An NHS England-funded report suggests that pharmacists “should be an integral part of general practice”, and calls for new training and education initiatives to be put in place to respond to a “new career path”.
The Royal Pharmaceutical Society has welcomed the report's findings and said it hopes to see pharmacists placed in surgeries “on a large scale,” but stressed that similar positive outcomes can be achieved in community and hospital pharmacy settings.
The report authors found that medication reviews, in particular, are a valuable way in which pharmacists can help release capacity for GPs and support people living with long-term conditions.
Clinical Pharmacists in General Practice – Pilot Scheme, which was funded by NHS England and undertaken by the School of Pharmacy at the University of Nottingham, along with patient representative and colleagues from the University of Queensland, looked at a pilot project involving over 490 “clinical pharmacists” being placed in more than 650 practices across England.
The researchers used a range of research methods to examine the impact of GP pharmacists from the perspectives of the pharmacists themselves, those working with them in surgeries, professional stakeholders and patients.
The key benefits of having pharmacists in surgeries that emerge in the report are improved capacity for GPs and changes to workload, the authors say. The results indicate that GP pharmacists “significantly increase patient appointment capacity and reduce pressure on GPs,” they say.
Medication reviews are described as being a particularly valuable service. The authors write: “As part of these reviews they were able to provide invaluable medicines education and usage advice to patients, in particular those with long-term conditions including diabetes, asthma and heart disease, which led to increased medication understanding and adherence.
“Where appropriate they were also able to de-prescribe 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 pat of this study have become an embedded member of the practice at scale.”
“Managing the medication for long-term conditions takes up a large portion of GP time and is a key area where clinical pharmacist made a significant impact,” Dr Boyd said.
He added that patients who took part in the report felt that as a result of spending time with pharmacists they felt “greater understanding of their medicines, improved ability and willingness to take their medicines and a feeling of individual value.”
“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,” Mr Boyd said.
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.”
RPS England board chair Sandra Gidley said: “This positive independent research from the University of Nottingham continues to demonstrate the value that practice-based pharmacists bring to patients and to the healthcare professionals they work with. In light of this, we hope to see pharmacists remain embedded in GP practices on a large scale after the initial funding has ended.
“It is clear that with 70 per cent of pharmacists reporting that clinical medication reviews are a major part of the role, the profession’s skills and knowledge are being used appropriately to benefit patients, especially those with long-term conditions.
“It is heartening to see that over 60 per cent of practice pharmacists are involved in the discharge of patients from hospitals back to home or care homes and are making a real difference by preventing hospital re-admissions.
“The impact of pharmacists’ prescribing expertise and support also enables GPs to understand their true value in terms of the professional support they offer. With 75 per cent of pharmacists responding to colleague enquiries every day, it shows that sharing workloads means a better use of skill mix across the practice so patients get the right care from the right health professional.
“These benefits can of course also be achieved in community and hospital settings, and we support better use of pharmacists’ skills to benefit patient care wherever they work.
“The research clearly demonstrates overall how patient outcomes can be improved by thinking differently about how pharmacists integrate into the healthcare system. The new Secretary of State has already shown that he is thinking differently and we are keen to work with him around how pharmacists in all settings can support patient care.”