Real-life story - Hassan Hajat
Hassan became interested in the problem of substance misuse when working as a community pharmacist. Now self-employed, he works with Derbyshire GP practices and Derbyshire Health Care Foundation Trust, delivering anticoagulation (blood-clot prevention) and substance misuse clinics.
How I got into the role
I wanted a health care career where I could work independently but also have direct contact with patients. Having trained as a pharmacist I began my pre-registration year with Boots and was then employed by an independent community pharmacy company as a community pharmacist (independent in this sense means a private company rather than an NHS-provided pharmacy service). My interest in substance misuse grew through the provision of services such as the supervision of methadone, and needle and syringe exchange.
In April 2003 I took up post as a senior commissioning manager with Derbyshire County PCT. In this role I advanced my specialist knowledge in pharmacy policy-making and the clinical aspects of quality assurance. For example I led on the commissioning (planning and purchasing) of a new type of anticoagulation service that would better meet the needs of patients. I also undertook the Royal College of General Practitioners' (RCGP) substance misuse programme as well as coaching and leadership awards. Additionally, I became a tutor for the University of Manchester Centre for Pharmacy Postgraduate Education (CPPE), which helped me develop my training and teaching skills.
After voluntary redundancy from the PCT, I set up a consultancy, sPharmex Ltd. My consultancy work is contracted by various organisations including Trusts and GP practices to provide substance misuse and anticoagulation clinics (including the prescribing of medication). It also involves working with organisations wanting to develop and deliver a range of health related training programmes.
Learning from the NHS Leadership and Top Talent programmes as well as experience of leading high-profile projects, I got involved in a range of new services that aimed to enable patients to take the lead in their own recovery through their lifestyle behaviour.
What I do
For the past seven years I have been providing clinics in a variety of settings. I see clients who have either referred themselves to our services or have been referred by GPs, community services or prisons. Clients may be involved in the misuse of alcohol or other substances including legal highs, or in the abuse of prescribed medication. On three days of my working week I usually hold two clinics. My work is with clients to improve their understanding of their psychological interaction with their social environment and how they respond to particular situations. This work takes a motivational interviewing approach; it also involves prescribing substitute medication. Clients move towards becoming stable and recovery; it is a process that may include detoxification programmes and rehabilitation.
During 15-minute appointments at my clinics, I see regular patients as well as those newly referred. Clinics are supported by administrative staff and drug (Key) workers are assigned to each client. The frequency of a client’s appointments is dependent on their risk and need.
My other area of interest, anticoagulation, came as a result of starting up new services across the PCT, shutting down the existing secondary care services, and project managing the delivery of all aspects of the new service. Through this work I have been involved in running services in primary and secondary care, delivering regular training courses for GPs, nurses and pharmacists and reviewing services for CCGs.
I enjoy training and helping others to learn. This involves designing, developing and delivering learning modules to diverse audiences for a variety of organisations.
The best bits and challenges
Providing substance misuse clinics can be both rewarding and challenging. I enjoy making a genuine difference to people, empowering them to take control of their lives and lifestyle behaviours so that they are able to recover and eventually be discharged. This type of work is made more challenging by aggressive behaviour and sometimes by dual diagnosis, such as mental health problems. Clients may be involved in domestic violence, offending, and drug dealing, and they may have hidden agendas.
It’s a mistake to believe that someone’s behaviour can be changed through rational reasoning, which is what makes the work both difficult and interesting. I feel a sense of achievement when I’m able to help change behaviour that has an impact on life beyond the substance misuse, eg parenting, relationships, finances and honesty.
Pharmacy careers are going through an evolutionary process, there are many opportunities to develop into whatever area is of interest to you.
Career plans and top tips for others
My intention is to expand the training aspect of my role using my coaching and motivational interviewing skills. For my clinical development, I am interested in specialising more in the misuse of alcohol and the abuse of a range of other drugs and chemicals. As public governor of an NHS Children’s Trust I enjoy volunteering my time and hope to do more of this.