“It solidified my decision to pursue a career as a GP Pharmacist.” 

Providing placements is a partnership 

University of Nottingham (UoN) GP placements are a result of collaboration between the School of Pharmacy, Health Education England Training Hubs and GP practices in the East Midlands area. 

Overview of pharmacy student placements 

Placements are designed to provide students with: 
An overview of the key healthcare roles associated with General Practice 
The opportunity to interact with patients and carers 
An appreciation of how primary care and GP services operate 
The placements are offered to UoN Year 4 (final year) MPharm students. These placements are invaluable to the students as part of their learning. The aim is for students to have a high enough level of competency to provide genuine value to the practice during their time in the placement. 
Placements usually last two days and take place in October-November and February-March, but they do have flexibility within the timetable and can work with practices to identify suitable dates. Students usually attend placements in pairs. 

The 3 core placement objectives for UoN pharmacy students 

Understand and observe the different roles and responsibilities of the GP team 
Observe a patient consultation and be able to identify factors supporting the safe prescribing of medication 
Speak to a patient about their health and medicines 
Students are also required to come up with their own personal objectives for these placements, using the SMART objectives criteria. 

Format of pharmacy student placements 

A suggested format for this placement is summarised below. This is designed as a guide and the exact format will vary between placement providers. 
Each placement setting offers unique learning experiences and students are advised to approach their placements with an open and flexible attitude. 

Day 1 

This is structured to allow students to gain an overview of how a GP practice operates and to meet key members of the team. The day should start with induction activities, health and safety, fire alarm/evacuation protocol and a tour of the premises. 
A timetable of shadowing opportunities should be in place to allow students to speak to different members of staff; an example is given below. 

Example of a shadowing timetable 

Practice manager – Induction, tour of building, overview of General Practice infrastructure, organisation and governance. 
Observe patient consultations with a doctor and discuss how GPs make prescribing decisions, manage long term conditions and repeat medicines, and use the clinical system. 
Observe front desk staff/receptionist and discuss triage of queries and decision-making processes etc. Opportunity to discuss management of patient expectation. 
Discussion with prescription clerk(s) to understand the repeat prescription processes and practice policies on repeat medication management etc. 
Lunch (students provide their own). 
Observe a patient consultation with a practice nurse including discussion of different roles (practice nurse/advanced nurse practitioner) and the management of chronic diseases etc. 
Observe patient consultations with healthcare assistant/phlebotomist
Debrief with practice manager including discussion on the business side of the practice, the management of the practice and local initiatives the practice is involved with. 

Areas covered in the induction 

Fire policy/procedures/precautions 
Any specific hazards 
Health and safety precautions 
Hand hygiene/infection control procedures 
Confidentiality and governance 
Introductions to staff 
Location of staff facilities (i.e. toilets, kitchen, rest area) 

Day 2 

The specific format of the second day will vary and will be tailored to meet the individual needs of the placement provider and availability of patients. 
In general, this day should provide students with the opportunity to speak with and interact with patients, and to provide the patient’s clinician(s) with additional information they may not have been previously aware of. 
It is recommended that some time is blocked out with at least one clinician to allow the students to feedback their findings. Below is a suggested activity to do on this day. 

Example Patient Medication Review Activity 

Placement providers have been asked to arrange a patient review clinic, preferably in the morning. It is recommended that no more than 4 patients take part in order to allow time to conduct in depth reviews (approx. 45 minutes per patient). 
Computer access is not part of this activity - students do not need access to the clinical system and prior knowledge of the patient’s medical history is not required. 
The tone of the review should be conversational and exploratory, focusing on rapport, empathy and person-centred care. 
Students should introduce themselves as student learners and explain the limitations of their role (i.e. students are unable to offer advice or guidance to patients. Patients need to be reminded to discuss any concerns with their GP. 

Consultation objectives 

Students aim to find out: 
What medical conditions the patient has 
What medicines a patient is taking and for what 
How are they taking them including how they manage their medicines day-to-day 
What the experience is like for them including side-effects 
What additional support would assist them to use their medicines more effectively 
How the patient’s medical conditions affect their daily lives 
Students may encounter issues that are not normally picked up in consultations e.g. dosage form size, lifestyle issues, social welfare challenges. Students should review the patient’s responses and identify any issues or potential opportunities for medicines optimisation (there may be none). 
At the end of the review, students should compile a query list to present to the patient’s GP. These queries may be prescribing queries, however they may also be questions about medicines the student hasn’t encountered before in the undergraduate programme or use in non-standard ways. 
Students should focus on accuracy with regard to recording the details of the consultation and are advised to take their British National Formulary (BNF). We suggest that one student conducts the consultation, whilst the second observes to provide feedback and then swap for each patient. 

Contact information 

If you would like any further information please contact Julia Thompson, Placements Manager for the School of Pharmacy at the University of Nottingham, on julia.thompson@nottingham.ac.uk 

Student testimonials 

Bottle of white round pills that has spilled onto table
“The placement enabled me to really appreciate and understand the role of the GP in the community. It made me aware of how prescriptions are delivered to pharmacies via EPS and the differences between repeat dispensing and the other way of issuing repeat prescriptions.” 
“I felt that our time actually assisted the care of patients that we talked to and improved patient’s understanding of their medicines.” 
Happy, smiling lady
"Absolutely loved the placement and the opportunity for us to do medication reviews - would happily have done more days!” 
“This was the best placement I have ever had. I felt really involved and was able to see first-hand patient consultations within a GP surgery. I also was able to get involved with my medication knowledge. All staff were really kind and welcoming. I also saw a variety of different conditions which expanded my knowledge. It also solidified my decision to pursue a career as a GP Pharmacist.” 
Clock next to three stacks of varying sizes of coins, each sprouting a flower from the top of the stack
“Very interesting insight into GP surgeries, their funding, time management and overall patient care. Also very beneficial to see a GP practice pharmacist at work as well as undertake our own medication reviews with patients for the first time, giving us the opportunity to assess a patients drugs and their clinical appropriateness as well as provided ideas on how to better structure a medication review with a patient in the future.” 
Tagged as: Case Studies, Placements
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