Integrating pharmacy into urgent care

NHS England is supporting the deployment of prescribing pharmacists in Integrated Urgent Care Clinical Assessment Service (IUC CAS) contact centres and in NHS111 services to help reduce the pressure on urgent and emergency care and general practice.

Pharmacists working in the Integrated Urgent Care (IUC) Pharmacists Programme will work as part of the multidisciplinary team as an expert resource. The work will involve handling medicines-related enquiries and issues, undertaking clinical assessment and treatment of minor ailments and prescribing where appropriate, prescribing for repeat prescription requests, and providing self-care advice.

Programme aims

  • To provide impetus for mobilisation, innovation and development of prescribing pharmacists in the IUC CAS environment by providing funding to support the recruitment of 60 whole time equivalent (WTE) pharmacist posts across England to work within IUC CAS/NHS 111 services.
  • To provide access to a role-specific training pathway for pharmacists including an independent prescribing qualification with up to 120 funded places to support these posts (commissioned by NHS England, through Health Education England).
  • To build on pilot work and the NHS 111 Phase 2 Learning and Development programme which showed that pharmacists, as experts in medicines, can add value to the IUC CAS clinical skill mix in terms of available expertise, patient care and call efficiency, and to explore and evaluate this further in different IUC models and scopes of practice.
  • To provide robust workforce evaluation to learn from the different models and scopes of practice to inform sustainability and future commissioning.
  • To provide a pharmacist professional network (across sectors) for peer-to-peer support, a discussion forum, topical webinars and the opportunity to share information and best practice.
  • To develop a new pharmacist role, competencies and career framework which is flexible to the needs of an evolving healthcare environment and aligned with the IUC / NHS 111 / NHS England / Health Education England Workforce Development Programme.

Benefits

Pilot programmes and case studies have detailed the benefits that pharmacists in IUC settings can have on patient care, the multidisciplinary team, and the wider healthcare system, as detailed below:

  • Potential benefits to the public including improved patient access to medicines, and supportive advice during the Out of Hours period, enabling self-care and self-management of conditions.
  • Potential benefits to Integrated Urgent Care including improved IUC CAS capacity and capability to meet patient’s medicines and prescribing needs.
  • Potential benefits to the wider healthcare system including improved integration to deliver better patient journeys, medicines optimisation for patients, and the development of a new role for pharmacists including having additional independent prescribers in the healthcare system.

How to access the training

  • Information on the NHS 111/Integrated Urgent Care Workforce Development Programme for Pharmacists can be found on Health Education England’s website.
  • Pharmacists will be able to apply to the programme through the IUC CAS/111 provider in their area. Many of the IUC Pharmacist jobs will be advertised on NHS Jobs or in the local press.
  • Pharmacists will need to meet the GPhC requirements to undertake the independent prescribing programme. The employing provider must ensure that the pharmacist has a designated medical practitioner (DMP) and arrangements are in place for 90 hours practice learning and assessment of competence by that DMP.

Please note: In order to access the IUC Pharmacist Programme training you must first be employed and committed to working a minimum of 0.4 whole time equivalent (WTE) in an NHS 111 / IUC CAS virtual contact centre environment and have been directed by your employer to register on the University of Derby website.

The University of Derby application process is the entry point to the IUC Pharmacist Programme funded training pathway, both the role-specific training and the independent prescribing; the latter being provided by a range of education providers. Trainees will complete the University of Derby induction and learning needs assessment which will inform their training pathway (available online or in person at Derby).

If you are interested in working in NHS 111 / IUC CAS, please look for advertisements on NHS Jobs, the Pharmacy Journal, local press or some of the well-known online recruitment websites.

We have asked that programme posts include the words ‘IUC Pharmacist’. However, it may be prudent to include ‘NHS 111’ and/or ‘Integrated Urgent Care Pharmacist’ in your search.

You may also want to approach your local NHS 111 / IUC CAS provider directly. If you don’t know who your local provider is, your local CCG Commissioning Lead for urgent care (or equivalent) may be able to help.

A selection of supporting information from case studies

In the pilot the pharmacist’s closure rate of calls without onward referral was 93%. This compared very favourably to nurse advisor closure rates of 77%.

 

Derbyshire Health United pilot

I usually put complex drug interactions through as ‘speak to GP dispositions’ and this is where an on-site pharmacist becomes highly valuable.

 

NHS 111 nurse, Yorkshire Ambulance Service

Assessment by the pharmacist let me leave my patient at home and gave me confidence in the decision. They also chatted to the patient about their medicines which is something I couldn’t do.

 

Paramedic from North West Ambulance Service