March 17, 2015, by Katherine Tallant

Pharmacists working alongside GPs to improve patient care: an idea that has come of age

Plans announced today by the Royal College of General Practice (RCGP) and Royal Pharmaceutical Society (RPS) to have an “army” of pharmacists to help treat patients at GP practices across England have been welcomed by staff in the the School of Pharmacy who have undertaken research in this area.

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There is great potential for pharmacists to work alongside GPs to improve patient care and we welcome the recognition of pharmacists’ expertise on medicines in the NHS. Today’s King’s Fund launch is the culmination of four years’ work by The Royal Pharmaceutical Society (RPS) and the Royal College of General Practitioners (RCGP) to increase collaboration between GPs and pharmacists and to break down the perceived barriers to joint working. David Branford chair of the English Pharmacy Board said, “this is serious and this is our priority. The skills of a pharmacist and a GP are entirely complementary”. Maureen Baker, chair of RCGP said “This has been a wholly positive collaboration and that RCGP are delighted to work together to break down the barriers between community pharmacy and general practice to improve patient care”.

Both organisations believe that pharmacists, with the appropriate skills and experience, based in GP practices will be able to contribute to the clinical work related to medicines, relieve service pressure and increase capacity to deliver improved patient care.

Practice-based pharmacists have been in existence since the early 1990s but it is now envisaged that they will become more widespread and a normal part of the primary healthcare team. This is not about having a pharmacy premises within a surgery, but making full use of the pharmacist’s clinical skills and knowledge about medicines to benefit patients and to alleviate current workforce pressures in general practice.

The primary role of the practice-based pharmacist
 will be to deal with the many medicine related problems and issues that arise in every GP practice on a day to day basis. This includes liaison with hospitals, community pharmacies 
and care homes to ensure seamless care and reduce potential medication errors. Practice-based pharmacists will also work closely with community pharmacy services to review the medicines of patients, particularly those who have complex conditions, such as kidney or liver problems or who take medicines with a higher element of risk.

The School of Pharmacy at Nottingham is at the forefront of robust high quality research showing that effective deployment of pharmacists in the healthcare team improves patients’ outcomes from medicines. A research team led by Professor Tony Avery and including  GPs, pharmacists and patients has developed and evaluated the highly effective and cost-effective PINCER intervention which involves pharmacists working with GPs to reduce errors around prescribing and monitoring medicines in primary care, now included in NICE guidelines for medicines optimisation.[1]  Professor Rachel Elliott and Dr Matthew Boyd led this research team which looked at the New Medicines Service, and provided clear evidence that community pharmacists improve use of prescription medicines for long term conditions,[2] leading to permanent funding of the service by NHS England. This service could easily be provided by a pharmacist at the GP surgery.

In the School we are promoting effective multi-professional team-working skills and professional leadership to support patient-centred care as part our fourth year teaching on the MPharm programme for our ‘future pharmacists…coming of age’.

Today’s announcement will allow wider uptake of these evidence-based, pharmacist-led interventions and move us towards more effective, patient-centred and efficient use of medicines for people with long term conditions.

Professor Claire Anderson is Professor of Social Pharmacy and Head of Division of Social Research in Medicines and Health in the School of Pharmacy at the University of Nottingham. @Clairewynn

Professor Rachel Elliott is Lord Trent Professor of Medicines and Health in the Division of Social Research in Medicines and Health in the School of Pharmacy at the University of Nottingham. @RachelElliott67

1.         Elliott, R., et al., Cost Effectiveness of a Pharmacist-Led Information Technology Intervention for Reducing Rates of Clinically Important Errors in Medicines Management in General Practices (PINCER). PharmacoEconomics, 2014. 32(6): p. 573-590.

2.         Elliott, R., et al., Understanding and Appraising the New Medicines Service in the NHS in England (029/0124)’ A randomised controlled trial and economic evaluation with qualitative appraisal comparing the effectiveness and cost effectiveness of the New Medicine Service in community pharmacies in England. 2014: University of Nottingham.

 

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