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Journal of Pharmacy Management January 2021, Volume Thirty-seven, Number One IN THIS ISSUE: • Rethinking our services during COVID-19 pandemic - using ‘drive through’ principles • Advice to a new Pharmacist • Advanced Pharmacist Practitioner • Public Health Pharmacist • Assessing the desirability of home working • Effective Team Leadership? Get the Basics right!
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CONTENTS
BEST PRACTICE IN PHARMACY MANAGEMENT
Rethinking our services during COVID-19 pandemic - 5
using ‘drive through’ principles
Mildred Johnson
ADVICE TO A NEW PHARMACIST 10
Anthony Young, Minesh Parbat, Finlay Royle and Sue Wen Leo
FACE2FACE
Advanced Pharmacist Practitioner 14
Martina Khundakar
Public Health England Pharmacist 17
Jackie Lamberty
MANAGEMENT CONUNDRUM
Assessing the desirability of home working 23
Luke Groves
LEADERSHIP
Effective Team Leadership? Get the Basics right! 26
Allan Mackintosh
READERS’ FEEDBACK
If the JoPM is to continue to publish material that you would find interesting
and helpful in your practice, it is clearly important that readers feedback their
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short SurveyMonkey questionnaire that will take just a couple of minutes to
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complete is available for each edition by the hyperlink opposite.
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1
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021
EDITORIAL
Preparing a journal in the time of COVID-19 is a challenge. Articles that were
expected cannot be delivered because their authors are fully occupied and we
would not wish to divert them from their tasks.
Despite that, we have been able to find a range of fascinating contributions this
quarter which we hope you will enjoy and benefit from.
Mildred Johnson describes the setting up of a drive-through pharmacy, which
would be a substantial achievement at any time, but particularly so in the
current circumstances.
A key function of the journal is to point to areas of practice that our readers
may not have considered and this issue includes two.
Martina Khundakar describes her work as an advanced pharmacist practitioner
and Jackie Lamberty sets out the scope of her job as Lead Pharmacist for
Medicines Management Services within Public Health England.
A new feature in this edition is “Things I wish someone had told me” - four
experienced pharmacists tell us the little snippets they wish they had learned
when starting out on their careers.
Now it is our readers’ chance to contribute.
Please send us any such tips that you would give to a new pharmacy team
member. They can be very mundane; in my own days in community pharmacy,
we regularly told new staff to find a comfortable pair of shoes because they
would be on their feet all day.
We will incorporate the best examples in future issues, so please send your
examples to katie.fraser@pharman.co.uk
In answering our management conundrum Luke Groves looks at how to handle
the difficult issue of home working and how to decide who can do it and who
cannot. There is no single straightforward answer but Luke will give us the
benefit of his experience to point to some key factors.
The pandemic will be with us for a while longer and in our leadership section,
Allan Mackintosh, provides some guidance on leading teams during the
pandemic. Of course, the lessons here can be adapted to almost any kind of
major disruption.
Just before going to press we heard the very sad news that Graham
Butler, a former colleague here at PM and of course, Ted’s son, had died
unexpectedly. Those of us who worked with him can tell of a perfectionist
who will be greatly missed. We extend our deepest sympathy to Ted and
his family on their loss.
2 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021
WRITE UP YOUR GOOD WORK
AND SPREAD IT TO YOUR
COLLEAGUES
Is it about managerial good practice, service developments and processes
involved in the management of medicines?
THINK JOURNAL OF PHARMACY MANAGEMENT (JoPM)!
This is distributed quarterly throughout the UK to senior pharmacists in primary
and secondary care.
Is it about good practice in medicines optimisation with a focus on ‘optimisation’,
which relates to quality and improving patient care, rather than cost aspects?
THINK JOURNAL OF MEDICINES OPTIMISATION (JoMO)!
This is distributed quarterly throughout the UK to clinical pharmacists, doctors,
nurses and other healthcare professionals.
Why not write an article that addresses the
medicines optimisation initiative for specific therapeutic areas?
Sharing such targeted work will hopefully facilitate discussion and the implementation
of best practice within specialisms.
If you have something to say to readers, we will help you say it!
About 3,000 words is good but full Guidance for Authors is available on the Pharmacy
Management website under the Journals tab at https://www.pharman.co.uk/ .
Any queries? Just contact the Senior Editorial Assistant (katie.fraser@pharman.co.uk).
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WOULD YOU LIKE TO
PUBLISH YOUR WORK
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The JoPM aims to disseminate good practice about service developments
and processes involved in the management of medicines to senior
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All material should be sent electronically to
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4 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021
BEST PRACTICE IN
PHARMACY MANAGEMENT
Rethinking our services during COVID-19
pandemic - using ‘drive through’ principles
Mildred Johnson, Clinical Director of Pharmacy and Medicines Optimisation/
Chief Pharmacist, Pharmacy Department, Maidstone & Tunbridge Wells NHS Trust,
Hermitage Lane, Maidstone, ME16 9QQ.
Correspondence to: mildred.johnson@nhs.net
Background and introduction One size doesn’t fit all
When Prime Minister Boris Johnson announced the Whilst the majority of medicines supplies from
national emergency on 23rd March 20201 instructing outpatient clinics (including virtual clinics) were either
everyone to stay at home from that evening, to reduce via FP10 prescriptions which were posted to patients
the spread of COVID-19 infection, shockwaves were felt for dispensing at their local pharmacies or via courier
at the heart of healthcare organisations. Although delivery to patients’ homes, we had to rethink a
operational planning across specialties and divisions, suitable solution for the group of patients that
for the management of COVID-19 cases was well needed to collect medicines that were only available
underway, and a letter on ‘next steps on NHS from hospital or unsuitable for courier delivery e.g.
response’ had been sent to Chief executives of all NHS medicines requiring refrigeration. These included
trusts and foundation trusts on 17th March 2020,2 the some cancer treatments.
news of a national lockdown was unprecedented.
Drive through establishments or drive through
The national lockdown meant that several service windows, are common in the fast food and restaurant
pathways had to be redesigned at an unimaginably business sectors in the United Kingdom. In other
short timescale. For example, most routine outpatient countries such as the United States, it is also common
clinics had to be converted to virtual clinics for the to find drive through banks.4 These establishments are
enablement of remote hospital consultations between designed for customers to be served whilst remaining
patients and their clinicians. This was in an effort in their cars. This model of service was not common in
to comply with the rules of the national lockdown, pharmacy, well, certainly not in hospital pharmacies
to reduce footfall in hospitals and ultimately to reduce in the United Kingdom.
transmission of COVID-19 infection.
The idea of a drive-through pharmacy medicine
For the Maidstone and Tunbridge Wells NHS Trust collection point developed very quickly, as I discussed
Pharmacy Department, a corresponding service with my Cancer and Technical Pharmacy Services Lead,
redesign of medicine supply pathways was a welcome engaged Estates and Facilities and the COVID-19
challenge, and to quote Roy T. Bennett ‘Every Operational Planning team. The rationale behind the
challenge, every adversity, contains within it the seed drive through pharmacy innovation was to limit patient
of opportunity and growth’.3 contact and help shielding of the most vulnerable
patients at high risk of contracting COVID-19. They
Pharmacy responded by creating innovative pathways could collect their vital medicines, without the need to
for timely supply of discharge medicines and supply enter the hospital building during the pandemic.
of on-going treatments for patients who were self- Cancer patients are amongst the most high risk
isolating and attending virtual clinics, to reduce the patients, due to their compromised immune system.
footfall in the Hospital.
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 5
The drive through set up
It was necessary to get the drive through medicine
collection point up and running as quickly as possible
for patients to collect their repeat medications. A fast
set up was also important to allow consultations
between patients and Pharmacists/Pharmacy
Technicians to take place within the safety zones that
this model was offering.
Our Estates and Facilities Department sourced a
simple 10ft x 8ft portable steel cabin which was
delivered on site two days after ordering. This was
quite an impressive turnaround considering that there
was a national lockdown and businesses were using
alternative ways of operating.
The cabin, named as a Medicines Pick Up Pod or
mPUP for short, was set up in a car park next to the
Figure 1: The Medicines Pick Up Pod.
Oncology Centre which caters for patients in Kent
County and beyond. The internal space was practical
with access to electricity, lighting, heating, appropriate
flooring and made hospitable with chairs and tables.
Necessary accessories to aid pharmacy activities such
as partitioned trollies to store individual patients’
medicines, space for PPE, stationery and to store cool
bags to maintain medicine cold chain, were also
available. No dispensing took place in the Pod. All
items were dispensed in the Oncology Pharmacy and
transported to the Pod for patient collection.
Prior to the dispensing of a repeat medication, the
patient undergoes a series of checks. First, a phone
consultation is carried out by either a Doctor or a
Figure 2: The partitioned trollies.
Chemotherapy Nurse to find out how the patient is
feeling and if they are experiencing any side effects
caused by the medication they are currently on. The
prescription is then sent to the oncology pharmacy
department. A pharmacist contacts the patient by
phone to find out if they have any allergies and if they
are taking any additional medications to ensure that
there are no contraindications.
Once the necessary clinical checks have been
completed satisfactorily, the patient details are passed
over to a scheduler, who arranges a suitable date and
time with the patient to pick up their medication. If the
patient is unable to get to the Pod or there is no one
to collect their medication on their behalf, Pharmacy
Figure 2: Patients pick up their medication. staff arrange for delivery via courier to their home
address.
6 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021
The whole setting up process took 7 days, from the needed per day to meet the government target of
initiation of the idea of a drive through pharmacy. mPUP 15m vaccinations by 15 February 2021.
became fully operational on the 8th day. Patients, or a
relative or carer, can drive up or arrive on foot to collect Pharmacy professionals have been pivotal in the roll
their prescribed medicines which are issued by one of out of COVID-19 vaccines and like all my colleagues,
the two members of staff from the Trust’s Oncology we are all in this together to help as many people to
Pharmacy Team who service the mPUP. receive this long awaited intervention against COVID-
19 virus, to bring us back some normality.
Ongoing patient feedback
Acknowledgements
The drive through pharmacy mPUP has been regarded
The author wishes to acknowledge the following
as a great success for patients’ safety since it went live
people and teams:
on 6th April 2020. At the time of writing this article, a
total of 2,271 patients have collected their ongoing • Conchi Blanco-Criado, Deputy Chief Pharmacist,
medications to treat cancer conditions from the Head of Pharmacy, Cancer & Technical Services,
window. We continue to see on average, 15 patients Maidstone and Tunbridge Wells Hospital NHS Trust.
per day at mPUP.
• Joanne Martin, Senior Pharmacy Technician,
We have received lots of positive feedback from those Pharmacy Oncology, Maidstone & Tunbridge Wells
patient users including the two listed below: Hospital NHS Trust.
“I am extremely grateful for the service. The staff have • Chris Sands, Pharmacy IT Lead and EPMA Technical
done a wonderful job at a very difficult time.” Manager, Maidstone & Tunbridge Wells NHS Trust.
• Doug Ward, Director of Estates and Facilities,
“I have to say that whoever thought up that idea
Maidstone and Tunbridge Wells Hospital NHS Trust
deserves to go to the top of the class! As a new user of
the service I can only say “you never have a second • Estates and Facilities Team, Maidstone and
chance to make a first impression, It’s a wow from me Tunbridge Wells Hospital NHS Trust
and I didn’t even have to get out of the car!”
• Oncology Pharmacy Team, Maidstone and
Tunbridge Wells Hospital NHS Trust
What’s next?
• Velda Nylander, Non-Technical Reviewer, London
December 2020 was a bitter sweet month for various
reasons. In this month, The Medicines and Healthcare
Declaration of interests
Products Regulatory Agency (MHRA) authorised the
The author have no declarations of interest to make.
use of the COVID-19 mRNA Vaccine BNT162 by
Pfizer/BioNtech, the first vaccine against COVID-19 in
the United Kingdom.5 In this same month, Prime
Minister Boris Johnson introduced tougher Tier 4
Stay at Home restrictions for parts of England, to
reduce the spread of the new variant coronavirus
which later progressed to a national lockdown on the
4th of January 2021.6 Currently, we may just be
starting to see some light at the end of the tunnel
albeit a faint light.
It was reported on Sky News on Thursday 21st January
2021 that almost 5 million people have been given a
first dose of a COVID vaccine.7 This is welcome news
although there is still a long way to go. As per Sky
News, an average of 401,070 first doses, are now
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 7
REFERENCES
1. Prime Minister's statement on coronavirus (COVID-19): 23 March 2020.
Available at: https://www.gov.uk/government/speeches/pm-address-to-the-nation-on-coronavirus-23-march-2020
2. NHS England and NHS Improvement. System Letter on COVID-19 on Next Steps on NHS response to COVID. 17 March 2020.
3. Roy T. Bennett’s quote ‘ Every challenge, every adversity, contains within it the seed of opportunity and growth’.
Available at: https://www.goodreads.com/quotes
4. Drive Through. Merriam-Webster.com Dictionary.
Available at: https://www.merriam-Webster.com/dictionary/drive-through
5. Medicines and Healthcare Product Regulatory Agency. Press Release: 2 December 2020.
Available at: https://www.gov.uk/government/news/uk-medicines-regulator-gives-approval-for-first-uk-covid-19-vaccine
6. Prime Minister’s address to the nation on coronavirus (COVID-19): 4 January 2021.
Available at: https://www.gov.uk/government/speeches/prime-ministers-address-to-the-nation-4-january-2021
7. Sky News COVID-19 vaccine: 21January 2021.
Available at: https://news.sky.com/story/covid-19-nearly-5-million-people-get-first-vaccine-dose-as-uk-records-another-1-290-
deaths-12194383
8 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021ADVICE TO A NEW
PHARMACIST
Things I wish I had been told...
In this new section we invite experienced pharmacists and technicians to share with us the piece of
advice that they wish someone had told them when they were starting out in their careers.
Anthony Young
Anthony is Deputy Chief Pharmacist at Cumbria, Northumberland Tyne and Wear NHS
Foundation Trust, the largest mental health trust in the UK, where he is currently responsible
for clinical pharmacy services trustwide. Anthony remains clinically active and is an
independent prescriber. With previous experience of the acute and community sector as well
as academia. Currently, Anthony is working towards an MBA in Strategic Leadership. Anthony
is a member of the editorial panel for PM and JOMO Journals.
The first thing an experienced pharmacist told me and I would encourage newly qualified pharmacists to get
something I tell everyone that I mentor is to not introduce involved in research early on in their career and to take
yourself as “Hi, I’m Tom, I’m just from Pharmacy or I’m advantage of any opportunity they get to enhance
just the pharmacist”. This immediately tells everyone their role and CV. This really makes a difference when
that what you are doing is not really that important. I going for jobs as, all pharmacists tend to have a very
encourage everyone to be confident and be proud of similar CV!
the job that you are doing. You are just as much of a
healthcare professional as the doctor or nurse. The real learning starts on day 1 of your job and not at
Uni. Learn from every team member including non-
Times have changed since I qualified. We used to wear professional staff. The longer that you are qualified,
white lab coats in the ward and I had pockets filled the more you realise that you don’t know!
with a BNF, blood result tables, lots of ‘green pens’ and
notes! Now, all you need is a couple of apps and you're
good to go!
Minesh Parbat
Minesh Parbat, MPharm(Hons), ClinDip, IPresc has worked in senior leadership positions
within the NHS and has led on medicines optimisation projects both strategically and
operationally. He continues to practice as an independent prescribing pharmacist and runs
long term conditions clinics in asthma and structured medication reviews in a GP Practice,
and has done for over 10 years.
A thing I wish someone had told me at the start of bounce ideas off, ask questions and for when you need
my career is that the pharmacy profession is dynamic, to seek support and advice. Start early with seeking a
innovative and is in a complex and forever evolving mentor or a coach with a focus on foundation skills
NHS. What you wish to do with your career is very development and your leadership skills.
much in your hands. I would encourage you to embrace
technology, opportunities to explore other sectors Write a 5 year plan, with an overall goal of where you
and focus on clinical practice, which remains at the wish to be in 10 years. Review these goals and ensure
core of what you do. they are objectives that are measurable, this will
enable you to review and reflect on your achievement
You should consider having a network of colleagues to and goals overtime.
10 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021Focus on making a change to someone or something I would also suggest that you consider a 360 feedback
for the better and take on challenges at work to learn exercise from your fellow colleagues and patients to
and development your skills. Use these ‘real life’ review your performance and how they perceive you
opportunities to reflect on and discuss them as part of at work. Be the change that you want to see!
your annual review.
Finlay Royle
Finlay Royle MPharm, MSc, Senior Clinical Commissioning Pharmacist, NHS South East London
CCG. Responsible for mental health, paediatric and respiratory prescribing in primary care, and
respiratory pathway commissioning, digital solutions and pharmacy workforce development.
As I've progressed through my career, I've always important!), think about what they are offering you,
tried to explore different experiences in all of my aside from a salary and a job. Finding a good employer
different jobs. Whether it is shadowing district or team to work in, is as important as the job itself. Do
nurses, participating in research projects, undertaking your research (phone them up or take a visit to the
post-graduate studies or teaching. Yes, this requires workplace) and ask relevant questions at interview.
you to put in more effort and time but you and others
get so much more out of it long term. Professionally, I However, one of the most important lessons for me
got involved in my 'RPS local' for example. You will has been nothing to do with pharmacy. A retiring LPC
meet people from across different sectors of the chief executive once advised me about the importance
profession and varying professional backgrounds. It of making time to explore interests and activities
can really open doors, help you find a mentor and help outside of the pharmacy world. It had helped him cope
you work out what you want to do in your career once with everything he had to deal with and made me
you've got through those Foundation years. Other really think. I've found getting involved in a grassroots
pharmacists can also share their experiences and help organisation has helped me get to know people from
you resolve any problems in your professional life. different walks of life. As well as being fun, it can
also be humbling. It also brings with it a different
Remember, when you apply for jobs, interviews are a perspective on how you practice as a healthcare
two-way street. You are interviewing the employer as professional and how you engage with patients and
much as they are interviewing you. As well as thinking colleagues.
about what you can offer the employer (this is
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 11Sue Wen Leo
Sue is a senior pharmacist specialising in antimicrobial and high cost drugs management.
She has a special interest in health economics. She found great satisfaction in optimising
medicines use and care through clinical knowledge and management skills.
“Things I wish someone had told me…” New pharmacists often limit their career options to
hospital, community, pharmaceutical industry and
Wearing a comfortable pair of shoes is a good start to academia. Whilst these are considered the common
your pharmacy career as you will be on your feet for career pathways and a good starting point, the
long hours. Keeping a secret stash of biscuits in your pharmacy industry is changing quickly over the years
locker will keep you going through the dispensing and and the skills you acquire in any of these settings are
accuracy checking assessments. transferable in many ways. If you are exploring your
career opportunities, seek to add value in your chosen
The early stage of your career is a good time to build
work settings and align your goal with a purpose.
a concrete foundation on your pharmaceutical and
In contrary to the common beliefs that a pharmacy
clinical knowledge. You may be overwhelmed by the
career is linear and vertical, you will discover new
complexity and the vast amount of information
perspectives and opportunities to add value in a
associated with a medication. Familiarising yourself
horizontal career growth.
with different sections on the summary of product
characteristics and getting to know your local Lastly, asking for help and seeking support are
medicines information department are good starting essential skills not only at the early stage but also at
points to learn where to seek information. More the advanced stages of your pharmacy career. These
importantly, learning how to dissect a problem and qualities are complementary to your experience and
formulate a solution using your knowledge in you will foster a learning environment anywhere
medications will position you as a problem solver, an you go.
essential life skill every pharmacist should learn.
12 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021PM CONFERENCES IN 2021 Celtic Conference Date: Thursday 11 March 2021 National Integrated Care Conference for Respiratory Medicines Optimisation Date: Tuesday 23 March 2021 Contracting and Procurement in the New NHS - What does the future hold for Secondary and Primary Care? Date: Thursday 29 April 2021 The Contribution of Women to Pharmacy Development and Success Date: Thursday 27 May 2021 National Integrated Care Conference for Diabetes Medicines Optimisation Date: Thursday 17 June 2021 PM National Forum for Scotland Date: Wednesday 25 August 2021 National Integrated Care Conference for Cardiovascular Medicines Optimisation Date: Wednesday 22 September 2021 PM National Forum for Wales Date: Wednesday 20 October 2021 PM National Forum for Northern Ireland Date: Wednesday 24 November 2021 Conferences in 2021 will be going ahead in either digital or face to face format subject to National Guidance at the time.
FACE2FACE
Advanced Pharmacist Practitioner
Martina Khundakar is an advanced pharmacist practitioner in education and training at
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW).
Martina has recently developed a comprehensive departmental induction programme and
widened participation of pre-registration pharmacist placements in mental health in the
north east and north Cumbria. She has also assisted in the pharmacist integration into the
trust medical education team. She is an associate lecturer at Newcastle University and coordinates pharmacy
student placements for local universities.
Martina graduated from the University of Manchester in 2001, before working at the University Hospital of South
Manchester NHS Foundation Trust, first as a pre-registration student, then as a clinical pharmacist, going on to
specialise in mental health. She then worked as a principal pharmacist in mental health for North Staffordshire
Combined Healthcare NHS Trust before starting at CNTW in 2007. She holds a Diploma in Clinical & Health Services
Pharmacy, a Practice Certificate in Independent Prescribing for Pharmacists and a Postgraduate Certificate in
Medical Education.
Correspondence to: Martina.Khundakar@cntw.nhs.uk
What is your job title? To whom do you report and where does the
Advanced Pharmacist Practitioner, including a role in post fit in the management structure?
medical education. I am still part of the pharmacy departmental structure
as I lead on education and training and my clinical role
What are your main responsibilities/duties? involves input into one of our trust’s psychiatric liaison
This is a new role established between the pharmacy teams in addition to a rehabilitation ward. I am
department and the medical education team, which directly managed by the deputy chief pharmacist for
ranges from teaching medical students to postgraduate clinical services. However, in my role in medical
training. I deliver “safe prescribing” sessions for all education, I have regular meetings with the director of
new medical staff at induction and facilitate medical education for on-going evaluation of my role.
postgraduate teaching sessions across the trust to
core, higher and GP trainees on identified themes How was/is the post funded?
after discussions with the relevant medical leads for Is the post funded on a non-recurring or
each area. I have developed and delivered practical
recurring basis?
prescribing training in mental health, along with a
psychopharmacology session to third and fifth-year Prior to the establishment of the post I had just
medical students. The third-year session in Integrated completed a Postgraduate Certificate in Medical
Clinical Placements in Mental Health was part of a Education at Newcastle University, which my
new curriculum, so I helped develop and design the department kindly funded and supported. I was an
learning materials for the mental health prescribing associate lecturer for a local school of pharmacy and
component. I respond to any on-going medical education always had interest in education, which prompted me
requests, sometimes supporting junior medical staff to have a discussion with my manager, who along with
and teaching fellows within the trust. I have also the pharmacy management team helped in the
produced a training session on the medicines establishment of this role.
optimisation policy to upskill prescribers at a new site
I successfully completed a business case for funding
within the trust.
for my time, equivalent to 0.2 WTE, to the trust medical
14 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021education teams for the delivery of undergraduate and Pharmacists provide a different perspective to medical
postgraduate training and continuing medical staff and offer expertise on safe prescribing and
education for staff. This is funded on a permanent medicines optimisation. The creation of my role has
recurring basis. improved the links between medical education and
pharmacy. This has greatly enhanced the profile of the
When was the post first established? pharmacy team, offering an insight into our unique
skills and knowledge by promoting safe and effective
The post was established in January 2019. prescribing.
Are you the first post holder? If not, how What have been the main difficulties in
long have you been in post? establishing/ developing the post to its
Yes, the formal integration of a pharmacist within current level?
medical education at Cumbria, Northumberland Tyne
As this post was new, I did experience some lack of
and Wear NHS Foundation Trust (CNTW) was a novel
understanding and reluctance from the medical
approach and I’m delighted to be the first post holder
education team on the scope and content of what I
within our department.
could teach. Unlike teaching fellow positions, which
are more formally integrated into the team when
What were the main drivers for the taking up the position, there was little communication
establishment of the post and how did it on the nature of my role. Medical education is far
come about? reaching and demands knowledge in many disciplines.
Effective communication with numerous members of
Pharmacists had traditionally supported the medical
the team from the different strands of medical
education department at CNTW through various ad-
education is an essential part of the role.
hoc commitments. However, this was a reactive
arrangement, meaning requests for pharmacy time Prior to the current COVID-19 restrictions, lack of
from the medical education team was dependent on visibility and communication was an issue, given I did
the capacity of the department. As I said, prior to the not work in proximity to the teaching fellows.
business case for this role, I had just completed a However, as the recent delivery of teaching has all
postgraduate certificate in medical education from been done remotely this has not been an issue.
Newcastle University, alongside some of the teaching
fellows currently employed across CNTW. From
discussions with my colleagues in the region, I was
What have been the main
aware of pharmacists in a local trust who worked achievements/successes of the post?
within their respective medical education team as Well, for a start I’ve freed up some time for the medical
teaching fellows to deliver practical prescribing staff so I’m sure that’s a bonus for them! I’d like to
teaching to medical undergraduates. think I’ve enriched the teaching within the team by
providing a different perspective, a “fresh pair of eyes”
The EQUIP 2 study found that the total mean error rate so to speak. The students/trainees now have different
for all medication orders written by doctors was learning opportunities with me in post; I hope this has
8.9%. Pharmacists were described as a “safety net” in improved their learning journey.
the study, as they were commonly approached for
advice about prescribing. Having a pharmacist on the At a personal level, I’ve fitted into the role and very
medical education team enhances the experience for much enjoy its wide-ranging nature. It’s a greatly
undergraduates and trainee doctors in promoting fulfilling experience knowing I potentially play a role in
interprofessional education. Pharmacists improve reducing medicine-related incidents and encouraging
prescribing practice by providing the necessary safer prescribing practice amongst junior medical staff
support through teaching, interactive case studies and within the trust.
workplace clinical scenarios. They also ensure training
provided is relevant and clinically-focused. A few months into the post I sent an electronic survey
to medical staff and trainees to gauge their views on
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 15the integration of a pharmacist into the team; these How do you think the post might be
were overwhelmingly positive: developed in the future?
“I cannot imagine the med team without a pharmacist. With the recent COVID-19 restrictions I’ve had to
Their input is highly needed and appreciated” rapidly change my usual pattern of delivery of
teaching sessions. An unexpected positive outcome
“Great idea! The more contact between junior doctors has been reaching a wider audience through remote
and pharmacists the better!” teaching, encouraging more innovative methods of
delivery.
What are the main challenges/ priorities for
Employing a pharmacist teaching fellow similar to the
future development within the post which psychiatric teaching fellows could potentially
you currently face? futureproof the role. There’s also the potential to
The main challenges are that certain aspects of the develop synergistic learning between medical and
role can feel all-consuming so being flexible and pharmacy students.
having good time management helps. In terms of
future developments, I have been approached by What messages would you give to others
regional medical education leads to develop a CPD who might be establishing/developing a
day for psychiatry trainees, in collaboration with
similar post?
Health Education England North East (HEENE).
If you have an interest in education or are already
involved in education and training, meet with your
What are the key competencies required to
medical education leads in your organisation and see
do the post and what options are available what’s out there! Many teams will be willing to
for training? embrace such a role when they realise the unique skills
Being motivated to promote a high-quality learning a pharmacist can bring to a team and how they can
environment is key to the role, as well as having good broaden and enrich their community of educators.
communication and presentation skills. You also need
to be adaptable to change and be innovative in terms Do you have any Declarations of Interest to
of teaching methods. Anyone who knows me is acutely make and, if so, what are they?
aware that I can’t sit still so that helps me bring energy
Personal fee offered by Pharmacy Management as a
and enthusiasm to the role. Although not essential to
contribution for writing the Face2Face.
the role, I completed a postgraduate certificate in
medical education; this provided me with tremendous
insight into education and delivering sessions in the
workplace.
How does the post fit with general
career development opportunities within
the profession?
It certainly embodies an excellent development
opportunity and serves to raise the profile of the
pharmacy profession. It promotes interpersonal,
interprofessional and highly-specialised communication
skills, along with an element of curriculum delivery.
REFERENCES
1. Dornan T, Ashcroft D, Heathfield H Lewis P, Miles J, et al. An in-depth investigation into causes of prescribing errors by foundation trainees
in relation to their medical education: EQUIP study. Final report to the General Medical Council. University of Manchester: School of
Pharmacy and Pharmaceutical Sciences and School of Medicine. 2009.
16 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021Public Health England Pharmacist
Jackie Lamberty is the Lead Pharmacist for Medicines Management at Public Health
England. She has worked in this role since 2007. She is responsible for medicines governance,
promoting best medicines practice within PHE and ensuring mechanisms are in place for
effective risk management, clinical governance and adherence to policies and guidelines
concerning medicines use.
She was previously Head of Medicines Management for Eastbourne Downs Primary Care Trust. Training roles have
included being a tutor for the Centre for Pharmacy Postgraduate Education and a Medicines Management Trainer
for the National Prescribing Centre.
Correspondence to: Jackie.Lamberty@phe.gov.uk
I have been asked to write about my role as Lead and provide health and social care services such as
Pharmacist for Medicines Management Services at immunisation and screening programmes, and to
Public Health England (PHE) and why public health develop the public health system and its specialist
needs pharmacists. workforce
Perhaps, I should start by explaining who PHE is and • improving the health of the whole population by
what we do. We are an executive agency of the sharing our information and expertise, and
Department of Health and Social Care (DHSC) but we’re identifying and preparing for future public health
a distinct organisation with operational autonomy. We challenges
formed in 2013 to unite over 70 separate organisations • helping to embed health improvement practice in
into a single public health service and we work closely the daily practice of pharmacy teams, working in the
with public health professionals in Wales, Scotland, different sectors
Northern Ireland and across the world.
• ensuring pharmacy teams located in the heart of
Our role is to protect and improve the nation’s health the communities they serve, with staff that reflect
and wellbeing and reduce health inequalities. We work the ethnic and social backgrounds of the
with the NHS, local government, other key partners in communities they serve, pro-actively reach out to
England, with the Devolved Administrations, Crown these communities to improve health and reduce
Dependencies and globally. We employ more than health inequalities
5,500 people working across 12 different directorates
• researching, collecting and analysing data to
and 20 regional offices, who are mostly scientists,
improve our understanding of public health
researchers and public health professionals.
challenges and coming up with answers to public
We are responsible for: health problems
• protecting the nation from public health hazards • providing evidence-based scientific expertise to the
government, NHS and the public
• preparing for and responding to public health
emergencies measuring and reducing health
inequalities My role
• improving people’s health and reducing differences In a nutshell, I am responsible for medicines
between the health of different groups by promoting governance throughout PHE, from a both a legal and
healthier lifestyles, advising government and quality perspective. In fact, quality and achieving high
supporting action by local government, the NHS and standards is what ‘gets me out of bed’.
the public, e.g. smoking, obesity, alcohol, sexual
We have a Medicines Governance Group (MGG), with
health and reproductive health
representation from all those areas within PHE where
• supporting local authorities and the NHS to plan medicines have a role. For example, the National
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 17Infection Service (NIS), Health Protection Teams, PHE develops and reviews national PGD templates for
Screening and Immunisation, the Centre for Radiation, immunisation and emergency planning. We have a
Chemical and Environmental Hazards (CRCE), the UK PGD policy and procedure to support this work. I am
Stockpile, the Nursing Directorate and Occupational the Lead Author for some of these PGDs, such as
Health. The MGG reports to the Quality and Clinical ciprofloxacin for meningitis, antivirals for seasonal and
Governance Delivery Board and I sit in the Medical avian influenza. For the other PGDs I sit on the Expert
Director Directorate. Panel to provide both clinical and governance input.
I am responsible for all medicines policies including Of course, there is no point having policies and
the Medicines Governance Policy and the Patient procedures if staff are unaware of them or do not
Group Direction (PGD) policy. The Medicines follow them. To ensure these are being followed, we
Governance Policy covers procurement, storage, have a programme of medicines audits, to identify if
distribution and disposal of medicines, prescribing, standards are not being met and to implement any
medicines protocols, medicines advice and record identified actions.
keeping. It is backed up with guidelines on improving
medicines safety, unlicensed and off-label medicines Risk management is a significant part of the role, both
and standard operating procedures. proactive and reactive. Any risks identified are entered
on the relevant risk register and monitored to ensure
mitigating actions are in place. CAS alerts are
monitored daily and, where relevant, are cascaded
to the appropriate Directorates. Any adverse events
or near misses are entered on our reporting
system, TrackWise®. I routinely monitor
any related to medicines governance,
follow up the actions and report
back to the MGG.I provide a pharmacy service to our Occupational Judith Field, as part of PHE’s role ensuring
Health service, which covers all of PHE including the effective response to major incidents, manages all
Centre for Infections at Colindale in North London and pharmaceutical aspects of the UK National Stockpile
PHE Porton. Colindale undertakes infectious disease for use in chemical, biological, radiological and
surveillance and control, reference microbiology, nuclear (CBRN) incidents. Judith also sits on the MGG
other specialist services such as sequencing and high and is responsible for emergency planning PGDs,
containment microbiology. PHE Porton leads on rare such as, antibiotics for use if there was a known or
and imported pathogens, research, culture collections suspected release of biological agents and protocols
and emergency response. The UK’s anthrax vaccine for stable iodine in case of a radiological incident.
manufacturing facility is located there.
Beth Graham supports the Immunisation and
Many of the scientists need immunisations to cover Countermeasures team within NIS, providing pharmacist
them for their research and other activities undertaken. expertise to support immunisations. Beth leads the
In addition, we have teams providing public health development and review of the national immunisation
advice and operations to many countries around the PGDs and recently provided sterling service in
world. These teams require vaccinations. The majority developing the PGDs and National Protocols, allowing
of my time with Occupational Health is spent the roll-out of the mass COVID-19 vaccination service.
developing and reviewing our Written Instructions (32
to date). This is varied and has certainly added to my Aoife Hendrick is one of the national Chief
clinical development as many cover unusual vaccines Pharmaceutical Officer’s Clinical Fellows, working
such as tick-borne encephalitis, Japanese encephalitis with Diane in the HCAI & AMR division to develop her
and anthrax, to name a few. In addition, I answer leadership skills and to contribute to development and
medicines-related queries and do annual clinic visits. implementation of interventions nationally.
Not all my work is directly medicines-related. In the Maria Pradilla is part of the Vaccines and
past 6 months, I have been working with the Deputy Countermeasures Response Department. She provides
Director for Quality & Excellence, preparing for the specialist pharmaceutical advice and guidance for the
credentialing process to enable PHE to issue National supply and management of vaccines, immunoglobulins,
Patient Safety Alerts. antitoxins, antidotes and antivenoms as well as
supporting both the routine immunisation programme
and countermeasures. She too has been somewhat well
Pharmacists at PHE
occupied with the COVID-19 vaccines.
This article would not be complete if I did not mention
my other pharmacist colleagues at PHE, which will Gul Root has a dual role in both PHE and with DHSC.
help to explain why public health needs pharmacists. She is the PHE National Lead Pharmacy Public Health
We each sit within different Directorates, depending in the Health and Wellbeing Directorate. She provides
on our roles, but are in contact with each other. In professional, system and strategic leadership to
alphabetical order, my colleagues are: ensure pharmacy teams play a pivotal role in
improving people’s health, for example the Healthy
Diane Ashiru-Oredope in the Healthcare Acquired Living Pharmacy work programme. In her DHSC role
Infections & Antimicrobial Resistance (HCAI & AMR) she provides professional and clinical advice to a
division within NIS. Diane leads on the development, range of work programmes including controlled drugs,
testing and implementation of antimicrobial stewardship including cannabis, seasonal flu, emergency
interventions to tackle antimicrobial resistance e.g. preparedness, working alongside DHSC policy leads,
the International Antibiotic Guardian Campaign and other government departments and external
World Antibiotic Awareness Week. She sits on our stakeholders. Gul supported Beth in the COVID-19
MGG and is Deputy Chair of the English Surveillance work programme on national protocols and PGDs.
Programme for Antimicrobial Utilisation and
Resistance (ESPAUR). Diane is also currently seconded Pharmacy is embedded in leading PHE health
part time working on an evidence review of improvement work programmes, working with
Pharmaceutical Public Health. internal PHE programme leads and external
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 19stakeholders such as sexual and reproductive health • advice on and supporting changes to the Human
and HIV, cardiovascular disease, drugs and alcohol. Medicines Regulations to allow a wider workforce to
administer influenza or COVID-19 vaccines
Why do we need pharmacists in public • working jointly with the DHSC and NHSE/I on a
health? number of workstreams such as the COVID-19
vaccine supplies, PGDs and National Protocols
This is possibly best illustrated with our joint activities
during the coronavirus pandemic. We have been using • dealing with pharmacy professional issues for
our skills developed as pharmacists to support the the Seasonal flu and COVID-19 Immunisation
COVID-19 response in a variety of ways both directly Programme Boards
and indirectly. To summarise our activities: • supporting work on mass distribution of medicines
• working directly with the PHE COVID-19 cells, in primary care should that become necessary and
supporting the Modelling Cell, Hospitalisations should treatments become available for COVID-19
Enhanced Surveillance System and Incident • working to improve antimicrobial stewardship and
Management Team reducing antibiotic resistance and healthcare
• working on surveillance of antimicrobial use, associated infections which is important for other
developing and implementing interventions to pathogens that can present as respiratory infection
tackle antimicrobial resistance in the context of or be co-infections with COVID-19.
COVID-19 pandemic
Pharmacists across PHE also continued to support
• practice guidance on use of medicines in hospitals the range of essential services provided by PHE, both
and the infection prevention and control measures their own work and new work which they would not
that need to be considered routinely have been involved in, allowing other
• supporting changes of legislation during the colleagues to contribute to COVID-19 cells. This and
pandemic to ensure access to medication for all their COVID-19 work have broadened the skills of
patients, including changes to the Misuse of Drugs pharmacists in PHE and allowed them to continue
Regulations to make it easier to access controlled their important contribution to pharmaceutical
drugs during the pandemic for example, access to public health.
opioids for the management of addiction.
• working to improve access to medicines during the
pandemic for care homes and hospices
20 Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021A regular webinar programme from PM to share skills
and learnings to enhance the future for pharmacy.
Date and Time Topics
10 March 2021 Effective communication and the balance of assertiveness.
10.00am – 11.45am – PM Consultancy Trainer
Creating good communication between the CCG and the PCNs.
Ben Garner, Deputy Head of Clinical Pharmacy, Leeds GP Confederation and
Heather Smith, Consultant Pharmacist – Older People, Leeds GP Confederation
24 March 2021 Using time effectively and the art of prioritisation – PM Consultancy Trainer
2.00pm – 3.45pm Getting inhaler technique correct. John Hamill, Belfast
21 April 2021 Dealing with personal change at work and leading others through the
10.00am –11.45am change process – PM Consultancy Trainer
PCNs today – what are the prescribing priorities? Minesh Parbat, Chief
Pharmacist, NHS North Solihull Collaborative Primary Care Networks
5 May 2021 The importance of coaching and the impact on collaborative working
2.00pm – 3.45pm – PM Consultancy Trainer
Deprescribing – how to do it with minimum stress. Emma McClay, Pharmacy
Integration Project Lead, Specialist Pharmacy Service/Sunderland CCG
19 May 2021 Managing time effectively in the NHS – PM Consultancy Trainer
10.00am – 11.45am DOACs and safety. Lynne Garforth, Advanced Practice Pharmacist and Director,
Ashburton Prescribing Consultants Ltd
26 May 2021 Leadership and Management – PM Consultancy Trainer
10.00am – 11.45am Developing and delivering advanced case clinics in primary care.
Surinder Kumar, Senior Clinical Pharmacist, Dawley Medical Practice
9 June 2021 Communicating messages effectively – PM Consultancy Trainer
2.00pm – 3.45pm Is Diabetes under control – how can we improve patient care and outcomes?
Melody Kan, PCN Pharmacist, Bristol Inner City
Journal of Pharmacy Management • Volume 37 • Issue 1 • January 2021 21You can also read
