Career profile: Rachel Cornish, Lead Pharmacist for Diabetes and Endocrine

What is your job?

I am the Lead Pharmacist for Diabetes and Endocrine at Imperial College Healthcare NHS Trust. I have worked in hospital pharmacy for 7 years and have been a specialist pharmacist in diabetes and endocrine for nearly 1 year. 

How did you become a pharmacist?

I had always enjoyed science particularly chemistry and biology but I did not know what I wanted to do, it can feel overwhelming to have to decide your career path so young but there’s lots of resources to help the decision making! I completed a course with the Open University on ‘molecules, medicines and drugs’ alongside my A-levels which helped me identify a particular area of science that I enjoyed. I also knew I wanted a rewarding job that helps people and I wanted a vocational degree. It was actually my chemistry teacher who suggested I do pharmacy and here I am! At the time of GCSEs and A-levels, I did not realise the vast range of career opportunities within pharmacy and didn’t even realise hospital pharmacists existed.

Once I accomplished the required qualifications, I had the opportunity to rotate through various specialties. I then completed my independent prescribing course with my scope of practice being type 2 diabetes mellitus (T2DM). This is how I identified a passion for diabetes and endocrinology and thus applied for a lead role within this area.    

What do you do day-to-day? 

My day starts by reviewing patients admitted on the endocrine ward; I liaise with members of the multidisciplinary team (MDT) in order to optimise patient’s medications. This involves but is not limited to, reviewing blood tests and advising on dose adjustments in patients with poor kidney function, advising on medication interactions and providing advice on treatment recommendations such as antibiotic choices. I also identify which patients are due to be going home and make sure their medications are ready for discharge and that they are aware of any changes we have made to their medications. 

In addition to the above, I have a role in outpatient care. I review and approve funding for specialist high cost medications within endocrinology, this involves reviewing if patients meet criteria for these and clinically screening the prescriptions to check they are appropriate and the correct dosing.  

My other daily tasks involve work for the directorate. This includes reviewing Trust guidelines to make sure they are updated in line with the latest evidence, completing finance reports to identify medication cost savings within the diabetes and endocrine department and reviewing clinical trials being carried out within the speciality.

I also have a role in education and training. I provide teaching on diabetes and endocrinology to junior pharmacists as well as trainee pharmacists. I also provide teaching to other healthcare professionals such as junior doctors and nurses, ranging from daily informal ward based teaching to more formal presentations.

What qualifications and skills do you need for your job? 

To become a Pharmacist you have to complete a four year Master’s degree in Pharmacy (MPharm) at a University, followed by a one year paid work placement called a foundation training year previously known as the pre-registration year. In order to be accepted onto an MPharm course you typically need three A-levels or equivalent in chemistry and a second science or maths. Alongside A-levels, GCSEs are considered of which you generally need a minimum of five GCSEs including maths, English language and one science. Entry requirements for pharmacy degree courses vary so I would recommend researching this and contacting Universities where required.  

Once qualified as a Pharmacist there are then additional opportunities to further your studies depending on which sector you go into. Within hospital Pharmacy, you complete a post-graduate Diploma in Advanced Clinical Pharmacy Practice followed by an independent prescribing course. 

The key skills required to being a pharmacist would include excellent communication and interpersonal skills, the ability to work as part of a team and with other professionals, and most importantly attention to detail. 

Why did you want to become a Pharmacist?

I knew I didn’t want to be a doctor but at the time wasn’t too familiar with other roles within the NHS, after speaking to my chemistry teacher I then wanted to become a pharmacist as I enjoyed chemistry but I also wanted a patient-facing role rather than being laboratory based. The pharmacy profession combines these elements perfectly and allows for a rewarding and interesting career.  

After working in different specialties and then in acute and emergency medicine, I wanted to then specialise within diabetes and endocrine, the endocrine system to me is the most interesting physiological system and medications can affect this.  

What do you love about your job? 

I love the opportunities for learning and the vast range of tasks that appear on my to-do list! I have been able to attend conferences within diabetes and endocrine which has allowed me to keep up-to-date within the area and network with other healthcare professionals. I am someone who enjoys learning new things so this is definitely an aspect of the job I love. 

Specialising in an area within Pharmacy also means you get to work with two great teams; the pharmacy department itself as well as the diabetes and endocrine team. The diabetes and endocrine team at Imperial are fantastic and it’s great to feel valued within a team. I love that I get to be a part of a team that is complete with a range of other healthcare professionals such as Consultants, Dieticians, Diabetes Specialist Nurses and many others all applying their individual skillset to enhance patient care and learn from. 

What do you find difficult about your job?

There are a few challenges within the NHS and a key one within Pharmacy at the moment is certain medication shortages. This essentially means when there is not enough supply to meet demand of a particular medication. This requires me to look into alternative products including unlicensed versions which can have a big impact on costs within the NHS. Although I enjoy the problem solving aspect, I have found this challenging recently. 

What advice would you give someone interested in becoming a pharmacist?

There are a range of different sectors within Pharmacy such as community, hospital, industry, general practice and the role has significantly progressed. I’d also advise doing your own research on all of the different sectors to get a feel for the skills required in each area and the opportunities available for career development.

Once you have then decided on Pharmacy, be sure to further seek opportunities to work in different specialties to help you identify key areas of interest if you did want to specialise (and obviously I am bias but diabetes and endocrine is the best!). 

How might your job change in the future?

The pharmacy profession has progressed significantly, pharmacists have more of a clinical role to play in a patient’s journey. The degree is changing whereby pharmacists will qualify as prescribers. There are pharmacist-led diabetes clinics. I’d anticipate we will potentially see more pharmacist-led clinics in both primary and secondary care which will further broaden the career opportunities within pharmacy – exciting times ahead! 

Where can I find out more? 

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