Rena Amin, member of the Royal Pharmaceutical Society, explains how recent legislation has fundamentally changed the nature of her role.
‘As a pharmacist with independent prescribing rights, I can diagnose a patient with hypertension or asthma. I can start a treatment, do some diagnostic tests, order blood tests, and manage them before and after the diagnosis and then follow up – all independently and autonomously. I take full accountability for all decisions I make.’
Rena Amin is a qualified pharmacist and member of the Royal Pharmaceutical Society. She represents the newly expanded role of pharmacists in the UK. Since 2003 pharmacists could become supplementary prescribers; that is, as a non-medical prescriber they could continue the management and care of the patient once the diagnosis was made by a medical professional. Since 2006 the law has changed to allow pharmacists to become fully independent prescribers.
Setting boundaries for pharmacists
‘One thing that really gets honed into you is that you work within your competency. Any time I feel there is something outside my competency, I seek help from my medical colleagues. Likewise, if they found something challenging in terms of medicine optimisation or a patient with complex needs, they will hand that patient back to me. That is the advantage of working within a general practice.’
Dedicating more time to patients
‘In my practice we’ve made a conscious decision that my consultations are longer than my GP colleagues’: 20 minutes instead of 10. If you have a very limited time, it can be a waste of time for me and for the patient.
‘Here we run a one-stop clinic. In other practices at a designated diabetic clinic they just look at your diabetes medicine. In my clinic I look at everything: is their medical condition(s) under control, have they had their blood tests, is everything safe, are there any side effects, do they take any medication over the counter, do they have any concerns about their medicines, do they feel that the treatment is not working? Sometimes their condition could be very well-controlled, but they might be having side effects, or they might be going through a period of stress. All these things are talked through.’
Thinking like a GP
‘I had to start thinking like my GP colleagues, not as a pharmacist. A patient walks into my consulting room and often I don’t know why they have come, just like when the patient sees a GP. I’ve never experienced resistance from patients who get me instead of a doctor. There’s some confusion because the role is not yet well established. Many think I’m a nurse or the doctor, and many think I’m the lady you go to talk to about your medicines.’
In future more pharmacists with whom the general public deal, will be independent prescribers, not only in an integrated role within the GP practices but also in community pharmacies on the high street. In fact 21st century pharmacists are returning to their ancient sphere of expertise when they were called apothecaries.
Edited by Professor Andy Friedman, CEO of PARN
First appeared in Newsweek, edn. 22 May 2015