Mike Hewitson’s excellence as a contractor saw him crowned Independent Prescriber of the Year at last year’s Independent Pharmacy Awards for his work at Beaminster Pharmacy in Dorset. Saša Janković caught up with him…

Beaminster may be a small market town in rural west Dorset, but its pharmacy has a large reach. Serving a population of around 10,000 patients within a 15-minute radius, Mike Hewitson and his team at Beaminster Pharmacy dispense an impressive 10,000 items each month and play a crucial role in meeting the needs of their predominantly older population.

Services play a big part in the pharmacy’s offering, including Covid vaccinations, private dermatology services, NMS, DMS, smoking cessation, emergency contraception, flu, travel vaccinations and UTI test-and-treat, with the range boosted by Mike’s Independent Prescriber (IP) qualification in 2021.

“During the Covid pandemic we noticed the number of people coming in for face-to-face appointments was going through the roof as local surgeries couldn’t see patients, but I got frustrated that I had to send lots of them back into a broken system to their GP when I knew perfectly well how to treat them”, says Mike, of the impetus for his decision to become an IP.

In particular, it’s Mike’s innovative approach to dermatology that has set him apart. Recognising the need for timely care for skin complaints during the pandemic, he introduced a dermatology first aid service so that patients no longer had to wait for GP appointments and could seek immediate assistance from Mike, who ended up often being the first healthcare professional to assess their skin complaints.

“I noticed during Covid that we were starting to see more patients for skin complaints in particular and that is really what drove me on to pursue my IP qualification”, says Mike.

“Skin is quite straightforward and there’s not much equipment needed to carry out a successful service as it’s all about a physical examination and taking a history, so it seemed logical that it can be really well done in pharmacy.

“It was also an area I had an interest so all I had to work out was whether to get specialist knowledge in dermatology first or get the IP first – and I decided to start with the prescribing and then went on to do the practical primary care dermatology course at the University of Hertfordshire, which gave me a lot more confidence.”

Coupling his prescribing qualification with this added dermatology knowledge, enables Mike to treat a wide range of skin issues, preventing complications and improving patients' quality of life. Although currently private, the dermatology service has seen impressive success, with over 110 patients benefitting from acute and ongoing skin condition management so far, and the electronic health record system tracking before and after photographs and sharing treatment details with GPs.

“Being able to help people with relatively straightforward skin conditions can make a big difference to their daily lives”, says Mike.

“For example, one particular lady worked as a music teacher and was having a problem with the skin on her hands which was making her really self-conscious but was also very painful. She’d been told it would be a three-week wait until she could see her GP but I was able to see and treat her on the same day, and she was back at work in a few days – which is yet another testament to the accessibility and knowledge of pharmacists, as we well know.”

And Mike has not only improved lives, he has helped save them too, detecting six cases of serious skin cancer, including melanomas and squamous cell carcinomas, which he referred for prompt treatment.

Looking ahead

In no mood to stand still, Mike is also continually advocating for locally commissioned services, and is looking forward to the opportunities that Pharmacy First will extend.

“We've been selected as an IP pathfinder site, which is the NHS’s attempt to work out how prescribing will work in community pharmacy, and that fits really well with Pharmacy First service as well”, says Mike, “which we are confident will increase awareness and drive footfall into pharmacy, as well as making access to healthcare more equitable.”

Mike thinks pharmacist prescribing in particular is “absolutely the future.”

“The whole pharmacy contract is not fit for purpose so that’s why the IP pathfinder project is really important as it will start to reimburse pharmacists who have invested in their knowledge and skills and expertise”, he says.

However, he feels speed is of the essence, adding: “We shouldn’t go at the speed of the slowest which is how the national pharmacy contract has evolved. We shouldn’t be ruling out options based on what some people won’t be able to do this as will always mean pharmacy is moving at a glacial pace.

“We’ve got to get on with getting things done – so, for example, I paid for my own prescribing qualification and covered the backfill cost, because at the time that was the way to get it done.”

Clinical independence

Mike’s advice for other would-be prescribers is to go for it. “You can of course run services using PGDs but you are limited in terms of which types of patients you can help and what you can do for them, which is a bit like being stuck on train tracks and being unable to go off in a different direction”, he says, “so there’s no substitute for having the clinical independence to be able to deal with whatever is in front of you.

“Prescribing is something that pharmacists can do, and shouldn’t be afraid of doing,” adds Mike, although he admits: “If someone had told me five years ago I could do it and do all this stuff, I’d have laughed at them as pharmacists had spent so long being told we weren’t clinical that it does start to sink into the psyche.

“But it’s only by breaking through that thinking that we can remind ourselves that we can, as profession, do all these things that are going to be transformational for our futures.”