Interview with Dr Nuttan Tanna, Pharmacist Consultant in Women’s Health & Older People

How did you get to where you are today?

Early in my career, I had to make a decision on my future pathway. I could either progress with the dynamic multiple company that I was working with, or I could apply for a more clinically oriented role at a local health centre run by four GP partners. Working closely with patients and clinical teams had always been how I had envisaged I would work, so I opted for the health centre job.

I undertook postgraduate study at King’s College London, with conversion to a PhD research program. I studied the benefits of having a specialist pharmacist working in the hospital outpatient clinic setting to support patients and multi-disciplinary teams in secondary and primary care sectors.

I presented the results at conferences in Australia and in the UK, which provoked a lot of interest and discussion on how pharmacists could support clinically oriented patient care. Remember, this was back when pharmaceutical advisor and formulary pharmacist roles were new, with appointments in primary care to ensure cost effective prescribing and management of prescribing budgets, and the emerging development of advanced level practice by pharmacist peers in secondary care.

What is your role today?

I run two weekly medication management clinics at Northwick Park Hospital. The first is a Mid-life Women’s Health Care clinic for women with premature ovarian insufficiency, high risk menopause management cases and it has a dedicated clinic for women with breast cancer in their survivorship phase. We accept referrals to the service from primary care and cross referrals from other directorates within the Trust. We also receive out of area referrals as our service is recognised as providing gold standard care. 

I love attending conferences; each time I am inspired with new ideas on improving patient care delivery.              

The second weekly clinic sees patients with osteoporosis and risk of fragility fractures. My oldest patient in this clinic is in her 90s and on multiple medicines, and we have built up a rapport which has helped with good adherence with her bone sparing treatments and de-prescribing to help reduce her medicines burden.

You were one of the first pharmacists to demonstrate consultant level practice, how did that come about?

The competencies that you need to demonstrate or work towards for advanced level practice as a consultant pharmacist include pharmaceutical or clinical care, research and development, education and training, management, leadership and policy work. When Consultant Pharmacist posts were established in the UK the competencies for my role were reviewed and my post was put forward for ratification for this title.

How has the UKCPA community supported you during your career?

I have been a member of UKCPA for a long time. What I find invaluable is the ability to discuss various issues on the forums, network with peers and the numerous opportunities to attend masterclasses and conferences for networking and professional development. I have also been a member of the General Committee, the Education & Training Group Committee and the previous Research & Development Committee. I have championed the establishment of the Women’s Health Group and I know that the current committee will take it from strength to strength.

What research are you involved in now?

As part of my research commitment in 2015, I worked with colleagues at Northwick Park Hospital on a service redesign project for elderly fallers. We considered the support that these patients might need at various stages of their journey, including in the community, within primary care, secondary care and at the interface. I conducted a literature review of the evidence base for medication review in elderly fallers, which was published in 2016.

The paper is included, along with other references, in the Consensus Briefing and Resource Pack developed by the Public Health England National Falls Coordination Group, on which I represent the Royal Pharmaceutical Society.

In another project, we have received funding from the Charitable Trusts to evaluate the improvement in clinical care delivery with use of the iNSight software which allows us to request trabecular bone scores (TBS) when a DEXA bone scan is done, and use this additional information to critically assess the risks for vertebral fractures. A third of vertebral fractures are never identified, so you can understand why the TBS score is going to be so important. I’m really looking forward to running this exciting project.

You were awarded Menopause Specialist accreditation by the British Menopause Society – congratulations! How is this accreditation awarded?

For accreditation as a specialist, the applicant must demonstrate a portfolio of patient care cases and confirm that they see at least 50 new menopause cases a year. The applicant must be a member of the British Menopause Society and attend the national or international conferences to demonstrate ongoing professional development. I love attending conferences; each time I am inspired with new ideas on improving patient care delivery.              


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