Insight: Advanced Pharmacist Addictions x Laura Wilson

I qualified as a pharmacist in 1999 after completing my pre-registration year in community pharmacy.  My aspirations were to work in a hospital setting, and I achieved that in December 1999, however, after 9 months working in a dispensary role I realised I missed the daily patient contact and fast pace of community pharmacy, so I returned.  

Once back, I quickly realised that one area of community pharmacy I had missed the most was working with patients receiving treatment for their opiate addictions.  I embraced this interest and spent the next 14 years building up an extensive opiate replacement therapy service for over 100 patients in my pharmacy and completed my independent prescribing qualification in addiction psychiatry.  My goal then became to work within the health board shaping how addiction services are delivered in community pharmacy. I started working for NHS Greater Glasgow and Clyde in October 2013 as an advanced pharmacist in addictions.

Within addictions services, pharmacists are taking on more extensive roles; they can be full or part time prescribers based within local community addiction teams and/or take on supporting and advisory roles for the health board.  Working as a prescriber within an addiction team gives pharmacists an opportunity to work as an integral part of a multi-disciplinary team. Pharmacists are also heavily involved in new developments within the health board, such as the enhanced drug treatment service.  We are also supported to undertake further studies relating to our roles, and I have completed certificates in the management of drug misuse as well as drug and alcohol studies.  

My role encompasses a number of different aspects, and I have the opportunity to work on a number of varied work streams.  On a day to day basis I provide support for almost 300 community pharmacies that provide an opiate substitution therapy as well as some addictions commissioned services, such as in-patient centres.  This can take the form of something simple such as a telephone call offering advice and can be as in-depth as a visit to review systems and processes, particularly after an error has occurred. As a team, we provide training and support to pharmacies offering an injecting equipment provision service which is part of a number of harm reduction programmes offered by the health board.

My role also involves aspects of service design and strategic planning.  Over the last 4 years I have been working on the implementation of a new payment model for community pharmacy contractors providing a service to addiction patients.  I was responsible for the design and testing of a new online module which challenged my IT skills but also gave me the chance to push myself and increase my knowledge.  I also had to plan the implementation to ensure the smoothest possible transition for the already busy stores. The whole project involved a lot of multi-disciplinary working with different stakeholders, from computer programmers, to local contractor committees as well as other staff within the health board.  Ongoing, I manage the claims for this service and help with any issues staff have using the module.

 I am the representative for the specialist pharmacist in substance misuse group on Her Majesty’s Prison Inspectorate team.  I visit prisons and provide advice to the inspection team on all issues relating to addictions and prescribing. This is a really interesting and challenging part of my role and one I thoroughly enjoy.

Working for the NHS, and with the support of my line manager, I was able to undertake a secondment to the University of Strathclyde to work part-time as a teacher-practitioner for a two year period while still carrying on my addictions role.  During this time I was able to advise on the addiction content of various courses at the university including the independent prescribing and post-graduate MSc courses. I gained experience in teaching a variety of subjects and have continued teaching in conjunction with the University and NES on addiction related courses.

A career in addictions is an interesting one which allows you to build a good base of transferable skills.  You will be challenged and given opportunities to form excellent working relationships with a number of different groups and disciplines.  Regardless of the field of pharmacy you go into, you will encounter patients with addiction problems. Treating these patients can come with a unique set of issues, for example, pain relief in palliative care or even managing poly-pharmacy in the ageing drug using population.  It is vital as a student to gain as much experience as possible working with and treating this group of patients. Forge links with your local specialist pharmacist in addictions and try to gain as much experience during your pre-registration year as possible. This will stand you in good stead for the career ahead of you and the work you do with patients suffering from addiction issues.  


This article was written by Laura Wilson


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