#WePH - Thursday 16th November 2017 8pm (GMT Standard Time) ACP pharmacists and Advanced Practice week

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Hosted by WePharmacists using #WePH

This chat is guest hosted by @s_awhyte

Advanced clinical practice originated as an extended nursing role; but now a growing number of pharmacists and other allied health professionals are moving towards Advanced Clinical Practice in keeping with recommendations of the Five Year Forward View.

An Advanced Clinical Practitioner can be defined as “A registered practitioner with an expert knowledge base, complex decision-making skills and clinical competencies for expanded autonomous scope of practice, the characteristics of which are shaped by the context in which the individual practices.”

The 12th to the 18th of November marks the first Advanced Practice week to be held in UK, which coincides with the very successful annual Nurse Practitioner week in the USA.

Join us at 8pm on Thursday the 16th of November using the #WePh hashtag to share, discuss and demonstrate the advanced practice roles of pharmacists and how this supports the developing healthcare workforce.





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 #WePH transcript

 
@WePharmacists
16 November 2017 20:00
Welcome to our #WePh chat on pharmacist advanced clinical practitioners for #AdvPracWeek17 Before we start, say *… https://twitter.com/i/web/status/931250540994093057
@LCH_IPC
16 November 2017 20:00
RT @WePharmacists: Welcome to our #WePh chat on pharmacist advanced clinical practitioners for #AdvPracWeek17 Before we start, say *…
@WePharmacists
16 November 2017 20:01
And not that you need reminding, but... #weph https://t.co/H39w1e4fgZ
@aptaim
16 November 2017 20:02
Hello #WePh! James here, #GPPharmacists & national quality lead for community services provider: want to know how I… https://twitter.com/i/web/status/931251061872119808
@WePharmacists
16 November 2017 20:02
#WePh https://twitter.com/HPILLminster/status/931250947258568705
@WePharmacists
16 November 2017 20:02
#WePh https://twitter.com/s_awhyte/status/931251004305215488
@HPILLminster
16 November 2017 20:03
@WePharmacists Hahahaha ?? #fail #weph
@HPILLminster
16 November 2017 20:03
RT @aptaim: Hello #WePh! James here, #GPPharmacists & national quality lead for community services provider: want to know how I…
@WePharmacists
16 November 2017 20:03
@s_awhyte @HPILLminster come on both - don't forget the hashtag! #WePh https://t.co/rtg4grTAks
@HPILLminster
16 November 2017 20:04
@aptaim Depends on the role you want them to do! #fourpillars #AdvPracWeek2017 #Weph - adjust the weighing of those pillars for the role!!
@aptaim
16 November 2017 20:04
@HPILLminster For the uninitiated - what are the four pillars & where do they come from? #WePh
@pharmerfour
16 November 2017 20:05
#weph #wephoz Jarrod from Australia here tagging so I can follow later - about to drive to work Get on this chat gu… https://t.co/SxFendNmFK
@pcpa_org
16 November 2017 20:05
RT @aptaim: Hello #WePh! James here, #GPPharmacists & national quality lead for community services provider: want to know how I might utili…
@PharmRJ
16 November 2017 20:06
RT @aptaim: Hello #WePh! James here, #GPPharmacists & national quality lead for community services provider: want to know how I might utili…
@HPILLminster
16 November 2017 20:07
@aptaim #realtime #advpractweek17 #stolengoods ????#WePh https://t.co/LRyYKo31js
@WePharmacists
16 November 2017 20:07
@s_awhyte So talk us through the four pillars - new to us! #WePh
@WePharmacists
16 November 2017 20:08
RT @HPILLminster: @aptaim #realtime #advpractweek17 #stolengoods ????#WePh https://t.co/LRyYKo31js
@aptaim
16 November 2017 20:09
@HPILLminster OK... so what can - or can't - ACP pharmacists do, and what benefit does it bring to patients or the service? #WePh
@WePharmacists
16 November 2017 20:13
Great to have you join us Ian, thank-you: could you talk us through your ACP experiences so far? good and bad! #WePh https://twitter.com/ian1to3/status/931253467032809472
@Cleverestcookie
16 November 2017 20:13
Hello, just observing as current field of practice wouldn't utilise the role #WePh
@Cleverestcookie
16 November 2017 20:17
@WePharmacists Not really - elective procedures hospital (unless you can convince me otherwise) #weph
@WePharmacists
16 November 2017 20:19
@Cleverestcookie Fair! Though remember ACP doesn't just mean pharmacist - nurses and allied professionals too... Convinced yet? #WePh
@WePharmacists
16 November 2017 20:20
#WePh https://twitter.com/ian1to3/status/931255485218611205
@Smileysingh
16 November 2017 20:20
@WePharmacists @ian1to3 @LSBU @cpharmUK @GPPharmacists lol Singh not sigh! First time i'ved "sighed" #weph
@WePharmacists
16 November 2017 20:21
@ian1to3 Fab, thanks Ian (just don't forget to add #WePh next time!) - so what value does the role add to being a non-ACP pharmacist?
@HPILLminster
16 November 2017 20:22
@aptaim #weph #adv #advpractweek17 https://t.co/E9SahBYOxs
@Cleverestcookie
16 November 2017 20:27
@WePharmacists Not quite yet, as I'd want pharmacists to have a good level of those skills anyway #weph
@HPILLminster
16 November 2017 20:28
@WePharmacists @s_awhyte In short - yes - but I'm just about to get off the train! #weph!!!
@s_awhyte
16 November 2017 20:29
@WePharmacists @HPILLminster The largest data set at present for pharmacists ACPs can be found here: http://www.pharmaceutical-journal.com/research/perspective-article/examining-the-emerging-roles-for-pharmacists-as-part-of-the-urgent-acute-and-emergency-care-workforce/20202238.article #WePh
@s_awhyte
16 November 2017 20:32
@WePharmacists @HPILLminster Basic summary - once trained, pharmacist ACPs can manage approx 35% of patients attending ED department. More data like this will strengthen rationale to extend to other areas. @HPILLminster in GP for example #WePh
@s_awhyte
16 November 2017 20:33
@HPILLminster @WePharmacists Every day is definitely a school day! #WePh
@WePharmacists
16 November 2017 20:33
@ian1to3 And where do you think ACP pharmacist can most effectively be deployed? #WePh
@WePharmacists
16 November 2017 20:34
Well worth a look #wePh https://twitter.com/s_awhyte/status/931258036852805632
@HPILLminster
16 November 2017 20:35
RT @WePharmacists: Well worth a look #wePh https://twitter.com/s_awhyte/status/931258036852805632
@WePharmacists
16 November 2017 20:36
@s_awhyte @HPILLminster And how do your experiences as a pharmacist ACP match or differ to ACPs from other professions? #WePh
@s_awhyte
16 November 2017 20:36
@WePharmacists This is not about replacing medics, this is about working WITH the medical and multi-disciplinary team to allow patient to be seen by a clinician at the right time, in the right place #WePh
@Smileysingh
16 November 2017 20:37
Currently non pharmacist ACPs are deployed all over NHS, there is no reason why we cannot work in nursing homes, geriatric units, acute care, ambulataory units, DVT clinics, we can diversify, IMO seeing treating and discharging isn't all we can do #WePh
@s_awhyte
16 November 2017 20:38
@WePharmacists @HPILLminster Nurses led the way, and we have SO much to be thankful to them for. Advanced clinical practice defines an expected level of clinical practice, and regardless of base profession, we should all be functioning at that level #WePh
@pabakz
16 November 2017 20:39
@Cleverestcookie @WePharmacists Our ACPs (some of whom are pharmacists) do far more clinical hands on examination than non-ACP pharmacists do #WePh
@HPILLminster
16 November 2017 20:39
@WePharmacists @s_awhyte I'm part of a MDT cohort. We all have similar anxieties, experience the similar challenges and barriers to #ACP - perhaps as the role is not clearly defined & titles aren't protected - all we know is that we are providing better care to our pts than we did before #weph
@Smileysingh
16 November 2017 20:40
In terms of data we are finding similar results in workload but this will increase. At the moment being a trainee in a trust means we have to have all patients screened by a mentor, may not be the same elsewhere but direct mentorship with freedom to practice is great #WePh
@pabakz
16 November 2017 20:40
@s_awhyte @WePharmacists Isn’t it (at least partly) driven by the upcoming lack of particularly middle grade doctors? #wePh
@s_awhyte
16 November 2017 20:40
@HPILLminster @WePharmacists The new framework defines the role better. IMO we do need some form of protection. Annotation of base profession would be preferred, but separate register is also being explored #WePh
@WePharmacists
16 November 2017 20:41
Interesting - what do others think? #wePh https://twitter.com/pabakz/status/931260782775545856
@Smileysingh
16 November 2017 20:42
Agree with @s_awhyte would be great to have a regulatory body independent from our own but annotation would be just as good #WePh
@ian1to3
16 November 2017 20:42
@WePharmacists Some colleagues are based in ED and I’m based in urgent care; where I find other team members are happy to consult us as pharmacists any medicines related queries promoting a good skill mix within a MDT, which includes GPs, @nurses, paramedics etc #WePh
@WePharmacists
16 November 2017 20:42
@dav_manku @s_awhyte @HPILLminster Great to have you join us! (& we hope work was good today...) Would love to hear your experiences of ACP: good and bad! #WePh
@s_awhyte
16 November 2017 20:44
@pabakz @WePharmacists I am sure some trusts use that as a driving force! For me, the consultants found juniors rotating through the dept and being "good" just at the time they were leaving a bit of a strain. They wanted a core team to support them, and appointed ACPs #WePh
@Smileysingh
16 November 2017 20:45
As a community pharmacist I saw, treated and managed patients. I am still doing the same but on a different level (not higher or lower -just laterally) but this time with additional skills. ADDITIONAL is the key word, encompassing previous with new skills #WePh
@WePharmacists
16 November 2017 20:46
Join us for our #WePh #pharmacywinter action day chat at 8pm-9pm a week today to share the value of community pharmacy in relieving winter pressures on the NHS. Tweet your day then join our evening chat! More on the chat and the action day here: http://wecommunities.org/tweet-chats/chat-details/4084 https://t.co/c1jA6ZuqK2
@aptaim
16 November 2017 20:47
*love this one* #WePh https://twitter.com/Smileysingh/status/931261858404880385
@dav_manku
16 November 2017 20:47
@aptaim @HPILLminster I've given chemo? cannulated, assisted with LP, diagnosed neutropenic sepsis, found a lung met, head to toe examinations - fall into clinics/ward rounds where they are pressured (lack of registrars) &reduce patient waiting times #WePh
@Smileysingh
16 November 2017 20:49
Yes there is a shortage of medics in primary and emergency care but we are not there to replace them. Pharmacist ACPs rather than ACP pharmacists. I am utilised but still not sure if colleagues know the potential of having us there, Still working on it. #WePh
@aptaim
16 November 2017 20:50
@dav_manku @HPILLminster So where do you see the most value of being a pharmacist ACP? #wePh
@HPILLminster
16 November 2017 20:50
@WePharmacists I would agree - partly reason - #5YVF #GPFV ticked that; but also the growing patient population and complexity, co-morbidity, medicines burden in polypharmacy - ACPs manage the disease progression & meds op #weph
@s_awhyte
16 November 2017 20:51
@WePharmacists @dav_manku @HPILLminster Managing the unpredictable/unplanned is the key difference for me. This often falls outside of the traditional pharmacist remit (when you would refer to a doctor). Very rewarding to manage this yourself, but always have senior support for backup/discussion PRN #WePh
@Smileysingh
16 November 2017 20:51
I work in and emergency dept which incorporates an urgent care centre as well. I see patients that are streamed to the GP side as well as those in the Majors and minors side. I see paeds patients too and dip into resus now and then #WePh
@CoProNorfolk
16 November 2017 20:51
RT @aptaim: *love this one* #WePh https://twitter.com/Smileysingh/status/931261858404880385
@HPILLminster
16 November 2017 20:52
@aptaim @dav_manku Complex patients and acute illness #weph (getting in the car now - almost got squashed by a suitcase ; also turns out my arms are too short to reach the train door handle from the inside of carriage!)
@s_awhyte
16 November 2017 20:54
@aptaim @HPILLminster You define an agreed scope of practice and work within this. There are no real cans or can't (within reason). Patients seen by a single person who can manage the whole journey. Evidence from patients: this is important to them. Base profession not so much of a concern. #WePh
@AmyTPage
16 November 2017 20:54
@aptaim @dav_manku @HPILLminster Complex patients and challenging scenarios are best use of pharmacist skills. Lots of education activities and quality improvement. #wePh
@Smileysingh
16 November 2017 20:54
Pharmacy still runs through my blood - nobody leaves without a hidden Meds review! We take histories, examines patients, manage patients, prescribe/verbal advice complex decision making. See anything thing from LRTIs to broken bones, from gastroenteritis to pancreatitis #WePh
@s_awhyte
16 November 2017 20:56
@aptaim @HPILLminster Some examples of more odd ball situations: I regularly lead the CET during clinical emergencies and have delivered 3 babies (!) #WePh
@WePharmacists
16 November 2017 20:57
So last few minutes of #wePh chat - how should the pharmacy profession approach, promote and utilise the ACP role?
@s_awhyte
16 November 2017 20:58
@Smileysingh I saw you do this beautifully during an observation. Patient also really appreciated that you cared about her health in general and not just the presenting complaint #WePh
@dav_manku
16 November 2017 20:58
@aptaim @HPILLminster so we are the chemo drug expert. know what treatment patient is due next. put that in a clinic - examine patient (e.g for splenomegaly), check bloods (e.g tumour markers, proceed chemo, prescribe next course, monitor for disease progression, refer when needed to cons #WePh
@Smileysingh
16 November 2017 20:59
Plenty we can do, we just don't know it yet, we have faith in ACPing, just need the profession to do the same. #WeACPs a new one maybe? #WePh




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