The eager entrepreneur

Being a community pharmacy owner and an independent prescriber enables professional autonomy for pharmacists, writes Bernadette Brown.

Bernadette Brown, independent prescriber and pharmacy owner, with her daughters at the 2016 Scottish Pharmacist Awards

Source: Scottish Pharmacist

Bernadette Brown (right) with her daughters at the 2016 Scottish Pharmacist Awards

Independent prescriber and pharmacy owner Bernadette Brown recently won awards for ‘Pharmacist of the year’ and ‘Community pharmacy team of the year’ for Cadham Pharmacy at the 2016 Scottish Pharmacist Awards. She explains what sets her pharmacy apart from the rest.

Why did you decide to become a community pharmacist?

At the age of 16, the artistic side of me wanted to go to a music school in Glasgow because I already played double bass in the Scottish Youth Orchestra. I also played cello and piano, but I chose to leave music behind and be pragmatic about my options. Pharmacy appealed to me as a career where I could have face-to-face with people and make a difference in their lives.

What services do you currently offer in your own pharmacy?

My community pharmacy, Cadham Pharmacy, in Glenrothes, Scotland, offers all the core NHS services, such as minor ailments, chronic medicines service and emergency contraception. I am especially proud to be involved in palliative care. As part of the service we provide ‘just in case’ boxes, which contain medicines in case patients require injections to alleviate pain or nausea out of hours, and additional support for carers and families at such a difficult time.

Other services include our nurse and pharmacist travel clinic and yellow fever centre. This has helped transform how the public perceives our skills. We also offer a gluten-free service, which involves an initial assessment to discuss a patient’s diagnosis and subsequent advice on the number of units of gluten-free food patients are permitted on the NHS. The patient does not then need to order the products from the GP — we can write prescriptions for the food order. 

Our spirometry clinic is proving popular and our nurse hopes to expand her role over the next year as we develop into more advanced minor ailments to relieve the strain on our GP and nurse colleagues further.

How do you use your independent prescribing qualification?

Being an independent prescriber allows pharmacists to prescribe medicines within their areas of competence. Its the best thing I have done since becoming a pharmacist and it transforms the way in which I practise and help people in my community. When I decided to go back to university in 2005 for a supplementary prescribing course, and 2009 to convert to an independent prescribing qualification, I thought that being an independent prescriber would only ever be useful for a role in a practice setting. Indeed, my first experience of using my qualification was as a practice pharmacist.

However, years later as a community pharmacy owner, I can see many ways in which having a prescribing qualification can support pharmacists in helping people stay healthy and lead longer, more active lives. For example, I am involved in prescribing for respiratory conditions, pain management and more advanced triage for minor ailments.

Another advantage of my independent prescribing is the ability to make professionally autonomous decisions while working in collaboration with nurses and GPs, which helps build trust between the professions.

I would encourage more community pharmacies to consider this qualification to enhance the offering of care they can provide. By the end of next year, we will have three pharmacist independent prescribers at my practice, including myself and my daughter, who is currently completing her training.

What would you consider your professional highlight to date?

The highlight was buying my own community pharmacy. It has transformed my world and given me the opportunity to change the way in which I practise and bring my experience from the GP practice role to a community pharmacy.

In response to public demand, I am building another treatment room this year to provide members of the public with another way of getting their health checked in a confidential, soundproofed professional environment. We are excited about the possibilities this can offer — in particular, it will allow us to take on more minor triage consultations to enhance the minor ailments service in Scotland.

Additionally, I already own a dispensing robot and intend to invest in another in the coming two years to allow myself and my staff more time speaking with patients face to face.

What advice would you give to another pharmacist looking to open their own pharmacy?

I would like to see a tiered system of care depending on the skill mix of the pharmacy staff. Ideally, pharmacies will be seen as health centres offering clinics for chronic conditions, such as chronic obstructive pulmonary disease, so pharmacists can help reduce the number of readmissions to hospital by prescribing for acute exacerbations in the community. Additionally, pharmacies will be able to provide an enhanced minor ailments services by prescribing for urinary tract infections, for example, and following up with patients appropriately.

Therefore, someone considering buying their own pharmacy now must be willing either to improve their own skills or invest in their pharmacists and provide enough support staff to allow innovation to happen. Personally, I intend to become competent in assessing ears for minor problems, including infection and wax, and treat or refer as appropriate. One of my GP colleagues specialises in ear and throat conditions and is allowing me to shadow him.

Citation: The Salvadore DOI: 10.1211/PJ.2016.20201131

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