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Keeping up to speed with a changing world

With evidence and guidance about treatments and condition management changing all the time, how can pharmacists keep on top of the latest developments and ensure their practice is up to date?

The need to keep informed about the latest developments in health and pharmacy is a crucial part of professional practice. 

“Pharmacy is an ever-changing profession and we have to be up to date with any changes, such as new clinical guidance. If not, we won’t be able to pass that information on to our colleagues, and, most importantly, care safely for our patients,” says Lila Thakerar, superintendent pharmacist at Shaftesbury Pharmacy, Harrow. 

“I only qualified 15 years ago, but I practise with about 10 per cent of the knowledge I graduated with. And that 10 per cent is about fundamental understanding, not application or action. The rest of what I learned has completely changed,” adds Ade Williams, lead pharmacist at Bedminster Pharmacy in Bristol.

The pharmacy profession has seen some “significant changes in recent years and the pharmacist’s role is changing as a result of this”, says Antania Tang, senior advice and support pharmacist at the NPA. “As always, pharmacists need to stay on top of new and updated clinical guidance to implement the best care for their patients, and ensure they are familiar and comply with all regulatory and legal requirements relating to their day-to-day practice in pharmacy.” 

The pharmacy regulator expects the profession to stay up to date. Pharmacy professionals registered with the GPhC need to undertake revalidation each year and those registered with the PSNI need to complete CPD. “These processes help to ensure pharmacists are continuing to develop their skills and knowledge beyond the initial education and training received, ensuring safe and effective care in line with the regulatory standards in place,” says Tang.

“All pharmacists should keep up to date in all areas of their practice in ensuring optimal care for patients,” advises Professor Parastou Donyai, chief scientist at the Royal Pharmaceutical Society.

“This can relate to keeping informed about changes in pharmacy practice, legislation, clinical guidance or medicines, to name a few examples. It is also important to note that this can vary for individual pharmacists depending on their scope of practice and speciality,” she says.

However, keeping up to speed with the latest evidence can be difficult for pharmacists who are faced with a lack of time and resources, and increasing workload pressures. “The challenge is having the time to be able to keep up,” says Lila Thakerar. “We are struggling with providing all the necessary services at the moment, looking after patients, being hands-on pharmacists, and having to deal with all the bureaucracy we face.” 

Top learning & development tips

  • Recognise and work within the limits of your competence and keep your knowledge and skills up to date
  • Sign up to receive notifications about the most recent safety concerns and adverse drug reactions
  • Maintain and develop the knowledge and skills that are relevant to your role and practice
  • Identify, appraise, and apply high-quality systematic reviews into your practice
  • Refer to trustworthy, credible and peer reviewed guidelines
  • Use the pharmacy press to keep up to date.

Information overload

Information overload can also be a problem. “With the growing use of technology, information is available from a wider range of mediums than ever before. It can be difficult for pharmacists to ensure they receive the correct and current information they are after,” says Antania Tang. 

While staying on top of the latest pharmacy developments can be challenging, failing to do so can have serious consequences for patients. “There is a potential risk to patient safety if pharmacists do not follow up-to-date, evidence-based information or care,” says Professor Donyai. The impact of the risk will vary depending on the situation, she says. For example, in 2014, domperidone was reclassified from a P medicine to a POM due to an increased risk of serious cardiac side-effects. “The implications of a pharmacist not being aware of this change had the potential for patient harm,” she says.

With pharmacy playing a greater role in supporting patients – particularly since the pandemic when it was often the only port of call for them – being up to date has become even more of an imperative. “You have to be on top of your game,” says Reena Barai, superintendent pharmacist at SG Barai Pharmacy in Sutton.  

“Demand on our knowledge has really increased. We are seeing more patients with minor illnesses and through the new hypertension and vaccination services, for example. If we are not up to date, we can’t safely support our patients.” 

Not being able to keep up to date can also undermine personal job satisfaction, suggests Ade Williams. “Anyone who has a professional role and is aware that they are not able to work to the best of their ability will feel dissatisfied and more likely to become burnt out and demotivated,” he says.

“Although not currently mandatory pharmacists would like to see learning time protected to support and enable their professional development”

Tools and support

There are plenty of tools and support available to help pharmacists keep on top of the latest developments. “Pharmacists work in a range of roles, so the tools required will depend on the role and sector they work in. This can also vary depending on what topic pharmacists may want to keep up to date with,” says Professor Donyai. 

Some broad examples useful to all pharmacists are the Medicines, Ethics and Practice guide from the RPS, MHRA safety alerts, the BNF and NICE/SIGN guidelines, says Professor Donyai. “As an example, OTC medications going from POM to P are key topics for community pharmacists. They can use our reclassification hub and pharmacy press publications to keep up to date.”

Being a member of a professional or trade body can also give pharmacists access to support and information to keep up to date. Contacting the NPA pharmacy advice and support team, “saves NPA members valuable time, enabling them to focus on their busy pharmacy work and priorities” – and the NPA website is “a great source of information too”, says Antania Tang.

She advises pharmacists to go to “primary sources of information”; for example, the BNF, NICE, local NHS guidelines, and Martindale:The Complete Drug Reference.

Different triggers

Learning and development opportunities can regularly result from patient queries. “Often the way I learn about new evidence and guidelines is from queries with prescriptions,” says pharmacist Peter Kelly of Kamsons Pharmacy in Clapham.

“I also find having a pre-registration or trainee pharmacist very helpful, as they are usually up to date on new developments and can help with your own research and learning,” he says.

Pharmacy teams can also keep you up to speed with new developments. Reena Barai recommends setting up WhatsApp groups and holding clinical team ‘huddles’ to share news and information, such as changes to guidelines.  

Fellow pharmacists are a valuable source of information and support, both through digital peer-to-peer groups and personal contact. “The challenge of keeping on top of everything creates an opportunity to network with those in the same situation,” says Ade Williams.  

Babir Malik, foundation lead for Weldricks Pharmacy, finds social media a useful way of keeping up with new developments and follows key people on Twitter, such as consultant pharmacist Dr Toby Capstick for respiratory updates.

Lila Thakerar finds that attending online meetings can be “very educational” and also recommends the training and learning that Health Education England has on offer to pharmacy. 

She finds the Centre for Pharmacy Postgraduate Education (CPPE) helpful for her own personal learning and development, as well as attending online meetings about pharmacy services, including those held by her LPC.

Thakerar aims to allocate time to keep up to date in between carrying out other pharmacy tasks, but finds “a lot of my updating and learning is done outside normal working hours – early morning or late at night”.

Time for protected time?

Currently, it is not a mandatory requirement that pharmacists have protected, funded time for keeping up to date and the standards set by the GPhC and PSNI place this responsibility on the pharmacists themselves. However, pharmacists would like to see protected learning time to enable their professional development.

“Pharmacists must have protected learning time and this is something the RPS is strongly advocating for,” says Professor Donyai. “Some employers provide protected learning time and may send employees to training courses. However, this can vary from employer to employer, as well as the sector pharmacists are working in.

“As part of our workforce and wellbeing campaign we are calling on governments and NHS bodies to enable funded, protected learning time and the infrastructure to support it. This must be available for all pharmacists to enable the continuum of professional development from foundation to consultant level and ensure a high standard of pharmacy practice. 

“Pilots have been welcomed across England, Scotland and Wales, but there must be a wider and more accessible offer made available nationally for all pharmacists,” she says.

“As we see ourselves transitioning to greater clinical service provision, we need to think about protected learning time for our teams. It is unsustainable to expect people to do this in their own time. GPs have protected time – I want the same for pharmacy,” says Reena Barai.

While it can be “really hard to stay on top of things in pharmacy”, she says keeping up to date “helps us to do our job better and feel a sense of worth”. 

We are all facing the same situation, agrees Ade Williams, “so there is no reason to feel guilty. What we can do is link arms together, lift each other up, and share information and advice.”

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