Vicky Bull wins pharmacy technician award for new falls and frailty clinic

Pharmacy technician Vicky Bull has won a national award for the work she’s done to help reduce falls across Mendip.

Vicky, who’s also our community rehabilitation manager for the Mendip area, found out she was a winner at a coveted awards ceremony held in Nottingham earlier this month.

The awards celebrate and acknowledge successful individuals, teams and projects within the pharmacy technician profession.

Vicky has been a pharmacy technician for over 30 years, and has experience working in community pharmacy, GP practices, the medicines management team at the former Somerset Clinical Commissioning Group, and our very own community rehabilitation service.

She was nominated for an award by Amanda Jones, our community rehabilitation service’s pharmacy technician, who also works in the Mendip area.

Vicky says she’s proud that the achievements of both herself, and her team, have been recognised, after they worked hard to successfully introduce a falls and frailty clinic, based out of Frome Community Hospital, which she says is making a huge difference to the lives of patients in Mendip.

“The clinic idea first came about when I was contacted three years ago by Dr Helen Milbourn, a geriatrician from the Royal United Hospitals Bath,” says Vicky.

“Dr Milbourn had moved from London, and wanted to bring to Somerset the same type of multidisciplinary falls and frailty clinic that she’d run in the capital.

“As part of this, we wanted a physiotherapist in the clinic for the physical assessments, a pharmacy technician or pharmacist for the medication reviews, and a nurse for the physical observations and blood pressure checks, with Dr Milbourn then reviewing the overall care.

“When we initially started the clinic, our medicines management team agreed to provide a pharmacist one day a month. The Frome Hospital clinic has grown so much over the last three years as we tend to see about 10 patients in a morning, with Dr Milbourn also bringing a registrar doctor along with her.

“It’s a bit of a ‘one stop shop’ really, as we have colleagues from primary care, secondary care and community services all working together to assess a patient’s goals, as well as the challenges they’re facing.

“At the same time, we also look at the quality of life for each individual patient who is at risk or has experienced a fall, considering any other conditions they might have that they aren’t currently on medication for, such as bone health. Dr Milbourn will refer on for further tests and assessments if identified in clinic.

“By providing this level of personalised care we’ve been able to increase the number of patients we can see on a caseload.

“If we feel that the patient needs a home environment assessment, or even equipment such as walking aids, then we can offer this as part of the same clinic.

“We were also able to spread the learning from our first clinic in Frome, as we opened a similar service at Shepton Mallet Community Hospital, with another geriatrician from RUH Bath, and a pharmacist from the primary care network involved – a great example of working together for the benefit of our patients.”

Vicky explains why the team’s work in setting up this sort of clinic is making a positive impact in helping to avoid potentially devastating patient falls.

“As we age and become frail, the risk of a fall increases and sometimes this can be caused by medication that a person may still be on, despite being prescribed it many years ago for a different condition,” she adds.

“For example, it could be that someone was prescribed medication for a painful knee when they were younger, but they can’t process the drugs in the same way when they’re 80, and they also experience a lot more side effects as they age, which can cause falls and other problems.

“At the falls and frailty clinic, we look closely at why the medication was started in the first place, and how long they’ve been on it, when it was last reviewed, and whether they’d been on any other medication during this time. We also consider whether it’s still needed and if it’s actually benefiting them.

“As part of this medication review, we’ll also check out their kidney function, look at anticholinergic burden and try to reduce that pill burden, which is a big problem in the elderly population and can cause confusion.

“We make sure that patients themselves are part of that decision making, and if they don’t want to stop something then that’s fine, and we’ll just discuss the risks and benefits with them instead.

“When we check a patient’s bone health, we’ll look at their previous fracture history as well as falls and we complete a FRAX test, which calculates a score and identifies their risk of breaking a bone.

“From this we assign them either into the high-risk group, where we treat their condition if their kidney function is within range. If they are medium risk then we send them for a bone density (DEXA) scan to check the strength of their bones, and if they’re low risk we give dietary advice, and ask the GP to monitor.

“I don’t think this would have been possible without a collaboration of colleagues like Dr Milbourn, our physiotherapists Jonathan Moore, Hanna Holmqvist, Charlotte Dunn and our pharmacist Sian Enos – they played a huge part in setting up that first Frome clinic.

“We’re now looking to extend this service in the near future, likely at West Mendip Hospital in Glastonbury, possibly with a Yeovil Hospital consultant involved, so we can see these patients at an earlier stage to try to avoid their conditions from getting to a more serious stage.”

Dr Milbourn adds: “Vicky's hard work and tenacity has been paramount in setting up and maintaining the clinic.

“Pooling resources across different trusts and primary and secondary care settings isn't easy, but Vicky's experience and vision has ensured an effective and cohesive multi-disciplinary and patient-centred service which runs efficiently."

Thank you and well done to Vicky and her team on the award!