Confronting Covid and cancer and changing lives
Independent Pharmacy Awards winner Jackie Lewis talks to Saša JankoviÄ‡ about Lewis Pharmacy’s continuing work to support cancer patients in the community and beyond…
“You can bounce back with vigour from a cancer diagnosis, and life goes on – that’s the message we want to give people”, says Jackie Lewis, explaining the motivation behind the ‘Not Normal For You’ early cancer diagnosis service she has pioneered from Lewis Pharmacy in Exmouth, Devon.
The idea for the service came about six years ago, in a bid to bring conversations about cancer into pharmacy. “I noticed people were coming in to ask me more questions about cancer”, says Jackie, “and although cancer patients were telling us that the secondary care they were getting was great, no one in pharmacy seemed to be talking about cancer much back then.
“What began as a conversation soon grew into offering MURs to customers on cancer-related medication, as well as working with local charities, hospitals and GPs to create a support network for people with cancer.”
Building on her local relationships with Cancer Research UK, Macmillan, Devon LPC, Jackie secured a grant from the Health Education Foundation and the National Pharmacy Association to design and evaluate a service for pharmacy staff to encourage referral of customers with red flag cancer symptoms to enable earlier cancer diagnosis
Called ‘Not Normal for You?’, the service trained 150 pharmacy staff in 10 pharmacies across East Devon to engage patients in conversation and refer on those with red flag cancer symptoms.
The South West Academic Health and Science Network was also instrumental in designing the questionnaire and evaluating the results, which showed 63 per cent of patients given a referral card from the service went on to see their GP.
“All our assistants offering the service know the red flags to look out for when selling OTC for cough and stomach problems”, says Jackie, “and they absolutely shone with these life-saving interventions.
“For example, one of our patients had been coughing for six weeks and our assistant referred him to his surgery. We later found out he had been diagnosed with cancer, and his wife recently called us to let us know he’s in remission.”
Covid and cancer
This level of support for people with cancer has been particularly prescient during the pandemic. Not only have operations been put on hold, but people spotting cancer symptoms have found it hard to see their GP for the early help they may need.
Indeed, figures from Public Health England showed that the number of people diagnosed with early-stage cancer fell by 33 per cent in the first wave of the Covid pandemic in 2020, with potentially detrimental effects on their chances of survival.
Her own diagnosis with breast cancer strengthened Jackie’s motivation to become involved in every stage of the cancer pathway and she says there is plenty that community pharmacy can do to help patients, depending on what their needs are.
“I keep in touch with all my customers having chemo to see how they are getting on, and during the pandemic I have been helping patients having chemotherapy access their Covid vaccinations at the right time in their treatment schedule,” she explains.
Let’s Communicate Cancer
As a member of the British Oncology Pharmacy Association (BOPA), Jackie’s most recent project has seen her create a series of free e-learning modules on cancer which went live on the BOPA website in April.
Developed with a grant from Pfizer, the ‘Let’s Communicate Cancer’ e-learning portal presents healthcare professionals with bite-sized videos, animation, quizzes and slide shows to give the whole of the pharmacy team the confidence and knowledge to better help cancer patients – from early diagnosis through treatment.
“A BOPA committee teleconference in mid-April showed 300 pharmacy staff had already accessed the e-learning and 65 were progressing with it”, Jackie says, “but I want to reach all the 13,000 or so pharmacies in the land. BOPA members mainly work in secondary and tertiary care, but I want this to get out to everyone we can – including undergrads and healthcare professionals outside of the UK – get RSPH accreditation for it and get it embedded in the NHS contract.”
Jackie is also keen for anyone who wants to get involved to take the project forward. “We've kept it off patents and intellectual property rights so that someone could develop it further if they wanted to.”
As well as this wide-reaching approach to patient care, Jackie and her husband run Lewis Pharmacy with a long-standing emphasis on serving their community’s needs – something which has come into sharp focus during the pandemic.
“It's a family business and the team has certainly pulled together during the pandemic”, she says, “not least because we have been using our three consultation rooms to run a covid vaccination service, with help from local GPs, nurses and volunteers from our local community, that has seen close on 1,500 people a week get their vaccination here.”
Jackie is also the local PCN community pharmacy lead and is working with local GPs to roll out the GP Community Pharmacist Consultation Service.
“Whenever we've forayed into this area before its fallen down”, she says, “so this time it simply cannot fail. We really want to make sure our quality of advice in pharmacy meets the expectations of the GPs who are referring patients to us, so we are putting project champions in place who can cover fulltime between them in each pharmacy for consistency of service.
“So far we are progressing well, and there will be a big training event in the summer for all interested parties.”
As pharmacy services begin to get back to some sort of normal as pandemic restrictions lift, Jackie admits that lessons learned during the past year will play in part in the evolution of her business.
“We’ve had nurses from all walks of practice coming to work with us in our pharmacy and I think we will retain some of them when we get back to running our flu clinics, travel clinics and covid vaccination clinics, rather than the pharmacists just downing tools to vaccinate,” she says.
“Plus, this will let the pharmacists deal with the GP CPCS consultations. Life will never be the same in our pharmacy but that’s in a good way.”
Let’s Communicate Cancer training is free to access here.