Thinking outside the box
By Neil Trainis
PUBLISHED: April 19, 2017 | UPDATED: April 19, 2017
Innovation has set Linda Bracewell and Baxenden Pharmacy apart. The Pharmacy Business award winner talks to Neil Trainis…
Linda Bracewell makes innovation sound so simple. Inspiringly simple given the havoc the government is wreaking on community pharmacy and need for the profession to think differently. Outside the box, if you like.
“An innovative pharmacist is someone who has the tenacity to make things happen, to keep pushing ahead with things,” the Pharmacy Business Innovation Award winner says chirpily.
“It can be very hard to do that but independents will always have the edge on the multiples to innovate. They have greater autonomy to do that. Independents have staff around them who they have been used to working with, people they can test things out with, taking part in the right training.
“You don’t get that with the multiples because they have to check things over with head office and they can have different priorities.”
In the 22 years since Linda established Baxenden Pharmacy, situated on a stretch of road in Accrington and a part of town which has a Last of the Summer Wine feel about it, tenacity has taken her a long way. A willingness to stick at something, refusal to throw in the towel even if it may not be working, has seen her clear hurdles.
There was a time, for instance, when she was in direct conflict with the dispensing doctors. Collaborative working appeared tricky. Not now however.
“Independents and GPs invest their lives in their businesses. I wouldn’t say it’s easy to form relationships with GPs. It’s something you’ve got to work at. If it’s about the clinical outcome for patients, I don’t have a problem with that,” she says.
“I know some people have struggled with GPs but I’ve not had any problems with them. If you’re just ringing them about wrong prescriptions all the time, that’s not the basis for a good relationship. If you support them in what they’re trying to achieve, that’s what it’s about.
“In terms of electronic prescriptions we are at between 75% and 80% and that means less deliveries. But that has been down to our good relationship with GPs.”
Linda has not only been steadfastly determined when it comes to developing relationships with GPs. She has found her way around problems through lateral thinking. And at the heart of it all is her local community who she insists is “part of my team” at Baxenden Pharmacy.
Dementia is a prime example. Not many community pharmacists, indeed healthcare professionals of any type, would think about getting patients to play a role in the health and well-being of other people. Convention says patients are not there to treat but be treated.
So when Linda started encouraging members of her local community to become Dementia Friends and inspire sufferers of the debilitating condition to live a full life, a few heads may have turned.
“When I set it up about 22 years ago it was based on the community’s need. The pharmacy has always been at the heart of the community. The community feel like it’s their pharmacy more than it’s mine. They are part of my team,” she says.
“When we started the Dementia Friends training, it was not only for staff. We advertised it for members of the public. They came into the pharmacy and trained to become Dementia Friends.”
Pondering for a moment if those who became Dementia Friends had been personally affected by dementia in some way, Linda says: “Some people came to share their experiences in dementia. It differs really. There were a variety of reasons.”
It has become Baxenden’s signature to get patients actively involved in improving the health of other people. One patient wanted to stage an event to raise awareness of heart disease and Linda decided to hold it at the pharmacy simply because the locals recognise it as the heart of the community.
It does not take great innovative thinking to visualise the role community pharmacy can play in mental health but she suggests healthcare in general is guilty of neglecting it. One hopes the promotional efforts of Prince William, the Dutchess of Cambridge and Prince Harry of Heads Together, a campaign designed to get people talking about mental health, will have some effect.
“Mental health can be neglected. We tend to focus on stop smoking services and weight management and things that are geared around vascular health. But if people get depression or are struggling to sleep, it’s important we help these people,” Linda says.
“Problems sleeping often comes up in pharmacy. It can be an indicator of other conditions. People come in for a product for their sleeping problems and you can sit down with them and talk about why they are having difficulty sleeping.
“It’s important to understand the pattern of sleep problems. Someone working shifts is different from someone who has suffered a bereavement.
“We get people to fill in a sleep diary and give them advice such as not using a mobile or watching television late at night. It gets them to document what their habits are and we give them suggestions about how they can modify their sleep patterns, how they can use techniques to relax.
“There’s massive publicity at the moment about mental health. We have a massive opportunity to raise awareness. People come in asking for advice and products but we know those people very well. We know when they’ve been bereaved, when they’ve been divorced, when they’ve had problems with their kids.
“Without pressurising them, you can give them advice and signpost them. They know when you’re available.”
Linda offers an uneasy chuckle when asked if she thinks the government is aware of community pharmacy’s role in mental health.
“Probably not. But then again, they don’t know a lot of what pharmacists do.”
Her local community is certainly aware of the work she is doing in healthy living. An innovative streak, vision and keenness to explore new avenues led her to indulge in the type of work Healthy Living Pharmacies are doing now – before HLPs existed.
“Before the public health white paper was published, a long time ago…well over 10 years ago…you now have healthy living champions but we started doing healthy trainers. We had a meeting about Healthy Living Pharmacy just after the launch of the national project,” she recounts.
“Deborah Evans, who was managing the HLP project in Portsmouth, was there. I told her we were already doing healthy living and she was very impressed. It’s important innovators lead change in other pharmacies and network so you all learn together.
“The size of the network depends on what you’re working on. In healthy living, there was a network of 50 pharmacies across east Lancashire and Blackburn and Darwen at that time. We’ve now got 100 pharmacies across Lancashire and our ambition is to get to 200 pharmacies across Lancashire.
“It’s important to innovate with the contractual framework we have because that helps us to build new models of care.”
Innovation, vision and hard work may not be enough to save some community pharmacies from closure as the government’s funding cuts start to bite. Linda is almost affronted by the idea that the cuts could imperil her pharmacy.
“Absolutely not. My pharmacy qualified for the pharmacy access payments. It gives us some security for 18 months although we don’t know what comes after that.
“It’s not about chasing up prescriptions but serving the health of the nation. As long as services are funded fairly I see no reason why we can’t build on that.”