I’ve been a pharmacist for almost 17 years now, most of that time spent as a patient-facing community pharmacist working in the small pharmacy here on campus at the University of Stirling. Pharmacy is, in some ways, a peculiar profession. Pharmacists receive very thorough training (a four year, science based Masters degree, the MPharm, followed by one year’s practical training and further examination) and work everywhere where there are medicines, from the pharmaceutical industry to hospitals. But it’s in the community (or ‘retail’) setting that we are at our most visible but, arguably, most misunderstood. Where retail space meets the NHS it’s no wonder really that the public often have mixed views regarding what we actually do!
In the last 10 years in particular the role of the community pharmacist has evolved across the UK, with Scotland arguably seeing some of the biggest changes. Our core role remains the same, to effectively & safely check, dispense and advise patients on medicines supplied on prescriptions written by doctors (mainly GPs), dentists and increasingly by nurse colleagues with prescribing qualifications. Interestingly a number of pharmacists also have additional prescribing qualifications, as do some Optometrists, Podiatrists and Physiotherapists.
Increasing pressures within the NHS and a desire for all health professionals to use their knowledge & skills to maximum effect has led to community pharmacists gradually taking on additional ‘walk-in’ clinic roles. For many years now we have offered a range of NHS public health services including:
- A national smoking cessation programme, community pharmacists manage70% of all quit attempts in NHS Scotland
- A national emergency hormonal contraception service
- A range of locally funded services including substance misuse/ opiate replacement therapy, needle exchange, Hepatitis C patient support and alcohol brief interventions
- Some private services have also become popular, especially influenza and travel vaccination
The traditional ‘over the counter’ sale of non-prescription medicines has also evolved into something more akin to a walk-in clinic service, with community pharmacists also able to assess and treat minor medical conditions as a free NHS service for certain patient groups e.g. children, over 60s, students under 19 and those receiving certain government benefits. All pharmacies in Scotland have private consulting facilities and in some areas, including Forth Valley, community pharmacists are starting to manage a slightly expanded range of common clinical conditions, for example UTIs (urine infections) and minor skin infections through locally funded NHS ‘Pharmacy First’ services.
We are being encouraged to work ever more closely with GP and nurse colleagues and pilots have finally begun to assess the impact of giving pharmacists in the community setting access, with consent, to patient medical records (electronic summaries). I am very supportive of this as, like all health professionals, we just want to be able to do our jobs as safely and effectively as possible. I’ve always loved the fact that I’m perhaps the most easily accessible health professional in my community, you literally never know who will walk through the door next & what you’ll be helping them with. But, despite this, our role isn’t perhaps as clear as that of the doctor or nurse for example, too many years spent hiding in dispensaries perhaps! We need to work on that.
There are many challenges facing community pharmacists as the NHS, our profession and healthcare in general evolves, but I do believe we have an important part to play alongside the other health professions, maximizing the impact of our in-depth knowledge of medicines and our unique accessibility. So, next time you’re feeling poorly or have a question about your medicines don’t forget that one of your options is to ‘ask your pharmacist’!
Jonathan Burton, Community Pharmacist, University of Stirling and
Vice-Chair, Royal Pharmaceutical Society in Scotland