Meet Dr Frances Akor, consultant pharmacist
Dr Frances Akor reflects on her career as a consultant pharmacist (anticoagulation) at Imperial College Healthcare and tells us about her wider work with UK Anti-Doping (UKAD) protecting clean sport, including her role at the 2012 Olympic and Paralympic Games in London.
Tell us what you do at the Trust.
I have been part of Imperial College Healthcare for almost 15 years and work as a consultant pharmacist for anticoagulation, which is a group of medicines that are used to treat and prevent blood clots. These medications are sometimes called blood thinners and are given to people who are at high risk of getting clots, including many patients in our hospitals, so we can reduce their chances of developing serious conditions such as ischaemic strokes and pulmonary embolism.
I support appropriate and safe use of anticoagulation medicines across the Trust, including when patients move between healthcare settings or home. I focus a lot of my time on stewardship and responding to colleagues’ anticoagulation queries. Anticoagulation is a therapy that a significant proportion of our adult inpatients are prescribed, either at doses to prevent or treat blood clots, yet at times managing anticoagulation can be complex. It’s important to me that staff from across the Trust know that I’m here if they need any help or support.
What does an average working day look like for you?
There isn’t really such a thing as an average day, given the wide-ranging remit of my role and as I work part-time (three days a week). The closest I get to a routine is probably my anticoagulation clinic, where I support patients who have been newly prescribed anticoagulation and determine appropriate duration of anticoagulation, follow-up and monitoring requirements. I also participate in the Trust’s antiphospholipid syndrome (APS) clinic, based at Hammersmith Hospital.
A significant part of my role is focused on stewardship of anticoagulants, which means desk time working on guidelines and policies. I also spend a lot of time with colleagues across the Trust discussing a range of issues relating to anticoagulation use, guidelines and pathways. This not only helps me to identify improvements I can make myself but also creates opportunities where I can support colleagues with their own anticoagulation quality improvement projects.
Dr Frances Akor"It’s important to me that staff from across the Trust know that I’m here if they need any help or support.”
Are you involved in research?
Previously, as the sole anticoagulation pharmacist, it was challenging finding the time to be involved in research. However, I’ve recently successfully applied for funding from the Patient Safety Research Collaborative. This has provided me with some additional hours to invest time in research. I’m currently exploring the impact of electronic prescribing and medicines administration (ePMA) systems on the safety of anticoagulation. This will hopefully further inform standards for safe implementation of ePma, particularly with respect to high-risk medicines.I also plan to undertake exploratory research into adjunctive immunomodulation therapies, which could potentially be used alongside anticoagulants to reduce the rate of recurrence of arterial and venous thrombosis in patients with APS who have had recurrent thrombosis despite well-controlled anticoagulation.
Outside your Trust role, you’re a UK Anti-Doping (UKAD) board member. Tell us about this.
It’s a real honour to be a member of the UKAD board, which I first joined in October 2017. UKAD are a national body responsible for protecting sport in the UK from doping, raising awareness of issues through education and testing, and also helping athletes and their support personnel to understand and follow the rules. The board has a big role in setting the strategic direction of the organisation and providing support and advice to the executive team to help them deliver an effective anti-doping programme. As a pharmacist, I offer UKAD my advice and foresight on medicines and substances.I also chair UKAD’s Innovation Commission, which brings together a range of experts with diverse perspectives from across the public and private science sectors in order to support innovation across the organisation – and ultimately to ensure that UKAD remains at the forefront of international efforts to prevent doping. We always have really positive discussions, looking at how we can develop an innovative culture across UKAD.
How did you get involved?
Growing up I always loved watching athletics, particularly sprint races. Michael Johnson, the American 400m sprinter remains my sporting hero. He was a cut above the rest. My interest in sports medicine first developed in the years running up to the 2012 Olympic and Paralympic Games in London.
I was blessed enough to be involved in the pharmacy set up for the games, as a member of the 2012 Olympic and Paralympic Pharmacy Clinical Services Group. The aim of the group was to design and deliver a world class pharmacy service for international athletes and their teams at the Games. During the Games themselves, I worked as the venue medical manager for Eton Dorney and Royal Holloway Rowing Village.
In 2017, I saw that UK Anti-Doping were looking for a new board member with experience in medicine and an interest in horizon scanning – exploring emerging medicines and what risks they could pose in terms of future doping patterns. It seemed like a perfect fit and now, just over seven years later, I’m coming to the end of my second and final term.
Do you have any advice for elite athletes or those about to break through?
The careers of elite sports people always start with a love of sport. But there’s a risk that this love can be swallowed up by the pressures of competition, even at a young age. This is when people can become vulnerable, particularly in terms of their relationships, and potentially end up doing something they later regret.
Dr Frances Akor"The careers of elite sports people always start with a love of sport. But there’s a risk that this love can be swallowed up by the pressures of competition, even at a young age."
It’s important that up-and-coming athletes are aware of these pressures and vulnerabilities – and that they ensure they have safe spaces where they can talk openly with someone they trust, whether that’s a parent, a friend or partner.
It’s also important that all athletes take responsibility for what they consume – and don’t leave this in the hands of others. And please be careful about supplements, which can contain contaminants. There are lots of resources and advice on the UKAD website to support athletes, including a global drug reference database (Global DRO) to check the anti-doping status of medications, and a supplements hub.
Ultimately, my advice would be: keep lines of communication open, recognise times when you might be most susceptible/vulnerable, and remember how you fell in love with your sport.
What are you most pleased with from your time at the Trust so far?
It’s a pleasure to be at a Trust that’s so collaborative and provides so many opportunities in and outside the organisation to work with colleagues to improve anticoagulation use.
I don’t always see patients directly in my stewardship role, so I don’t always get to see the impact of my work. But I would like to think that I’ve made a difference to patients indirectly by improving care through advice, training as well as through the anticoagulation guidelines I've developed and put in place - all of which impact on patient safety.
