I have worked as a Hospital Pharmacist since qualifying as a UK Pharmacist in 2018. Over the past three years, I progressed from a rotational band 7 pharmacist to a band 8a Specialist Pharmacist. I completed multiple rotations in both planned and unplanned medicines divisions. I started my band 8a pharmacy career in research and clinical trials at Lister Hospital in Feb 2022 and was successful at increasing pharmacy funding for the department by 0.6 WTE. I then pursued my passion in microbiology and antimicrobials at a large London hospital and was successful at getting a role as the Lead Pharmacist for Outpatient Parenteral Antimicrobial Therapy (OPAT) at King's College Hospital NHS Foundation Trust. I was part of a small team setting up the OPAT service at the Trust and my team was nominated for two awards.

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Due to increasing pressure and work/ life balance, I wanted to try Locum work which does not involve weekends, bank holidays and on-call duties. I have many colleagues who worked with a Locum Agency who have encouraged me to take this route.

In my role as the OPAT Lead Pharmacist, I had to deputise for the Principal Antimicrobial Pharmacist when they were off. In addition, I had to provide regular ward cover on a weekly basis. On one occasion which happened to be on the day I was covering the ward, both my OPAT team nurse specialist were off and I was also deputising for the Antimicrobial team which requires me answering enquiries from doctors and pharmacists regarding Antimicrobials. In addition, I am expected to provide a full clinical pharmacy service to the ward plus due to being the only available OPAT team member, it meant that I must ensure the service continues to run thus preventing any unnecessary delays to discharges.
At first, the situation felt overwhelming however I took time to plan my work. I also ensured that I informed all the stakeholders (OPAT Pharmacy team, ward staff and the pharmacy team lead for the ward specialty). I ensured that my time on the ward was managed effectively and I set my priorities, for example, some of the antimicrobial queries I received on the Antimicrobial Pharmacy Team's phone were not time critical so I took the relevant details and informed the caller that I will call them when I am back from the ward. In addition, I ensured the OPAT referrals were triaged to the relevant Consultant who would confirm if a prescription was required immediately.

The outcome was that I managed to review all the ward patients who were on critical medications and those newly admitted to the ward, I also completed all the paper work required for the discharge. I handed over to the Team Lead at the end of my ward cover with any outstanding orders/ queries so another colleague could follow them up. All antimicrobial queries were dealt with in a timely manner either once I finished work on the ward (for the non urgent queries) or by referring the caller to a useful resource or a microbiology doctor/ consultant when appropriate (for enquiries that had to be dealt with immediately). All OPAT referrals were also dealt with by the Consultant and I completed the prescriptions after I went back from the ward and in time for the discharge to go ahead as planned.

A regulatory framework which ensures the safety, quality and efficacy of medications available in the United Kingdom. Its purpose is to protect the health of public through regulating medications development, manufacturing, distribution and use. It sets out the requirements for licensing, labelling, advertising and sale of medications to make sure they meet the required standards. It applies to pharmaceutical companies, manufacturers, wholesalers, pharmacists and healthcare professionals. It applies to medications which require a prescription as well as those that can be bought over the counter.

If I came across such scenario, I would seek to clarify with the medical team looking after the patient and ensure a clear documentation of the plan in the medical notes before I prescribe. I also would only prescribe a medicines that is within my scope of practice and would ensure appropriate documentation.

I would immediately inform my Line Manager/ a senior member of the team and would report the incident via the patient safety incident reporting portal if that had not been done already. I would ensure I reflect on my practice which had led to the incident and would undertake the required learning to prevent similar incidents/ complaints from happening in future.

It is a system by which NHS organisations are held accountable for continuously improving the quality of services and safeguarding their standards of care through creating an environment in which clinical excellence would flourish. It includes seven pillars which are audit, risk management, education and training, patient and public involvement, information, staff management and clinical effectiveness.

One of my OPAT patients had a delivery of their homecare medications but it was not received in a cool box as per usual process. The patient had been staying with their relative closer to the hospital. The relative called us complaining that the medications were not received in a cool box as advised by the OPAT team and the patient was very anxious and not happy about using the medication. I allowed the relative the space to speak and listened actively and carefully all the while trying to gather facts of what happened. I ensured I was calm and empathetic.

The relative demanded that the medications are replaced as the patient was refusing to use them. As the medication was delivered by an external homecare company, I informed the mother that I will need to contact the supplier to understand the reason for delivering the medications without a cool box. Having gathered the facts from the company and having established a diversion from the usual process, I requested that the company replaced the antibiotics. I ensured I called the relative and informed them of the outcome. Because the delivery could not be made on the same day, I made arrangements for the patient to come back to hospital so that their antibiotic is given without delay which they were happy with.
The following day, I followed up once the new delivery was made to establish the patient was satisfied and happy to use the product.

I reported the incident via our patient safety incident reporting system and ensured our service manager from the homecare company was aware so they investigate the incident at their end also.