Clinical pharmacists

Clinical pharmacists are increasingly working as part of general practice teams. They are highly qualified experts in medicines and can help people in a range of ways. This includes carrying out structured medication reviews for patients with ongoing health problems and improving patient safety, outcomes and value through a person-centred approach.

A successful pilot showed that clinical pharmacists in general practice are really benefiting patients. There are currently over 1000 Full Time Equivalent clinical pharmacists working across the country through the NHS England Clinical Pharmacists in General Practice Programme since it started in 2015.

The NHS Long Term Plan commits to increasing the number of these health professionals working in primary care over the coming years. This will make it easier for patients to get a convenient appointment with the right expert health professional for their needs.

The new GP five-year contract framework was launched in January 2019 to support Primary Care Networks (PCNs) recruit up to an additional 20,000 additional staff to work in primary care teams including clinical pharmacists, physician associates, physiotherapists, community paramedics and social prescribing link workers.

Support for recruitment and employment

As part of the five-year GP Contract Framework reform, a new Network Contract Directed Enhanced Service (DES) will be introduced. GP practices working in Primary Care Networks will be guaranteed funding for up to 20,000 additional staff, including clinical pharmacists. This scheme will meet a recurrent 70% of employment costs for additional clinical pharmacists (subject to specific rules) from 1 July 2019.

In light of the introduction of these new arrangements, the Clinical Pharmacists in General Practice Scheme will close from 30 April 2019.

The Enhanced Service (ES) for the current scheme will continue for those practices claiming reimbursement for an employed clinical pharmacist, or which have received approval and appointed a clinical pharmacist prior to the 30 April 2019, until either:

  • The clinical pharmacist is transferred to become part of a Primary Care Network’s workforce team from 1 July 2019 onwards (and in accordance with the rules set out in Table 1 of the Network Contract DES guidance); or
  • The reimbursement for the clinical pharmacist under the terms of the current ES comes to an end, e.g. at the end of the three-year tapered funding period.

Practices should read the Network Contract DES guidance for information on transferring clinical pharmacists employed under the current national scheme to the new Network Contract DES. NHS England is committed to supporting this process.

About clinical pharmacists

Clinical pharmacists work as part of the general practice team to improve value and outcomes from medicines and consult with and treat patients directly. This includes providing extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks. The role is pivotal to improving the quality of care and ensuring patient safety.

Having clinical pharmacists in GP practices means that GPs can focus their skills where they are most needed, for example on diagnosing and treating patients with more complex conditions. This helps GPs to manage the demands on their time.

Pilot site external evaluation

The clinical pharmacists working in general practice launched as a pilot scheme in 2015. The pilot scheme funded 89 applications from GP federations who recruited more than 490 pharmacists (>450 whole time equivalent (WTE) to work across 658 GP practices.

NHS England commissioned the University of Nottingham to independently evaluate the pilot scheme over a one year period. The evaluation aims to provide an overview of the first phase of the programme to integrate clinical pharmacists into general practice and identifies how best to implement and evaluate the final roll out.

Within this process University of Nottingham identify the potential impact of the clinical pharmacists, describe how they are likely to affect working practices and how they may improve service delivery related to medicines both within the medical practice and working alongside what were clinical commissioning groups (CCGs) – now integrated care systems (ICSs) -, community pharmacy and hospital pharmacy teams.

The full evaluation and executive summary was published in July 2018 and can be found on the University of Nottingham’s website.

Case studies