1. “Advanced Clinical Practice” - a Pharmacist’s perspectiveBy
Hirminder Kaur Ubhi
MPharm
PG Dip Prescribing & Therapeutics IP

2. Background
Health Education England - national project for emergency medicine
HEWM – WestMidlands pilot in three trusts
What impact could pharmacists have in this crisis? Members of the ED teams?

3. The ED Pharmacy Pilot
Investigate potential of an enhanced clinical role for Pharmacists
As part of (not alongside) the multi-disciplinary team working with Advanced Practice Nurses & Physician Associates
HEFT , BCH (paediatric) & Worcester

4. CLINICAL PHARMACY AS YOU MAY
NOT
CLINICAL PHARMACY AS YOU MAY
know it!
This is something else!!

5. Who are Advanced Clinical Practitioners?
ADVANCED Nurse Practitioners
Paramedics
Respiratory Physiotherapists
Different governing bodies, separate definitions and statements for practice.
Pharmacists with IP? Not really but a step in this direction.
Nursing and Midwifery Council (NMC) (2005) stating
“…highly experienced and educated members of care team who are able to diagnose and treat your healthcare needs…”
PAs “

6. Who are Advanced Clinical Practitioners?
Physicians Associates??
Clinical Pharmacists (IPs) ??
Independent prescribers (IP) with recommendations from the Pharmaceutical Council (2006)
Once qualified these individuals with these advanced skills to, work in primary, secondary or tertiary care can prescribe autonomously for any condition within their clinical competence (GPC, 2006).

7. What can an ACP do? Conduct comprehensive physical exams
Request and interpret tests
Diagnose and treat illnesses and injuries
Counsel on preventive health care
Key points

8. Is there a need for Advanced Clinical Practice Pharmacists?
Lets look at the pilot

9. BCH was phase II of the project.
Patients were coded according to a perceived professional ability to manage (PAM) that patient.
Professional ability to manage (PAM)

10. PAM Categories CP: Community pharmacy intervention.
CP: Community pharmacy intervention.
e.g. Conjunctivitis
IP: Independent prescriber intervention.
e.g. Asthma
IPT: IP with enhanced skills training.
e.g. Abdominal pain? Differential diagnosis
MT: Medical team only – Pharmacist intervention unsuitable.
e.g. Known cardiac patient
MINOR AILMENTS A DISTRACTION

11. What we found…. Me and consultant
Reviewed independently by consultant on completion

12. Type of additional training required for the IP caseload
Clinical examinatrion_ By the end of the module you should be able to:
Critically evaluate the functional anatomy and altered pathophysiology of a range of body systems relevant to common conditions
Assimilate the information gained by taking a complete clinical history and synthesise salient points
Adapt a standard approach to performing a full systems clinical examination, providing reasoned rationale for the adaptive approach
Critically appraise the patients presenting clinical features, formulate a working and differential diagnosis
Provide a detailed plan of justified investigations and a treatment plan based on a critical appraisal of best evidence, appropriate to the patient’s presenting complaint and fulfil professional requirements related to record keeping and documentation
Develop critical appraisal skills in assimilating and synthesising patient variables in order to support autonomous practice and improve patient experience
Provide a detailed portfolio of autonomous practice demonstrating attainment of clinical competence Present a reflective assignment of a detailed case study incorporating critical appraisal of relevant literature

13. Conclusion
Clearly a new role for ACP qualified pharmacists exists in the new NHS
Advanced Clinical Pharmacy a new discipline
Integrated into Consultant teams across a range of specialities
Spin off–Flu vaccine Champion !!
Discuss the ACP training at Warwick.

14. Health Education West Midlands
A Big thank you to
BCH ED
Pharmacy department
Health Education West Midlands
Contact details