Example of a CPD reflective account for Pharmacy First

The GPhC asks you to reflect on one or more of the following standards:

• Standard 1: Pharmacy professionals must provide person-centred care
• Standard 2: Pharmacy professionals must work in partnership with others
• Standard 5: Pharmacy professionals must use their professional judgement.

Tell us briefly about your area of work (the setting of your practice and your main roles)

I am an independent community pharmacist working in a fairly new pharmacy (open for just over a year) on the edge of a large city centre in the north of England. My emphasis in designing the pharmacy was on promoting easy access to clinical advice, treatment and public health. I quickly signed up to provide the BP check and contraception services as well as Pharmacy First, and I am keen to build my clinical skills.

Tell us briefly who the typical users of your service(s) are

My pharmacy serves a mixed population including affluent young professionals who live and work in the city centre, and people working in the retail sector and in local offices. The city has quite a large population of homeless people and the pharmacy is not far away from a deprived locality with many persisting health inequalities.

Tell us how you meet the standards for pharmacy professionals we have selected

This year I started to provide the Pharmacy First service. There were many challenges to be faced and one where I had to learn a lot very quickly was making clinical records.

One thing that became clear to me straight away was how hard it was to interact with the patient during a consultation while at the same time having to type information into the computer. I learned from my early mistakes and the patients were very tolerant of my initial efforts. I learned how to explain to the patient that I would sometimes need to look at the computer and that this wasn’t being rude but it was important not to miss any information out.

Before the service started I phoned my nearest GP practice and asked if I could have a brief slot at their regular practice meeting to answer their questions about how the service would work and who the clinical pathways said needed to be referred to the practice and why.

The GPs were quite sceptical at first although they did say they could see the potential benefit to patients. We talked about antibiotics and I reassured them that my aim was to only supply them when there was a definite clinical benefit. They gave me some tips on how to say no while maintaining my relationship with the patient. The GPs were most positive about Pharmacy First enabling quicker access to antivirals for shingles and could see clear benefits here for patients.

Another challenge was that the new service requires you to take more explicit responsibility for clinical decisions and explain the basis of professional judgements made during the consultation. I felt a particular responsibility when considering supplying an antibiotic and my duties towards antimicrobial stewardship. Over time I found that I became more at ease with these professional judgements as I became more familiar with the clinical pathways.

Give a real example(s) taken from your practice to illustrate how you meet the standards we have selected    

In the early weeks of Pharmacy First we had quite a few patients who fell outside the age range for eligibility for the service. This was frustrating for them and for me too, because they were usually worried that they would not be able to get a timely GP appointment. Sometimes I could offer a treatment that they could buy over the counter and, if not, I encouraged them when they phoned the practice for an appointment to say that they had already tried to use the Pharmacy First service and that I said they needed to see their GP. This was something I had discussed and agreed with the practice.