With the recruitment crisis facing general practice the importance of skill mix has come to the fore. In 2015, the RCGP and the Royal Pharmaceutical Society (RPS) unveiled plans for pharmacists to be employed as part of general practice teams.
Towards the end of 2015, NHS England ran a £15m three-year pilot, which aimed to employ 250 clinical pharmacists in GP practices.
The scheme proved so popular that NHS England made a further £112m available to ‘enable every practice to access a clinical pharmacist’ under its GP Forward View plans. NHS England is aiming for an additional 1,500 clinical pharmacists in general practice, with one pharmacist to be available across a population of, on average, 30,000.
Why employ pharamcists?
Practices that already employ pharmacists are positive about the value they bring to the team.
Another case study on Medeconomics highlights the benefits practice pharmacists bring for practices with a high number of care home patients.
But if your practice is keen to employ a pharmacist and has never done so before, what do you need to consider? The Primary Care Pharmacy Association's recently updated guide to employing pharmacists in general practice, which is endorsed by the RCGP and RPS, is a good place to start.
The guidance includes a sample business case to help practices assess the value of a practice pharmacist, along with providing a wealth of information about what the role involves and practical advice for practices.
What can pharmacists do?
The NHS Alliance and the RPS have put together a list of functions a pharmacist can perform in a GP practice. These broadly break down into four areas:
- Clinical services - working with GPs and patients to address medicine adherence, reviewing patients on complex medicine regimens, triaging and managing common ailments, responding to acute medicine requests, managing and prescribing for long-term conditions (often in conjunction with the practice nurse), signposting patients to appropriate services and linking the GP surgery with specialist pharmacists and community pharmacists to reduce medication errors.
- Prescription management - dealing with medication for patients recently discharged from hospital, supporting the practice to deliver on the QIPP and QOF agenda and enhanced services, delivering repeat prescription reviews, being the point of contact for all medicine-related queries, overseeing the practice’s repeat prescription policy.
- Audit and education.
- Medicines management.
What do you need from your pharmacist?
The PCPA guidance provides detailed examples of job descriptions for entry-level and advanced pharmacists, which Medeconmics has reproduced here:
- Practice-based clinical pharmacist job description
- Senior practice-based clinical pharmacist job description
All qualified pharmacists have undergone a three- or four-year degree and 12 months of ‘on the job’ training before taking their final exams. Following qualification they undertake foundation training, after which they may undertake postgraduate studies.
Some pharmacists may have a prescribing qualification and have undertaken a physical assessment course. Most practices will probably want a pharmacist to have these skills, so you should be prepared to support a successful applicant through through training in these areas.
Education and support for practice pharmacists
If you employ a pharmacist via the NHS England pilot or extension of this scheme, the pharmacist will receive a comprehensive package of training and support, which is currently delivered by the Centre for Postgraduate Pharmacy Education. This is an 18-month pathway, that includes study days, learning sets and assessment. Pharmacists will need 28 study days provided by their practice over the 18-month period.
Pharmacists on the NHS England scheme will need a GP education supervisor, who will also receive support and materials from NHS England to undertake this role.
If the practice is employing a pharmacist outside of the NHS England scheme, the RPS recommends that practice pharmacists complete its Foundation programme.
Pharmacists who have not worked in general practice will probably also need training in:
- The surgery computer system
- The QOF and QIPP agenda
- Clinical coding
- Clinical and information governance
- Safeguarding adults and children
- Management of the practice’s repeat prescribing.
How to recruit a pharmacist
Practice pharmacist roles can be advertised on NHS Jobs. Other options include pharmacy journals and magazines, where charges will apply.
The PCPA guidance provides an example job advert for an entry-level and an advanced practice pharmacist.
Practices not involved in the NHS England scheme may also want to consider the option of employing a pharmacist on a freelance or locum basis for a set number of sessions a week.
Career development
The RPS is developing a possible career structure for pharmacists working in general practice, along with professional guidance to support their ongoing education and training.
Medical indemnity
It is essential that your practice has adequate indemnity in place for all of the staff that you employ, including a pharmacist. Practice pharmacists will need their own medical indemnity – the Pharmacist Defence Association and the National Pharmacy Association provide professional indemnity for pharmacists.
GP partners are vicariously liable for the actions of all of their employees, therefore the partners need to make sure their medical indemnity organisation (MDO) knows about the practice's plans to ensure they have adequate arrangements in place. If your practice is part of a group scheme, you should inform your MDO that you are employing a pharmacist and be prepared to explain what the role will involve and the duties they will be undertaking.
Educating patients
NHS England has produced a patient film and downloadable resources, including patients leaflets in several languages, explaining the role of the clinical pharmacist, when patients might expect to see a pharmacist and what they can expect from there appointment. You can access these resources here.
Other useful resources
- Watch a video by the RPS on what a general practice pharmacist does
- NHS England information on clinical pharmacists in general practice
- Patient information explaining the practice pharmacist role
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