GPs positive about practice pharmacists, review of NHS England scheme finds

Placing pharmacists in general practice improves patient care and reduces GP workload, according to a year-long assessment of NHS England's clinical pharmacist programme.

The independent study, which funded by NHS England and carried out by the School of Pharmacy at the University of Nottingham, evaluated the initial pilot phase of NHS England's clinical pharmacists in general practice scheme, which launched in 2016.

The researchers investigated the work of the newly created clinical pharmacist roles from the perspectives of the pharmacists, those working immediately with them in their roles, professional stakeholders and patients.

They found that the deployment of pharmacists can lead to greater capacity, reduced workload for GPs, medicinal optimisation and improved patient care in general practice.

The study said: ‘Clinical pharmacists have made a unique and valuable contribution to the primary care skill mix. Pharmacists contribute significantly to patient safety, bring medicines and prescribing expertise, support with prescribing tasks [and] support patients with long term conditions including support for healthy lifestyles.

‘They have improved medication knowledge in the wider clinical team, leading to the prospect of overall improvements in care related to medicines. The introduction of pharmacists has led to increased capacity in practices. Although the role requires financial commitment from practices, GPs believe the role to be sustainable [and] most will keep the one they are working with after the funding expires.’

One GP who took part in the study concluded that practices ‘can’t survive without pharmacists’, while a lead for one of the pilot sites added: ‘There are virtually no negatives in terms of the [CP] role.’

Of the pharmacists who took part in the project the majority (89%) said they enjoyed working in the new roles.

The researchers recommended that national competencies for the clinical pharmacist role should be developed and that long-term wokforce planning should take account of the role and ensure it is considered as part of pharmacist undergraduate training.

NHS England is aiming to have 2,000 clinical pharmacists working in general practice by 2020. The pilot programme was funded as part of the GP Forward View. Under the scheme NHS England pays 60% of the cost of recruiting and employing a clinical pharmacist in the first year, this reduces to 40% in year two and 20% in year three.

NHS England and Health Education England provides training, education and development to clinical pharmacists and the practices they work in. The programme is continuing to expand and GP practices can still apply for funding.

GP workload

Dr Matthew Boyd, associate professor in patient safety and pharmacy practice, who led the research, said: ‘Clinical pharmacists have made a unique and valuable contribution to the primary care skill mix and for the first time as part of this study have become an embedded member of the practice at scale. They contribute significantly to patient safety, bring medicines and prescribing expertise and support with prescribing tasks and provide support for patients with long term conditions including support for healthy lifestyles. 

‘Managing the medication for long term conditions takes up a large portion of GP time and is a key area where clinical pharmacists made a significant impact. Patients provided the evaluation team with examples of the benefits of time spent with the pharmacist in the practice including greater understanding of their medicines, improved ability and willingness to take their medicines and a feeling of individual value.’

Dr Krishna Kasaraneni, BMA GP committee executive team member, said: ‘This report reflects what the BMA has been saying for a long time about the value that clinical pharmacists bring to general practice, both by supporting GPs, and improving patients’ understanding of their medication and confidence to practise self-care.

‘We hope this evaluation will put further pressure on the government to provide the recurrent funding so that all patients and doctors can benefit as soon as possible.’

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