The PJ Pod

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: editor@pharmaceutical-journal.com. 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.

***Warning: this episode contains some potentially upsetting content about suicidal thoughts and miscarriage. If you would like to skip this part please fast forward from 09:50 to 17:00*** Julia Robinson speaks with experts in the field of psychedelics and mental health, and hears the personal account of someone with first-hand experience of participating in one of these trials, to uncover the truth behind the hype. Thanks to Sarah Bateup, therapy lead at Clerkenwell Health; David Nutt, professor of neuropsychopharmacology; and David Taylor, director of pharmacy and pathology at the Maudsley Hospital and professor of psychopharmacology at King’s College London. A special thank you to Mat for sharing his story with us. This episode was produced by Geoff Marsh, with support from Nigel Praities.

So-called ‘skinny jabs’ have been heralded as game-changers for weight management. Wegovy (semaglutide) is due to be launched in the UK imminently, will soon be available from community pharmacies, with large chains already setting up waiting lists for people wanting to get the weekly injection privately. In this episode, Nigel Praities, executive editor, talks with Dawn Connelly and Emma Wilkinson about how these injections work, who is eligible for them and concerns about whether community pharmacies can provide the long-term lifestyle and psychological support needed for weight loss to be successful. This episode was produced by Geoff Marsh.

TV personality Davina McCall has been at the forefront of a much-needed sea change in the awareness of menopause symptoms, leading to many more women seeking HRT. However, as demand as risen, there have also been major shortages of certain products and there have also been claims that, in some cases, hormone therapies are being overprescribed. In this episode, Katherine Sole and Julia Robinson speak with two experts on how best to prescribe HRT and how pharmacists can manage difficult conversations when it comes to shortages. Thanks to Paula Briggs, consultant and chair of the British Menopause Society, and Hayley Berry, lead learning development pharmacist at the Centre for Pharmacy Postgraduate Education, for their help. British Menopause Society’s tools for clinicians: https://thebms.org.uk/publications/tools-for-clinicians/ Newson Health Menopause Society’s ‘Easy HRT Prescribing Guide’: https://www.nhmenopausesociety.org/resources/easy-hrt-prescribing-guide/ This episode was produced by Geoff Marsh.

In this second Spotlight episode, we talk through an investigation that has shown the awarding gap between white pharmacy graduates and their ethnic minority counterparts in the UK has narrowed during the COVID-19 pandemic. PJ journalists Dawn Connelly and Corrinne Burns share the inside story on how they put the investigation together, what the results show and their potential implications for more inclusive teaching on the pharmacy degree after the pandemic. Read the full investigation here: https://pharmaceutical-journal.com/article/feature/infographic-the-ethnicity-awarding-gap-for-the-pharmacy-degree-during-covid-19 This episode is presented by Nigel Praities, executive editor, and was produced by Geoff Marsh.

In this learning episode, we have enlisted the help of two experts to explore what it takes to deliver effective deprescribing and ask what pharmacists can do to help patients get the most from their medicines. For links to relevant articles and further resources on deprescribing visit the PJ website: https://pharmaceutical-journal.com/article/feature/effective-deprescribing-getting-the-most-from-medicine Many thanks to Lelly Oboh, consultant pharmacist in the care of older people at Guys and St Thomas’ NHS Community Health Services, and Tony Avery, GP and NHS England’s national clinical director for prescribing, for their expertise. This programme is presented by Alex Clabburn, senior editor, research and learning, and was produced by Geoff Marsh.

In the UK, three babies are still being born each month after being exposed to sodium valproate. This is despite the risk of foetal valproate spectrum disorder being known about for many years. In the first of a series of shorter ‘Spotlight’ episodes, executive editor Nigel Praities speaks with senior data journalist, Julia Robinson, about her recent investigation into this issue and whether NHS England is on track to meet its target to reduce the use of the drug in people who can get pregnant by 50% by the end of 2023. Julia also gives an insight into new research that may suggest the risks from sodium valproate and other drugs used for epilepsy may have been underestimated. Click here to read the full investigation: https://pharmaceutical-journal.com/article/feature/why-is-the-uk-struggling-to-contain-its-sodium-valproate-problem This episode was produced by Geoff Marsh.

The COVID-19 pandemic has starkly exposed how inequalities in health can be affected by factors such as ethnicity, gender or geography — and all the evidence points to these getting worse. But in this episode, we hear from two pharmacists trying to turn this around. First, Ade Williams, superintendent pharmacist at Bedminster Pharmacy in Bristol, explains how he used a "Pulse in the Pub" blood pressure checking service as a springboard to better understand his local community’s health needs. Second, Suhayla Dhanji Merali, advanced specialist pharmacist at Central and North West London NHS Foundation Trust, speaks about her outreach work in perinatal mental health, going into local mosques to help people get the support they need. Lastly, Carolyn Wickware, investigations editor, outlines new data that shows how funding cuts are putting much-needed pharmacy services at risk in England’s most deprived areas. This episode was presented by Corrinne Burns and produced by Geoff Marsh.

Will pharmacists go on strike over pay? Will medicines shortages improve? What will be the biggest clinical developments next year? The team unpicks some of the biggest pharmacy stories of 2022 and shines a light on what pharmacists should expect in the coming 12 months. Please do let us know what you think we have missed in this episode on social media, using the hashtag #PJPod. See you next year! This episode is presented by Nigel Praities, executive editor, and produced by Geoff Marsh. Thanks to PJ journalists Corrinne Burns, Dawn Connelly, Carolyn Wickware and Julia Robinson for their contributions.

Two years since the Royal Pharmaceutical Society (RPS) took on responsibility for approving consultant pharmacist posts, we look at how these roles are evolving. We also ask how many consultants the profession needs, look at the barriers to reaching this level of practice and explore how the path to becoming a consultant could be made easier. Thanks to Hannah Beba, consultant pharmacist in diabetes at West Yorkshire Health and Care Partnership; Paula Crawford, consultant pharmacist for older people services within the Belfast Health and Social Care Trust; Rani Khatib, consultant pharmacist in cardiology and cardiovascular clinical research at Leeds Teaching Hospitals NHS Trust; Andrew Radley, consultant in pharmaceutical public health at NHS Tayside. Thank you also to Paul Forsyth, lead pharmacist in clinical cardiology (primary care) at NHS Greater Glasgow and Clyde, and Joseph Oakley, associate director of education and professional development at the RPS. This episode is presented by features editor Dawn Connelly and produced by Geoff Marsh.

Anticholinergic drug use is on the rise due to the COVID-19 pandemic and the UK medicines regulator is also considering extending access to the anticholinergic bladder drug oxybutynin over the counter. In this episode, we will look at the potential implications of these changes, particularly in older people, and examine the case for deprescribing. We will also assess emerging evidence that suggests that the cumulative burden of anticholinergics over a lifetime could be a causal factor for dementia. Thank you to Graham Stretch, chief pharmacist at the Argyle Group in west London, his patient Miriam* who agreed for us to record her consultation, and also to Chris Fox, professor of clinical psychiatry at the University of East Anglia. This programme is presented by executive editor Nigel Praities and senior data journalist Julia Robinson. It was produced by Geoff Marsh. *Some details have been changed to ensure confidentiality.

In this episode, Caitlin Killen, assistant clinical editor, and Alex Clabburn, senior editor, enlist the help of two experts to explore what the rise in immunotherapy treatment means for the ongoing care of cancer patients. Many thanks to Dharmisha Chauhan, lead genomic clinical pharmacist for North Thames Genomic Medicine Service Alliance and specialist oncology pharmacist at The Royal Marsden NHS Foundation Trust, and Stuart Evans, cancer pharmacist at South West Wales Cancer Centre at Singleton Hospital and Swansea Bay University Health Board for their expertise. For a list of related immunotherapy resources and links to the research mentioned in the podcast visit the PJ website: https://pharmaceutical-journal.com/article/feature/immune-related-cancer-toxicities-what-pharmacists-need-to-know This episode was produced by Geoff Marsh and was supported by Merck.