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September 2018

Question marks over practice pharmacy scheme



A scheme intended to ease workload pressures in general practice could come unstuck, despite the multi-million pound investment.

NHS England launched the ‘clinical pharmacists in general practice scheme’ 3 years ago as part of the Five Year Forward View. £31 million was provided to general practices to employ pharmacists for three years to relieve GP workload, and an 18-month training programme was provided for the pharmacists.

But the first study into the way the scheme is working in practice has found pharmacists frequently feel unsupported in their practices, with insufficient contact with the practice team and sometimes no proper workspace of their own. Their GP mentor role is unfunded, and GPs are already short of time.

With NHSE funding soon to end, practices will have to decide whether to find the resources for continued employment of pharmacists themselves.

Fay Bradley and colleagues from the University of Manchester surveyed 457 pharmacists to assess progress with the scheme. They found that their work with patients in chronic disease clinics was increasing, along with medication reviews, working with QOF, ordering investigations, and providing support for patients by telephone and in care homes.

But only 25% of pharmacists reported involvement in the management of acute and common ailments, possibly because not all the participating pharmacists had an independent prescriber qualification – or because this area is traditionally the domain of the GP, and increasingly, the nurse practitioner.

The authors say that there may be ‘little need’ at present for pharmacists to undertake this role but ‘this may shift in future because the NHS is facing a shortage of practice nurses, with approximately one-third planning to retire by 2020.’

The authors conclude that ‘clear demonstration of the benefits and costs of effectiveness of the scheme are likely to be needed if it is to survive.’

Bradley F, et al. Br J Gen Pract 28 August 2018. https://bjgp.org/content/early/2018/08/27/bjgp18X698849