The PJ Pod

The ‘NHS mental health implementation plan 2019/20–2023/24’, published by NHS England in July 2019, identified a need for “new and integrated models of primary and community mental health care” to support 370,000 adults and older adults with severe mental illness (SMI).

With many of these patients on psychotropic medication, such as clozapine, lithium, valproate and antidepressants, to treat a range of conditions, including schizophrenia, bipolar disorder and eating disorders, the plan aimed to recruit 260 pharmacists into integrated community care teams by April 2024.

However, an investigation by The Pharmaceutical Journal in May 2024 revealed that there are 160.95 whole-time equivalent pharmacists in adult SMI community services across 43 out of 49 mental health trusts that responded to a freedom of information request.

In this ‘Spotlight’ episode of The PJ Pod, Carolyn Wickware, executive editor, and reporter Tammy Lovell discuss the funding that was offered to set up these teams and how it was used, and what happens now that the implementation plan has ended.

This episode was produced by Geoff Marsh.

Please note that this episode includes discussions of war and injury that may be distressing to some listeners, with stories from pharmacists working in Sudan, Ukraine and Gaza.

Horrific stories of injury and death in war zones across the world have become a staple of daily news headlines since the invasion of Ukraine in February 2022. In an effort to help, the UK government and grassroots organisations have sent packages of aid — including medicines — to support local healthcare systems. However, pharmacists on the ground have reported that large portions of the supplies sent go to waste and have called for a shift towards aid that is more targeted to the needs of their patients.

In this episode of The PJ Pod, David Lipanovic, senior clinical reporter, speaks to pharmacists with first-hand experience in sourcing medicines to treat patients with both chronic and acute conditions in areas of conflict. We hear from them about what medicines their patients desperately need and what happens to when medicines that are not needed go to waste.

Thank you to Saleyha Ahsan, a humanitarian doctor undertaking research into how patients are impacted by the destruction of healthcare in war zone at the University of Cambridge; María Alejandra Martin Escalona, a humanitarian pharmacist working for Doctors Without Borders; Mark Koziol, chair of the Pharmacists’ Defence Association; and Catherine Duggan, chief executive of the International Pharmaceutical Federation.

This episode was produced by Geoff Marsh, with editorial support from executive editor Carolyn Wickware.

As we reach the end of 2023, this final podcast episode of the year continues our annual tradition of looking back at the biggest stories to affect pharmacy teams across the UK, while reflecting on our highlights from The PJ Pod over the past 12 months.

While 2023 has been a significant year for pharmacy, with the announcement of a new NHS 'Pharmacy First' service in England and accelerating plans for pharmacist prescribers, we also venture to make our predictions for the year ahead.

Please do let us know what you think we have missed in this episode on social media, using the hashtag #PJPod or email us at: [email protected].

This episode is presented by Carolyn Wickware, executive editor, and produced by Geoff Marsh. Thank you to Alex Clabburn, senior editor — research and learning; Dawn Connelly, senior features editor; Michael Dowdall, executive editor — research and learning; David Lipanovic, senior clinical reporter; and Tammy Lovell, RPS correspondent, for their contributions.

From 2026, all pharmacists will be independent prescribers when they first qualify. But that leaves a whole cohort of non-prescribing pharmacists already in the workforce, many of whom do not want to be left behind.

In this episode of The PJ Pod, we accompany three pharmacists — Isabel Macho and Isheeta Mendiratta, who work in primary care, and community pharmacist Rachael Patel — as they train to become independent prescribers. We get the inside track on what motivates them and how they have managed to complete the course alongside a demanding job, as well as the highs and the lows, and whether it was all worth it.

We also hear from Danny Bartlett, a primary care network pharmacist, who is a designated prescribing practitioner and teaches on the University of Brighton's independent prescribing course. He gives insights on how to succeed on the course and what needs to change to smooth the path for more pharmacists in the workforce to become independent prescribers.

This episode was presented by Dawn Connelly, senior features editor, and produced by Geoff Marsh.

In November 2023, an investigation by The Pharmaceutical Journal revealed that two-thirds of patient safety incidents related to homecare medicine provision were for services provided by the company Sciensus, according to the latest data provided by NHS trusts.

The findings came after the House of Lords Public Services Committee opened an inquiry into homecare medicines services in May 2023, following press reports of complaints from patient organisations and others about the service provided.

The inquiry has since published its findings, warning that “serious problems” with the provision and governance of homecare medicines services in England are putting patients’ health at risk.

In this ‘Spotlight’ episode of The PJ Pod, Carolyn Wickware, executive editor, Dawn Connelly, senior features editor, and freelance journalist Alison Moore explain the investigation’s findings, as well as the impact on patients and what the next steps are towards improving homecare services.

This episode was produced by Geoff Marsh.

The term 'deprescribing' refers to the tapering, stopping, discontinuing, or withdrawing of medications for the benefit of patients. It was first used 20 years ago in an article titled 'Deprescribing: achieving better health outcomes for older people through reducing medications' by Michael C. Woodward. Since then, the body of literature has exploded.

In this 'spotlight' episode of The PJ Pod, we talk to the author of a paper about deprescribing inappropriate analgesia in community pharmacy, from our sister journal, the International Journal of Pharmacy Practice (IJPP), and to the guest editor of a themed collection on deprescribing, which was recently published by IJPP. The collection features a range of article types from across the globe and captures the breadth of research that is taking place across sectors in different patient groups, to better understand how deprescribing can become part of routine practice.

Bruton tyrosine kinase (BTK) inhibitors are used to treat cancers caused by defective B cells, such as chronic lymphocytic leukaemia, B-cell lymphomas and Waldenström macroglobulinemia (WM). While B-cell malignancies are relatively rare cancers, their incidence is increasing. There are significant side effects and drug interactions associated with these therapies, and as the clinical use of BTK inhibitors increases, so does the need for pharmacists and pharmacy teams to be aware of them.

In this episode of The PJ Pod, Caitlin Killen, assistant clinical editor, speaks to a patient who has received these therapies, as well as with two experts to find out more about the different BTK inhibitor classes, their mechanisms of action and considerations for their use in practice, with a focus on WM.

In June 2023, The Pharmaceutical Journal revealed that the number of adults in England prescribed medicines for attention deficit hyperactivity disorder (ADHD) has more than doubled since January 2020.

The increase, which was particularly pronounced in females, has been largely fuelled by increasingly frequent opportunities for adults to pinpoint the symptoms of ADHD in themselves, either as a result of COVID-19 lockdowns or owing to growing awareness of famous faces recounting their own ADHD diagnoses.

While the added demand is already seeing patients wait years for treatment from over-extended NHS services for the condition, experts say ADHD is still vastly underdiagnosed.

In this episode of The PJ Pod, executive editor Carolyn Wickware and senior features editor Dawn Connelly take a closer look at the prescribing data and talk about what this increase in diagnoses means for patients and the NHS going forward.

Medicines play a critical role in ensuring that people at the end of their lives, and their carers, can manage symptoms, including pain, and remain comfortable at home.

But there is evidence that the systems supplying these medicines are difficult, complex and often lead to delays in vital care that leave patients in unnecessary suffering. This in turn can increase costs for the NHS if these patients then have to receive emergency care.

In this episode of The PJ Pod, executive editor Nigel Praities examines how this situation can be improved, looking at how medicines supply could be protected, the use of "just-in-case" boxes and how specialist pharmacists can ensure that patients with life-limiting illnesses have effective and compassionate care.

Thank you to Tarun Nayyar, specialist clinical pharmacist at Birmingham Hospices; Sue Latter, professor of health services research at the University of Southampton; and Emyr Jones, consultant pharmacist and national lead for community healthcare in Wales for their input into this episode. Special thanks to patient Suzie*, who allowed us to record her consultation in her home.

This episode was produced by Geoff Marsh.

*The name of this patient has been changed and other details omitted to protect her confidentiality.

The UK government has said it will introduce a ‘Pharmacy First’ service for England by the end of 2023, as part of a plan for recovering access to primary care.

Negotiations are ongoing, but the new service is designed to enable pharmacists to supply medicines for seven common health conditions, including earache, sore throat and urinary tract infections. However, it is not clear whether community pharmacies have the capacity to take on such a large new NHS service and some academics are warning of the potential for “extremely serious” consequences for antimicrobial resistance.

In this episode, executive editor Nigel Praities and investigations editor Carolyn Wickware take a closer look at the plans and the main stumbling blocks to the service’s implementation by the end of 2023.

More information regarding the independent prescribing pilots mentioned in the episode can be found here: https://pharmaceutical-journal.com/article/news/all-integrated-health-boards-in-england-submit-bids-for-pharmacy-independent-prescribing-services

This episode was produced by Geoff Marsh.