Tuesday 16th December 2014
Mac Voice, the magazine for Macmillan professionals: Winter 2014
Emyr Jones is a Macmillan Palliative Care Pharmacist and has been in his post at Aneurin Bevan University Health Board since 2013. He was recently awarded an 'Integration Excellence Award' in the 2014 Macmillan Professionals Excellence Awards.
What is different about your role as a pharmacist?
It’s the first time in Wales a palliative care pharmacist has been in primary care, where historically they’ve been based in hospitals or hospices. This shows the shift towards palliative treatment in the community.
How did your professional background lead to your current job?
My background is hospital pharmacy, where I worked a lot on the care of the elderly wards. I spent time working in a hospice in Swansea, which led to an interest in palliative care, and then moved around different hospitals – the majority of my work being caring for the elderly. Before I came to this position, I had split roles as a hospital pharmacist and a primary care prescribing adviser. When this job came up, it ticked all the boxes for me. It was the ideal opportunity and one I’m really glad I’ve taken.
What are the aims of your role?
We need to ensure people with palliative needs have the same kind of care they would get in a hospice or hospital, and prevent inappropriate hospital admissions. To do this we need to support the community services and pharmacists. At the moment, our access to medication is probably not as good in the community as it is in hospital, so we want to identify the gaps and ensure that, if people do want to spend their last days in their homes, they have the same timely access to services they would have in secondary care.
Why do you think strong community palliative care support is important?
Reports show that two-thirds of people would prefer to die at home, but the majority of deaths take place in hospital. Obviously there’s something going on in primary care that’s preventing people from staying at home. If it’s a problem with access to medication that’s preventing these people from dying at home, that’s something we need to look at. Strong care and support in the community ensures people can spend their last days where they choose to.
What particular initiatives have you been involved with?
My main role has been in helping develop educational tools, such as an e-learning module for pharmacists about the most common symptoms and how they can support carers – simple stuff they can offer over the counter. I also realised there’s a lot of support and information out there that I wasn't aware of. I thought ‘Well if I'm supposed to be a specialist in palliative care and I don't know, your community pharmacist is unlikely to know'. So one of the initiatives has been the production of a signposting guide, putting all the information a community pharmacist should need in one place.
I’ve also been managing the Just In Case box scheme – a type of anticipatory prescribing different to traditional methods as it’s done much earlier in the process. The Just In Case boxes are generic boxes that people are prescribed when they may have two or three months to live. If their health deteriorates unexpectedly, these drugs are already in their homes. This allows quicker symptom control, reduces the need for the carer to run around out of hours, and potentially prevents hospital admissions. In addition, we’ve set up an All Wales Palliative Care Pharmacist Group. There were a lot of pharmacists in Wales with an interest in palliative care, but there was very little communication between them. So we identified a group of pharmacists across Wales that come together quarterly. We have our work streams which feed into the All Wales Chief Pharmacist Group and then feed it into the Palliative Care Implementation Group in Wales.
What would you consider to be the challenges of your role?
I think a big challenge in palliative care is that the community pharmacist isn’t seen as part of the multidisciplinary team. They are often left out when information is shared, but if we’re going to treat people in the community, we need to be aware of what’s going on with each person.
What are the rewards of your role?
I really enjoy doing new initiatives – having the freedom and support to look at the current service and see how we can improve it. It’s very focused because we’re looking at the end user of the service and, ultimately, it’s people being treated who are going to benefit.
Some of the works are now being incorporated into an all-Wales approach which just shows what we were doing here in Gwent is recognised across Wales. That’s probably the most rewarding part of the role, seeing what we actually do being used in practice.
Email Emyr at firstname.lastname@example.org