Clinical pharmacists should be an integral part of general practice, according to a new independent report
The NHS England funded report, undertaken by experts from the School of Pharmacy
at the University of Nottingham, supported by patient representatives and colleagues from the University of Queensland, Australia showed that clinical pharmacists significantly increase patient appointment capacity and reduce pressure on GPs.
More than 490 clinical pharmacists were placed in over 650 practices across England in the pilot project which supports the aim of having over 2,000 clinical pharmacists working in general practice by 2020/21 – a ratio of one per 30,000 patients.
The research team 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. These were evaluated in a range of ways including; observational studies, one to one interviews with staff and patients, patient focus groups and case study site visits.
A key area where the clinical pharmacists made a significant impact was medication reviews which often accounted for significant amount of their workload. They undertook these on a regular basis, releasing capacity for GP’s and alleviating appointment issues.
As part of these reviews they were able to provide invaluable medicines education and usage advice to patients, in particular those with long term health conditions including; diabetes, asthma and heart disease, which led to increased medication understanding and adherence. Where appropriate they were also able to deprescribe medicines, which has potential for positive health and cost saving benefits.
Dr Matthew Boyd, Associate Professor in Patient Safety and Pharmacy Practice at the University of Nottingham, led the research and 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 Boyd continues: “Throughout the process of putting together this report we repeatedly came across examples of the positive impact the clinical pharmacists were having on patient outcomes. Patients told us they understood their medicines in a way they never had, and were now trying to follow lifestyle advice to help manage their health conditions such as diabetes and had improved conditions following a medication review. Now we know the positive impact this new pharmacist role can have we need to ensure robust education and training is in place to respond to this new career path.”
Dr Keith Ridge, Chief Pharmaceutical Officer at NHS England said “Clinical pharmacists in general practice are playing an important role in the NHS – they are helping GPs to manage demands on their time, they upskill the wider practice team about medicines and crucially, they are providing better outcomes and quality of life for patients, especially elderly patients and those with chronic illnesses. The report’s recommendations are timely and we are confident that the benefits of the programme will continue across more GP practices, as we continue the rollout of the programme.”
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