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Impementation of pharmacist prescribing
Transcript of Impementation of pharmacist prescribing
in Scotland hindsight is a beautiful thing!!! Lessons learned non-responders Food for thought service maintenance implementation toolkit trust confusion learning in practice praise strategic framework learning in practice Pharmacist prescribers what do pharmacists think of this development? Implementation What are their early experiences? What did they think of the transition from SP to IP? How keen are newly qualified students to take part? What are the patients' experiences? What do other healthcare professionals think? What does the general public think? "Within the medical practice we are almost doing a prescribing role anyway...so you are doing [prescribing]...going through the motions almost anyway so this was just a natural next step to do the qualification" opportunity to improve patient care enhanced autonomy and integrity "I mean taking clinical responsibility rather than just putting referrals to the doctors saying "could you change this?"...I think I work more closely with the GPs and nurses now that I am doing the prescribing than before..." funding practice settings
training "For community pharmacists it is difficult to practice as first you have to pay for your locum; then after qualification, primary care does not support your subsidies; the GP does not want to pay you and there are not many primary care trusts who have protocols for prescribing pharmacists to practice" formal support network CPD "There should be special training days for prescribers within each area to update their knowledge and other training needs" competencies "You sometimes don't realise what you don't know and you can genuinely think that you are doing something that is ok but just because your knowledge isn't as good as it should be, you can make maybe an error that way and that is my main concern" prescription pads Pharmacists on the course & those yet to do the course "There wasn't much guidance given choosing a mentor...because there was a shortage of numbers and it was all very new, people just ran to the GPs that they knew of and used their relationships. But they may not have been the best mentors" "I went into the period in practice not really knowing what I was to do...so there's got to be some kind of guidance as far as what's expected" I went and spoke to the doctor and found that...I couldn't go on a number of days that suited me and the locums. So I then had to go and book other locums...basically you just had to accept that you were neglecting your business" I really don't think 12 days in practice for someone who is newly qualified and who has really not had any hands on experience will be enough" contemplation awareness of course integration in Ug/Pg courses Other healthcare professionals "it can simplify the process in that the pharmacist often has more expertise and knowledge in actual drug interactions, side effects, contra-indications; so they can provide information to the patient" teamwork "well I think the main strength is that the doctors in our outreach clinic can't always be there. I am only there twice a week so the pharmacist can be there the rest of the time" competence "patients can be very demanding and put pressure on us and other professionals to do more. So it's definitely a question of knowing your limitations and not letting patients dictate what they take and not take" "Well my concern is that obviously you need to be in a position to make a diagnosis - an appropriate diagnosis - and not to miss the problems that may be going on which takes all of us a long period of time to gain the kind of knowledge and then the experience" "I think pharmacists aren't doctors. That's the bottom line. I think it's all very well for pharmacists to prescribe as per protocol but they've not done medical training....you have to be very careful about what you are expecting pharmacists to actually be doing" "I think you'd be lucky to get GPs to do it [for more than 12 days] whithout sort of paying them full rate and that would be prohibitive" respect "I think initially we didn't know how much work was involved in those competencies. It was quite hard to do a sort of formal assessment on someone you know quite well. As a mentor, I would have preferred a bit more clinical orientated assessment" Patients & General public apprehension satisfaction "I am very happy with the pharmacist and how carefully he managed my condition and keeps an eye on me. I would say I get better care for my condition from the pharmacist when it comes to my prescription" respect service managers practice environment education time commitment learning in practice implementation toolkit
validated assessment tool for consultations
prescribing competencies robust evidence (clinical, economic, humanistic)
novel methodologies You can do it!!!!!