by Viv Horton
As an Advanced Clinical Pharmacist for Neurosciences at South Tees Hospitals NHS Foundation Trust with a special interest in Parkinson’s I am involved with patients’ non-oral therapies and refer them for deep brain stimulation. It was Dr Neil Archibald who I work alongside in the movement disorders team who first suggested the MasterClass to me. I felt a little nervous applying; I wasn’t sure about joining a course with consultants and “almost consultants” but Archie assured me I would find it very interesting – and he was right, I have benefited enormously from the course.
I did the Advanced MasterClass (module 1) in June 2016, so reflecting on what I’ve learned is still a work in progress. I’ve continued to work within movement disorder clinic and the Parkinson’s Advanced Symptoms Unit (PASU). In PASU I have been seeing more patients lately whose Parkinson’s is becoming complex and I feel more confident now seeing and managing those patients. I also feel much more confident in helping patients with PSP and MSA too.
Everybody’s needs are different so it’s really useful that the Academy does a needs analysis beforehand which means that as well as covering a range of topics, the course focuses on the things you want to know about.
It was important for me personally to maximise my engagement by disciplining myself to think about what areas I would like to learn more about and doing some reading in preparation so that I knew more about the subjects the speakers were covering.
The teaching at the MasterClass is very high quality and worth the investment of both time and cost. I certainly found that it both challenged and encouraged me; and it is interesting to think that in fact the course might need you and your input. For example, the Parkinson’s nurse specialist who attended our MasterClass was able to provide some really important insights that perhaps nobody else would have known.
One of the things that comes as part of working in a complex clinic is that you appreciate the different roles of the multidisciplinary team by working together so much better for patients. Patients tell us they benefit from PASU because we are able to give them more time, and they can come and see us all at once. The blend of professionals at the MasterClass brings out those strengths of a multidisciplinary approach.
Chatting to the elderly care registrars at the MasterClass I realise that there are so many things we can learn from each other: their specialist skills in dealing with an older person means their approach is valuable; however, I probably see more Parkinson’s patients on a day-to-day basis so I could also offer my experience.
We had a couple of people on the MasterClass who were from other countries; they were picking our brains about services, the challenges involved, technology and access to treatments. It’s interesting to have the opportunity to have those conversations about what is possible and where we are aiming for – it’s inspiring to think about that. The venue was lovely and we had the run of the place, which meant we could have breakfast together in the morning or a drink in the bar for formal and informal networking and sharing ideas with each other.
A lot of the speakers made a point of using the handheld voting system or asking us to shout out ideas – so you couldn’t be passive; you have to be ready to contribute. That’s especially true when it came to the case studies. Looking at the videos of how a patient first presents we were encouraged to ‘say what you see’, and occasionally, that even with 20 or 30 years’ experience you may still not necessarily know and need to proceed with a working diagnosis.
My MasterClass mentor is a pharmacist and in discussion together I had various ideas for my intermodule project. One thing I come across when speaking to patients as part of our “Moving Forward with Parkinson’s” course run by the neurophysiotherapists, is how patients are terrified/overwhelmed when they read patient information leaflets.
So for my project I created a patient friendly information leaflet about common medication for Parkinson’s and the common side effects to watch out for. With the help of various patients, Parkinson’s support groups and colleagues who helped to review it, the leaflets are now awaiting approval by the Trust’s Clinical Standard’s Subcommittee.
They will then be printed to be given to patients when discussing new treatments during clinic appointments and available for self-selection in neurology outpatients. I also plan to see if there is interest in sharing these leaflets with the Parkinson’s Excellence Network and Parkinson’s UK.
The impact of these will be gathered by feedback from patients, carers and the movement disorder team and I am hopeful that the next UK Parkinson’s Audit will reflect patients feel they have more written information.
Since returning for MasterClass Module 2 where I presented my project, I have also been involved in the Academy’s non-oral therapies roadshow speaking to regional colleagues about what to expect when you refer for levodopa intestinal gel.
I also contributed to the recently launched integrated care pathway for non-oral therapies in Parkinson’s around medicines management and nil by mouth, and have produced a simple, quite pictoral, pathway for use in our locality.