For the last 3 years I have worked as a general practice pharmacist (prescribing) at Park Medical Center, in Chester, United Kingdom. Here I am responsible for; complex medication reviews, long-term health condition review, acute illness review - this involves face-to-face consultations/remove consultation, hands-on examination, ordering diagnostic testing, performing phlebotomy/urinalysis and prescribing. I am also responsible for medicines management at the practice; this involves clinical auditing, quality improvement project work, policy/SOP writing. Additionally, have some line management responsibility - general practice assistants and an additional clinical pharmacist.

No - N/A.

I have previously registered with TLA and been placed at two other sites; prior to my most current role. These were Southport and Ormskirk and Mid Cheshire Hospitals. I have always been satisfied with the quality of the service I've received and have a lot of confidence in my recruiter (Danny Miller).

In my current role, I arrived at work on a busy Monday morning to a full clinic of patients; the clinic had been overbooked due to staff shortages. Minutes before starting my clinic, I was informed by reception, that the second clinical Pharmacist at the Practice could not attend due to illness. She also had a full clinic of patient; the reception manager was unsure on how best to deal with her patients. This was quite a stressful situation, as I already had a significant workload, but this had to be resolved in the interest of those patients who had been booked with my colleague. I firstly started by speaking with my patients in the waiting room and advising them there would be a delay in starting my clinic; they were understanding and thankful of the update. I then methodically reviewed the patients booked with the second Pharmacist and prioritized those bookings accordingly into 1 of 3 groups 1) Urgent 2) Less Urgent 3) Routine. I booked the "Urgent" patients in with the Duty Doctor or my afternoon clinic to be resolved the same day, the less urgent patients were rebooked with the second Pharmacist the next day (limited capacity) and the routine patients were booked later in the week. I communicated this plan clearly with the reception manager, so she could send out the appropriate communication to those patients. I then Bulk Messaged all the patients in my morning clinic, that were booked later, to advise them there could be delays in seeing them due to a late start - I feel by making people aware of issues ahead of time, this causes less frustration and upset. Thankfully, I was able to work through some of my morning admin time an get my clinic back on track. I then used some free time later in the week, once the other Pharmacist had returned, to catch up with this routine admin.

The Medicines Act 1968 is a key piece of legislation that provides guidance/laws the govern the supply and manufacture of both human and veterinary medicines. It provides key pieces of legislation such as; Section 72A - "responsible pharmacist" legislation, sections 74 "registered pharmacy" premises legislation and section 58 which governs which medications may be supplied by prescription only - amongst others.

1) Determine where this request has come from; verbal, written? From a patient, prescriber, member of the MDT?
2) Find out the rationale for prescribing this medications - new? indication?
3) Determine if the prescription is evidence based - in line with policy? local guidelines? national guidelines?
4) Determine if this prescription is safe - contraindications? interactions? side effect consequences?
5) Determine if this medication can be given - need IV access? oral? can the patient swallow? is the patient conscious?
6) Determine if the medication is in my scope of practice - i.e. am I the most appropriate person to prescribe (e.g. I don't routinely prescribe IV fluids - so I wouldn't be comfortable doing so routinely).

All of the above would involve communication with the patient/family/carers, wider care team (e.g. GP practice potentially), MDT (ward team) amongst other to determine.

Only if all the above criteria can be satisfied, would it be appropriate to issue the prescription.

Firstly, I have a duty of candor, so if have made a mistake, or acted inappropriately, it is my duty to act accordingly. This involves being open and honest with everyone affected. I would firstly discuss this issue with my line manager, to determine the appropriate action - this may then involve taking to a patient, other healthcare professional, submitting a datix, speaking with my locum agency, or even seeking professional guidance i.e. RPS, insurance provider etc. The key to any incident or complaint is to be completely transparent so all the facts can be gathered before any conclusions are drawn.

Clinical governance refers to a framework of integrated systems, processes, and leadership responsibilities aimed at ensuring and continually improving the quality and safety of patient care within healthcare organizations. In the context of pharmacy, clinical governance involves the systematic oversight and management of pharmaceutical services to optimize patient outcomes. This includes implementing evidence-based practices, monitoring and evaluating the effectiveness of pharmaceutical interventions, maintaining high standards of professionalism and ethics, and actively engaging in continuous quality improvement initiatives. Through clinical governance, pharmacists contribute to the overall delivery of safe, effective, and patient-centered healthcare services.

I recently had a scenario whereby a patients relative had rang up very angry that their parent had not received a prescription for a medication suggest by the hospital. This was a request we'd recieved from the pain clinic for Tapentadol. However, I had written back to the pain consultant expressing some concerns around comorbidities (severe COPD), interactions (other opiates, antidepressants, gabapentinoids) and frailty (severely frail). These had therefore cause a apparent "delay" with issuing the medication. The family member expressed dissatisfaction with the perceived delay in issuing what they thought to be a critical medication. Understanding the gravity of the situation, I immediately reached out to the relative, acknowledging their concerns and expressing genuine empathy. I took the time to explain the reasons behind the apparent delay, providing information about the steps being taken to ensure the patient's safety. I assured them that their concerns were taken seriously and that we were actively working to address the issue and look at alternatives. Throughout the conversation, I maintained a calm and professional demeanor, actively listening to their concerns and addressing each point thoughtfully. By the end of the discussion, the relative appreciated the transparent communication and the efforts being made on the patient's behalf. The outcome was a strengthened rapport with the family, increased understanding of the complexities involved, and a collaborative resolution to ensure optimal patient care. This experience reinforced the importance of effective communication and empathy in navigating challenging situations within the healthcare environment.