarti at the FIP in Glasgow after I presented on behalf of the Royal Pharmaceutical Society on what is possible to deliver from community pharmacy in Scotland with use of innovation, technology and clinical services. They were interested in how I transformed a retail pharmacy into a health centre community hub with face-to-face triage assessments with our pharmacist practitioners.
They were also interested in how we support long-term care, in particular, with saving lives in asthma, as this disease is highly prevalent in their country and on average one person dies per day there. It is particularly a problem with their high-needs populations, and after meeting with policymakers, it is also an area of interest which community pharmacists can support by reducing hospital admissions, and so hospital avoidance became a clear priority in my thinking.
A common comment from Kiwi pharmacists I met was that they were interested in offering new services but couldn’t see how to free up pharmacist time from dispensing. I observed that in actual fact their young pharmacists do not only do the final check, they also dispense. In one pharmacy there were five pharmacists on duty at the same time.
I was so very honoured and proud to have met up in person – along with his pharmacy advisors and Ian McMichael, the President of the Pharmaceutical Society of New Zealand, and Richard Townley, Chief Executive Officer of the Pharmaceutical Society of New Zealand – with the Minister of Health, New Zealand, the honourable Dr David Clark.
He spoke with me, with his advisors, and the Pharmaceutical Society of New Zealand for 30 minutes and was interested in listening to my stories where the outcomes were improved quality of life in asthma and hospital avoidance, as well as greater access to the public to a highly qualified workforce for minor illness. I explained how my team and I have skilled up to provide an enhanced common clinical conditions clinic which is not only improving access, but we have evidenced the ways in which this clinical care is supporting saving appointments in GP practices and accident and emergency and out-of-hours services. I shared how Choose Pharmacy First is a big campaign which allows the pharmacists to skill up and assess and treat their own patients.
I met with the Pharmaceutical Society of New Zealand senior team – also in Wellington – and we discussed the education of pharmacists, and how I have been particularly lucky in Scotland with our universities and education bodies, as well as the government getting behind us and providing excellent training resources. I discussed Common Clinical Conditions as being the one course that transformed my thinking as to what could be possible to deliver from community pharmacy.
I am so very proud that my pilot in Fife – which took over two years and a nine-month evaluation phase – is now a priority of NHS Fife and any community pharmacy can now apply for funding with the correct level of education, skills and experience to deliver a funded common clinical conditions clinic. There are now three pharmacies offering this and more doing their training so that they can apply for funding.
I have a service level agreement that was adapted from a Welsh one thanks to the amazing generosity of my Welsh colleague and I can now assess and treat any person registered in my town at the seven local GP practices as a drop-in centre with a wider scope of practice including ear, nose and throat infections; chest infections; cellulitis; paronychia; acute exacerbations of asthma; COPD; eczema; and psoriasis.
The pharmacists were keen to hear about our innovations on how we have achieved releasing pharmacists away from the final check and into a more person-centred role. The key for the consultations is that we as pharmacists like science and numbers and our team at Cadham have realised that the public respond to these when they are explained in the context of their diagnosed conditions and how those medicines can relate to that and improve their quality of life.
I spent time sharing my case studies in asthma and how we have seen people who have been sick for years, and how with that simple support and motivational interviewing, in the space of just three months their lives have been turned around.
I have had contact from one of the pharmacists I met and she and I are working together to support her starting up her own clinic to support saving lives in asthma in her town. I’m so happy that I was given this opportunity of a lifetime to meet with these wonderful people who all have a desire and want to do more. I do hope that in some small way I have been able to inspire on what is possible and then support with advice and the tools on how to deliver more clinical funded services in New Zealand, making the most of their exceptionally-talented workforce.
