There are key points in the cancer pathway when a Clinical Pharmacist can be involved:

• Medication Review and Optimisation post diagnosis and pre treatment
• post treatment
• follow up of end of treatment summaries that have medication advice
• Palliative and EOL
• Care Home Residents
• Tackling inequalities

Clinical Pharmacists are not only expert in medications they are prescribers this enables them to make changes to current regimes stopping and starting medications and actioning requests from secondary care.  They complete medication reviews for any non-elective secondary care admissions over 60 years of age.  Often important medicines such as analgesia and anti-emetics are not put on repeat therefore delaying patient access to medication.  There is potential for Clinical Pharmacists to lead on QI projects looking at medication access and Oral Nutritional Supplements for cancer patients.

Clinical Pharmacists are often involved in Enhanced Health in Care Homes many of these patients will have cancer or have been admitted to care home for palliative reasons – they are often involved in the optimisation of these patients providing assisting with end of life medications.

A clinical Pharmacist can support the following:

Prevention

• Making Every Contact Count
• Healthy Lifestyle advice
• Signposting to services

Screening

• May pick up screening not completed during routine medication reviews

Early Diagnosis

• Knowledge of signs and symptoms of cancer and recurrence

Personalised Care

• Management of symptoms of cancer and its treatments (key areas are likely to be around pain, nausea and constipation)

Medication Review

• Analgesia
• Access to medications
• Processing secondary care requests for medication and changes
• Managing side effects of medications
• Monitoring medications
• Nutritional supplements review
• Problems taking medications/swallow

Patients and Cancer Nurse Specialists often report issues with timely access to medications for pain relief, constipation, nausea.  This leads to added anxiety, discomfort and potentially admission to hospital. Pharmacists could be a resource to improve this situation through service improvement and driving better links between secondary and primary care.

We can offer training and education to help you support and provide personalised care to cancer patients, improve your cancer knowledge and understand what is available to support cancer patients in your area. Please see here for more details (Appendix 7).

We welcome ideas on further training needs or innovation. If you are interested in quality improvement within your PCN including improving access to medications and optimisation, please do contact us to discuss further.

Wessex Cancer Alliance provides a Primary Care Newsletter which provides up to date information and education offers. Please contact us if you would like to subscribe.

Macmillan also provide a Primary Care Update which includes latest developments, learning and case studies relating to cancer across primary care, to sign up please access the following link: Sign up for Primary Care Update – Macmillan Cancer Support

We have provided some insight on how you could utilise a Clinical Pharmacist and how this will help deliver the GP Contract DES and other primary care responsibilities (Appendix 9).

Clinical Pharmacists are embedded in most PCNs but If you would like more general information about the Clinical Pharmacist role and supportive documents, please access Wessex LMCs: PCN Workforce – ARRS  and Clinical Pharmacists – Dorset Primary Care Training Hub (primarycaredorset.co.uk)

Wessex Cancer Alliance provides a Primary Care Newsletter which provides up to date information and education offers. Please contact us if you would like to subscribe.