As general practice evolves, clinical pharmacy expands

Case study summary

NHS England has committed to 1,500 more clinical pharmacists in general practice by 2021 – funding applications are now open (from 9 January 2017).

 

In 2014, Robin Conibere made the leap from working in a local pharmacy to a role as a clinical pharmacist at Beacon Medical Group in Devon. The key driver for Conibere was the opportunity to move out from behind the pharmacy counter and play a greater role in providing one-to-one health advice for patients.
Conibere says: “I felt I could do more with my skills. I always enjoyed the contact with patients and thought I could do more to help them with their health conditions, which is what drew me to working in general practice as a clinical pharmacist.”

Clinical pharmacists work from GP practices alongside GPs, nurses and other primary care staff. Their role involves assessing and treating patients using their expert knowledge of disease and medicines. Conibere says: “It is now common for patients to have a number of conditions, often long term, where they might have more complicated medication needs. Helping patients manage and get the most out of their medication really does make a difference to their health.”

While the role of the clinical pharmacist in general practice has been developing for some time, it is now an integral part of a transformation in GP services. NHS England has committed to get an additional 1,500 clinical pharmacists working in general practice by 2020-21. This is in addition to a pilot scheme launched in July 2015, which has already seen 490 clinical pharmacists working in around 650 GP practices across the country. A further rollout towards the 1,500 target has now been launched and GP practices will be able to apply for funding in January 2017.

It is the benefits that clinical pharmacists can bring to general practice that lead to such widespread support from GPs. Dr Lawrence Brad, a GP for 20 years, who works at Westbourne Medical Centre near Bournemouth, says: “We’ve had a clinical pharmacist in practice for around five years and benefits include the impact of providing advice relating to the increasing number of patients with complex issues and their medication needs, helping follow up on patients with one or more long-term conditions, as well as helping us manage everyday prescription queries. Patient safety is improved if clinical pharmacists can help oversee patients’ transition from hospital, often with multiple medications, back into the community.”

Clinical pharmacists play a vital role in helping general practice integrate further with wider healthcare teams. “We are only starting to realise the possible benefits for the public, general practice and the wider healthcare system,” said Keith Ridge, NHS England’s chief pharmaceutical officer. “Clinical pharmacists in general practice can really help to provide a seamless service for patients, joining up care with hospital and community pharmacists and other health professionals, whilst reducing the workload for GPs by utilising their specialist knowledge of medicines, and alleviating pressures on hospital services by helping reduce avoidable admissions”.

That is why Keith is encouraging pharmacists to be part of the national rollout programme. ‘‘It is an exciting and promising career opportunity for any pharmacist,” he said. “The role enables you to use your expert skills and knowledge to help deliver the best form of care to the public by working in collaboration with other healthcare professionals.

“This programme is the start of great things to come. I envisage that there will be a clinical pharmacist working in every general practice across England. I hope we see an increase in the number of pharmacist partners working in general practice too.

“It helps improve access to healthcare, ensures that patients get the best use out of their medicines, and improves patient quality of life.”

Conibere hasn’t looked back. He argues that “by not having a pharmacist in general practice historically, we’ve been missing a trick, especially when the most common intervention is the prescribing of a medicine. By having a pharmacist there, it makes it a bit easier for patients and GPs to have more in-depth discussions about their medicines.

“And for me, it’s all about the difference you feel you have made in a patient’s life. Sometimes patients aren’t really keen on seeing a clinical pharmacist at first, but they give you a chance and when you help them out it’s great to see them come back to you again and it’s that which is really rewarding. As a profession, we now need to build on this to show patients that getting the best care doesn’t always mean having to see the GP.”

This is certainly the experience for Philip Varlow. Aged 63, he’s a patient from Stratford, east London and was first introduced to the clinical pharmacist in his GP surgery several years ago. Varlow says: “I’m a passionate believer in self-care and the expertise that the clinical pharmacist can offer helps me to do this, managing multiple medications and giving me broader clinical advice.”

For Varlow it’s all about the wider benefits to the health of the nation. He says: “The way clinical pharmacists in general practice can help to educate patients and support them in managing their healthcare is so important. It supports people to live their lives as best they can and helps prevent more serious illness.”

Find out more about the NHS England’s clinical pharmacy rollout programme.