Kieran Reynolds talks to Professor Alastair Hay and Simran Sirpal about some of the clinical issues surrounding the sinusitis service under Pharmacy First. Discussion includes why intranasal steroids are first line in suspected bacterial sinusitis, treating patients who are breastfeeding, as well as how to administer nasal sprays. (16m 58s)

Professor Alistair Hay – GP & Professor of Primary Care, Bristol Medical School
Simran Sirpal – Community Pharmacist, Sirchem Pharmacy Group
Kieran Reynolds – Specialist Pharmacist (Medicines Governance), SPS

Useful links: 
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
How to use a nasal spray - The British Society for Allergy & Clinical Immunology (BSACI)
https://www.rbht.nhs.uk/sites/nhs/files/How%20to%20use%20a%20nasal%20spray.pdf
NICE sinusitis (acute) antimicrobial prescribing guidance
https://www.nice.org.uk/guidance/ng79

Pharmacy First: Sinusitis

Kieran Reynolds talks to Dr Alicia Demirjian and James Milner about some of the clinical issues you may encounter when providing the new Pharmacy First service to children. Discussion includes practical hints and tips for examining children, how to manage parents’ expectations as well as reassure them about their child’s treatment. (13m 41s)

Dr Alicia Demirjian – Paediatric infectious diseases consultant, Evelina Children’s Hospital
James Milner – ICD Community Pharmacy Clinical Lead, NHS Shropshire, Telford and Wrekin
Kieran Reynolds – Specialist Pharmacist (Medicines Governance), SPS

Useful links: 
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (otitis media (earache)) for pharmacists 
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/earacheotitis-media-advice-sheet
Medicines for Children – how to give different types of medicines
https://www.medicinesforchildren.org.uk/advice-guides/giving-medicines/

Pharmacy First: Children

Kieran Reynolds talks to Professor Paul Little and Simran Sirpal about some of the clinical issues you may encounter when providing the sore throat service under Pharmacy First. Discussion includes the FeverPAIN score, information to provide patients who don’t require antibiotics, strep A antigen tests, and exclusions from the PGDs. (11m 58s)

Professor Paul Little - GP & Professor of Primary Care 
Simran Sirpal – Community Pharmacist, Sirchem Pharmacy Group
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS

Useful links:
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (tonsillitis/sore throat) for pharmacists 
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/sore-throat-advice-sheet
NICE sore throat (acute) antimicrobial prescribing guidance
https://www.nice.org.uk/guidance/ng84
Community Pharmacy England Pharmacy First FAQs
https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first-service/pharmacy-first-service-faqs/
NHS England Direct-to-consumer point-of-care in vitro diagnostic devices for group A streptococcal infections
https://www.england.nhs.uk/long-read/direct-to-consumer-point-of-care-in-vitro-diagnostic-devices-for-group-a-streptococcal-infections/

Pharmacy First: Sore Throat

Kieran Reynolds talks to Professor Nick Francis and Rahul Sharda about some of the clinical issues you may encounter when providing the otitis media service under Pharmacy First. Discussion includes information to provide patients who don’t require antibiotics, signposting to resources to help with otoscope examination and why the otitis media service is limited to individuals aged 1-17 years. (15m 50s)

Professor Nick Francis – GP & Head of School at School of Primary Care, Population Sciences and Medical Education, University of Southampton 
Rahul Sharda - Community pharmacist, Butt Lane Pharmacy
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS

Useful links: 
NHS England Pharmacy First resources
https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Healthier Together guidance (otitis media (earache) for pharmacists 
https://www.what0-18.nhs.uk/professionals/pharmacists/safety-netting-documents-parents/earacheotitis-media-advice-sheet
NICE otitis media (acute) antimicrobial prescribing guidance 
https://www.nice.org.uk/guidance/ng91
Otoscope examination resources: 
CliniSkills: Clinical Examination Skills Training for Community Pharmacists
https://www.cliniskills.com/community-pharmacists/
CPPE: Ear, nose and throat examination – advancing clinical assessment skills workshop
https://www.cppe.ac.uk/programmes/l/ent-w-01/
CPPE: NHS Pharmacy First: Otitis Media e-learning 
https://www.cppe.ac.uk/programmes/l/nhsphfrst-e-01/
British Society of Audiology Recommended ear examination procedure
https://www.thebsa.org.uk/wp-content/uploads/2023/10/OD104-54-BSA-Recommended-Procedure-Ear-Examiniation-February-2022.pdf

Pharmacy First: Otitis Media

Kieran Reynolds talks to Naomi Fleming and Reena Barai about some of the clinical issues you may encounter when providing the uncomplicated urinary tract infection (UTI) service under Pharmacy First. Discussion includes measures taken to limit the impact of antimicrobial resistance from Pharmacy First and why urine dipsticks aren’t recommended in the uncomplicated UTI service in Pharmacy First. (13m 08s)

Useful links:
NHS England Pharmacy First Resources: https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/
Community Pharmacy England (CPE) FAQs: https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first-service/pharmacy-first-service-faqs/
TARGET Treating your infection UTI leaflet: https://elearning.rcgp.org.uk/pluginfile.php/172235/mod_book/chapter/465/TARGET%20TYI-UTI%20leaflet%20V23.5.pdf

Pharmacy First: Uncomplicated Urinary Tract Infection

Kieran Reynolds talks to Sital Shah in our introductory podcast about liver disease. Discussion includes the functions of the liver, difference between liver disease and liver impairment, liver blood tests and how to classify severity of cirrhosis (scarring of the liver) (17m 38s) 

Sital Shah - Consultant Hepatology Pharmacist, King’s College Hospital London and Chair of the British Hepatology Pharmacy Group (BHPG) 
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS

Useful Links
Assessing liver function and interpreting liver blood tests
https://www.sps.nhs.uk/articles/assessing-liver-function-and-interpreting-liver-blood-tests/
British Liver Trust - about the liver
https://britishlivertrust.org.uk/information-and-support/liver-health-2/abouttheliver/
NHS conditions - liver disease
https://www.nhs.uk/conditions/liver-disease/
Calculating and using the Child-Pugh score
https://www.sps.nhs.uk/articles/calculating-and-using-the-child-pugh-score/
British Liver Trust - liver blood tests
https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/liver-blood-tests/

Liver Disease

Kieran Reynolds talks to Naz Kanani Alviri about liver cirrhosis. Discussion includes what cirrhosis is, and how it is diagnosed, the difference between compensated and decompensated cirrhosis, complications of decompensated cirrhosis and initiatives being undertaken to improve the earlier diagnosis of liver disease. (19m 16s) 

Naz Kanani Alviri - Principal Pharmacist -Hepatology & Liver transplantation, Royal Free Hospital, London  
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful Links
Calculating and using the Child-Pugh score
https://www.sps.nhs.uk/articles/calculating-and-using-the-child-pugh-score/
Prescribing weight-adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
NHS mobile testing scheme finds thousands of new cases of liver damage
https://www.england.nhs.uk/2023/10/nhs-mobile-testing-scheme-finds-thousands-of-new-cases-of-liver-damage/

Cirrhosis

Kieran Reynolds talks to Aimee Francisco about drugs in liver impairment. Discussion includes key issues to consider when prescribing in liver disease, medicines to avoid (or use with caution) in liver disease, drug induced liver injury and herbal medicines. (13m 29s) 

Aimee Francisco - Advanced Specialist Gastroenterology Pharmacist at Gloucestershire Hospitals NHS FT and primary care lead at the British Hepatology Pharmacy Group (BHPG) 
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful Links
SPS medicines monitoring tool
https://www.sps.nhs.uk/home/tools/drug-monitoring/
Questions to ask when giving medicines advice in liver impairment
https://www.sps.nhs.uk/articles/questions-to-ask-when-giving-medicines-advice-in-liver-impairment/
Information resources for managing medicines in liver impairment
https://www.sps.nhs.uk/articles/information-resources-for-managing-medicines-in-liver-impairment/
Symptom control in adults with advanced liver disease
https://www.basl.org.uk/index.cfm/content/page/cid/33 (available under Resources)
Prescribing weight adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
LiverTox
https://www.ncbi.nlm.nih.gov/books/NBK547852/
Memorial Sloan Kettering Cancer Center's About Herbs database 
https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search

Drugs in liver impairment

In this extended podcast, Claire Dearden talks to Nicola Stockmann who is the President of the Association of Pharmacy Technicians UK. To celebrate Pharmacy Technician Day, Claire and Nicola look back at the previous 14 episodes of series two of the SPS coffee break conversations with pharmacy technicians. They reflect on each individual podcast and discuss the diverse and inspirational roles that pharmacy technicians hold. This podcast also touches on the Association of Pharmacy Technicians UK and Nicola’s role as President. (27m 27s)

Nicola Stockmann - President of the Association of Pharmacy Technicians UK 
Claire Dearden - Chief Pharmaceutical Officer’s and Specialist Pharmacy Service National Pharmacy Technician Fellow 

SPS series two of coffee break conversations with pharmacy technicians 
https://www.sps.nhs.uk/articles/pharmacy-technician-coffee-break-conversation-podcasts/
Association of Pharmacy Technicians UK
https://www.aptuk.org/

Celebrating Pharmacy Technician Day: a Pharmacy Technician Coffee Break Conversation

Claire Dearden talks to Lucy Featherstone who is an Oncology and Haematology Clinical Trials Pharmacy Technician. Lucy is responsible for managing, organising, and maintaining the oncology Pharmacy Clinical Trials Portfolio. Her role also includes education, leadership, multi-disciplinary working, compliance, as well as developing and maintaining governance frameworks. (6m 21s)

Lucy Featherstone - Principal Pharmacy Technician, Oncology and Haematology Clinical Trials 
Claire Dearden - Chief Pharmaceutical Officer’s and Specialist Pharmacy Service National Pharmacy Technician Fellow

Clinical Trials: a Pharmacy Technician Coffee Break Conversation

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines.  Our motto is 'do once and share'.

New tracks tagged #communitypharmacy