Interviews...

Since interviews are around the corner (some already past, some tomorrow) I thought I would put together a few summaries, hints and tips that I compiled through my own interview prep. As you've probably guessed I passed the London Collaboration assessment along with half the world and now need to prepare for the interview. For about a week I was struggling to figure out what on earth I was expected to do in preparation and below I have listed some pretty important/ good documents to read before your interview.

Note: this list isn't by any means exhaustive so read, read, read whatever you can find. The more reading the better!

The Five Year Forward View (October 2014):

This I didn't actually read because these documents are long and complex and who has time, really?! So here's an amazing video summarising the whole thing that you can watch on your way to work, uni...wherever. Yes it's over 20mins long but no pain no gain right?

5 year forward view

Delivering The Forward View (December 2015):

This one I actually tried to read and I struggled but luckily I've summarised what I found below so you don't have to.

• Delivering the forward view was designed to implement the five year forward plan and upholds the 'mandate to NHS England', a settlement between the government and the NHS.

• The document is split into 2 plans. The first is a five year Sustainability and Transformation Plan (STP), the video for which is below. This part covers from October 2016 to March 2021 and will be formally assessed in July 2016. This is the main part of the reform and will be planned by the individual institutions.

• It will be the first NHS planning process with significant central money (part of the £560 billion NHS fund for this process) and will be the 'single application and approval process for being accepted onto transformational programmes' from 2017/18 onwards.

• Nonetheless this money must be allocated with care as each trust must have a good end-of-year financial outturn in order for the plans to work well. This is a big aspect of the plans as financial balance is an important factor in any system, especially the NHS. This will mean focus on areas such as emergency care which are known to be a problem in terms of waiting times and costs already. Prevention is also key along with care redesign all of which are areas pharmacists could be the solution for.

• The other phase of this process describes the Operational Plan for 2016/17. This is a one year process and, from my understanding, aids the changes implemented whilst working side by side with the emerging STP. This one will be specific for each trust /CCG. This part really confused me but I think it manages the commissioning of services to providers and the management of finances and quality of services. This was actually a major issue highlighted in an article in the PJ where the NHS was called to become more transparent with finances in this department and it was thought to be wasting a lot of money (If I find the link I'll post it below).

I'm not going to waffle to much because, to be honest, I'm still trying to get my head round the whole thing. But here's the link to a document by PSNC, summarising the effect of these changes on pharmacy. It focuses mainly on community pharmacy in the document but this can easily be used to understand what it would mean for hospital pharmacy.

The elements of plan which are of most relevance to pharmacy

NHS 5 Year Forward - STP

Other Documents:

In addition to these two documents there are a number of other documents that you would need to have a vague knowledge off. These include the Francis report and the Carter report, one of which actually came up in the assessments. There are summaries for everything online so this shouldn't take up too much time.

What Else:

Additionally you would need to be up to date with pharmacy news. The Pharmaceutical Journal is an ocean of knowledge in this department so make sure you read it! There are 3 articles I found quite interesting which I have shared below. One describes the low rate of detected ADRs in under two's, another is pharmacist-led anticoagulant clinics (which helps alleviate some of the stress on the NHS), opioid dependence and talks of a seven day hospital pharmacy service.

Adverse drug reactions underreported in children aged under two years

Assessing the impact of a targeted pharmacist-led anticoagulant review clinic

The measurement and treatment of pain needs to be reassessed

NHS England sets out recommendations for seven-day hospital pharmacy services



This should be enough for now, I think.

Make sure to prepare the regular, why hospital pharmacy?.. Tell us a bit about yourself.. questions as well. There's also plenty more tips on Pharmalife and on online forums, so use those too!

Good Luck & Happy Reading!

S.

The London Collaboration - Stage 1 Assessment (The Good, The Bad and The Ugly)

On Wednesday I sat the Stage 1 Assessment for the London Collaboration and it was one of my most nerve-wracking experiences to date. This was not because I hadn’t covered enough material (although I probably didn’t) or because the calculations were too difficult. This was mainly due to the fact that we had no idea what to expect. There was very little guidance on the emails sent as to what the paper would look like and it was the fear of the unknown that made me so uneasy. Being the first year to go through this process didn’t make matters easier too as we literally had nothing to go by.

I understand that the Thames Valley Assessment on Thursday had a similar layout so I’ve summarised each section below. I have also included some of the experiences from people who also sat the exams for both The London Collaboration and Thames Valley and things I would have done in hindsight.

Prioritisation:

So I left this section till last simply because I knew it would confuse the hell out of me and it would be smarter to do the more straight forward sections first. I don’t think there is a right or wrong answer for this but they will be using this to gain an insight into your approach to problem solving. In the scenario we had you were a pre reg trainee who had a 26 week appraisal coming with your mentor. You also had an audit meeting the following Monday, a friend that needed help with a case study presentation, an outpatient that needs to be called for their medication and a 2 week community placement to sort out. Oh and a doctor waiting for information on a patient. This scenario required you to priorities each task and state whether they were high or low priority with a reason. There were only about 3 lines to write this on so you had to be really concise. In these scenarios it is important to consider whether or not there are any other members of staff free to help. It’s also good to think about whether there might be a better department to direct questions to. For example if the doctor wanted to know information regarding medication, does the hospital have a Medicines Information Department? If it’s a clinical trials prescription, is there a clinical trials pharmacy? Also you need to remember that you are only human so putting many things on high priority can exhaust you which could put patients at risk. Don’t bombard yourself with work and take your time with these scenarios.

Numeracy:

I did this section first because I personally find that calculations are easier to do when your mind isn't worrying about how badly you did in another section or another question you skipped. This section wasn't too bad. It was more clinical than anything we did in OSCE calculation stations at Uni. But that was expected. There were questions related to Creatinine Clearance, formulations switches, quantity to dispense and strength calculations. These were all quite straight forward and could be done pretty quickly with the use of a calculator. The only suggestion I would make here is to make sure you take a look at the answer sheet. There was a particular way they wanted us to write our answers down and so it is important that you read the instructions before anything. Also there are many books on pharmacy calculations and pre reg past papers available. Use them!

Clinical Assessment:

This was an interesting station which many disliked. Funnily enough I quite liked the clinical station and found it to be one of my better stations. This was in the form of multiple choice questions and contained a few extended matching one (similar to the pre reg paper). For this station I was afraid that I had forgotten all my clinical knowledge over the summer and was frantically trying to memorise my OSCE notes from the previous year. However this was all futile revision as the questions seemed mainly focused on counselling points of medication. All I can remember from this section was the antibiotic side effects and counselling points that formed 5 of the 10 questions in this section. This isn't because I struggled with them but because I kept hearing how much people hated those questions because they hadn't revised it. Luckily for me, counselling on a daily basis in the Outpatient pharmacy where I work has meant that all those points were already ingrained in my brain. I would highly recommend getting a part time job in a pharmacy as this reinforces all the learning at Uni. The extra cash at the end of the month is just a bonus. In addition to this I worked through a few pre reg papers whenever I got a chance at work. This was because I didn’t fancy reading lecture note after lecture note. I had tried that for a day and got bored, so working through old pre reg papers just helped me see what I knew and taught me what I didn’t. (Plus one of the questions from the pre reg paper actually came up – written differently of course. So it works)

Pharmacy in Practice:

This section actually threw me off. It was filled with questions I had expected to be asked at the interview stage. There were numerous questions about the Carter report, the code of ethics, the NHS constitution and the 76 performance standards for the pre reg year. No one I spoke to had expected it and it came as a surprise. There were a few other questions on prescription legalities and CDs but these were the ones that stumped everyone. Moral of the story: Learn EVERYTHING!!! Even if it means reading hundreds of PJ articles or reading pharmacy news every morning with breakfast, DO IT!

                                                                      

Overall advice:

• ·         Manage your time during the exam – the time flies by and before you know it the hour is over. Make sure you leave ample time for each section. If you’rebad at a section leave extra time.
• ·         Time management also includes your journey time – Aint nobody gonna wait for you!
• ·         Read the five year forward plan, the Francis report, the Carter report and any other report they release in the next year or so. Even if you read the summary it’s better than nothing.
• ·         Practice Practice Practice those calculations because you need to be quick with those calculations

And that’s it!

Our results should be out by Wednesday so whether I passed with flying colours or failed miserably I shall let y’all know. Stay tuned…

   

      *Special thanks to Zahra who helped compile the tips and experiences!*

S.