A 2 week cross sector placement at Guys and St Thomas’ Hospital
A community Pre-Registration Pharmacist’s experience in hospital
Sunday night, eleven O’four. Bag check, shirt check, Bible (BNF) check, shoes check. I was ready.
Monday morning had arrived and I felt excited. What will this 2 week cross sector placement be like, what will I learn? Fast forward 2 weeks the experience was fantastic! The learning has been steep but so much fun. There were 10 of us, and we were split into 5 pairs, and were given a timetable of rotations and study sessions.
During our rotations we were assigned to current hospital Pre-Registration Pharmacists as well as current Pharmacists. We rotated between cardiology, dispensary, Evelina London Children’s Hospital, surgery and general medicine. In all rotations except dispensary, we went to the wards and actively worked with the Pharmacist or the Pre-Reg in their cases, which allowed for a more practical learning experience (which I prefer). We undertook patient medicine histories, clinically screened prescriptions and helped in a discharge. It was interesting to see the difference between community pharmacy and hospital pharmacy. In community, we have a greater focus on medical law whereas in hospital there is a focus on a different aspects of clinical.
There seemed to be a bit of an attitude that community pharmacists are either too interested in money, or are simply shop keepers (the attitude from a few interactions during the placement) or both. Having now gained some experience in both hospital and community, it was interesting to compare both. In community there is a greater decision making ability and the aspect of clinical is different. Furthermore, Pharmacists in community work in greater isolation from other qualified healthcare professionals. The differing aspect of clinical in community is in regards to OTC sales. When a patient comes in with a problem, the Pharmacist must be able to extract all the necessary information, then decide: 1) Should I supply a product? 2)What should I supply? This can be a difficult decision — for example, the evidence regarding chloramphenicol eye drops for bacterial conjunctivitis, a usually self-limiting condition, is only slightly better. However patients demand it on the spot. On the other hand, in hospital the clinical cases are more complex and hence they are seen as “more clinical”, but the independent decison making is lost as all decisions are based directly from the trust guideline/formulary. How about we just get rid of the title ‘Clinical Pharmacist’ and just use ‘Hospital Pharmacist’?
During the placement, we also got an insight into Pharmacist’s Support by our tutor, Aamer Safdar who is an ambassador and 175 hero for the charity. Pharmacist Support is the official charity of the Royal Pharmaceutical Society and provides support to members of our profession ranging from our students through to our retired members. Aamer is raising money to support them by running the London Marathon!
Another fantastic learning point was being able to speak to the technicians, as their role in hospital is far greater than in community. Being in dispensary, my partner and I initially thought this may be a boring rotation, however after being given a full tour by our dispensary lead, we were handed a free reign to speak and do as we please (within reason). So we spoke to anyone who wanted to talk! I spoke to the technicians who work with private sector firms to organise social care for out-patients who need the care. Being interested in the digital health tech scene, this was amazing to see, learning first hand from those who work with the companies to provide social care, an area very lacking in the current NHS structure.
All in all, the experience was fantastic, but this raises a question, why aren’t the majority of Pre-Registration programmes mixed with 6 months in community and 6 months in hospital? The funding comes from the Department of Health so the issue of pay becomes negligible. The experience makes you truly appreciate how different aspects of care come together to help the patient. You also learn the different roles of healthcare professionals and how they all interlink as part of an ecosystem with the end aim of improving care for the patient and an understanding of the NHS. To conclude you learn to become a true all-rounder Pharmacist.
From myself and my fellow cross sector Pre-Reg’s, we want to say a thank you to Aamer for setting us up and supporting us throughout the placement!
Thank you for reading. Please consider supporting Aamer Safdar in his London Marathon, in 1 of 2 ways, tweet him and use the hashtag #runaamer and/or consider a donation to Pharmacist’s Support.
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