WIREDGOV

Aims to support GPs in areas with biggest primary care workload pressures.

A new £15m scheme to fund, recruit and employ clinical pharmacists in GP surgeries has been launched yesterday by NHS England Chief Executive Simon Stevens.

The three year initiative, which will go live this year, will give patients the additional support of an expert pharmacist in their GP surgery. Examples of the benefits patients can expect include extra help to manage long-term conditions, specific advice for those with multiple medications and better access to health checks.

The pharmacists will be employed directly by the general practice to help patients, while also easing GP workload and improving communication between general practice, hospitals and community pharmacists. The scheme will focus on areas of greatest need where GPs are under greatest pressure, and aims to build on the success of GP practices already employing pharmacists in patient-facing roles.

The announcement is an important part of the New Deal for General Practice outlined by the NHS Five Year Forward View, and is the result of close collaborative work with Royal College of General Practice, the BMA’s General Practice Committee, the Royal Pharmaceutical Society and Health Education England.

Simon Stevens, NHS England Chief Executive said: “This has the potential to be a win-win-win for patients, their GPs and for pharmacists.

“Tapping into the skills of clinical pharmacists should help expand care and relieve some of the pressure that GPs are clearly under. This isn’t a silver bullet but it is a practical and constructive contribution to the wider challenge.”

Dr Maureen Baker, Chair of the Royal College of General Practitioners said: “GPs are struggling to cope with unprecedented workloads and patients in some parts of the country are having to wait weeks for a GP appointment yet we have a ‘hidden army’ of highly trained pharmacists who could provide a solution.

“They will not be substitutes for GPs, but will work closely with us as part of the practice team to resolve day to day medicine issues, particularly for patients with long term conditions who are taking a number of different medications. This has the potential to have a major impact on patient care and safety, as well as reducing waiting times for GP appointments.

“This arrangement is already running successfully in some GP surgeries and we hope that this £15m pilot scheme will be a catalyst for more GPs and their teams to participate.

“We are delighted that the proposals we announced with the Royal Pharmaceutical Society back in March this year are already coming to fruition, meaning that patients – and GPs – will see the benefits more quickly.”

Dr David Branford, former Chair of the Royal Pharmaceutical Society English Board said: “This is a fantastic initiative by NHS England. Pharmacists working as part of the team in general practice can make a huge difference to both patients and clinical colleagues. Pharmacists can consult with and treat patients directly, relieving GPs of casework and enabling them to focus their skills where they are most needed, for example on diagnosing and treating patients with complex conditions.

“As part of the multidisciplinary team, pharmacists will also be able to advise other professionals about medicines, resolve problems with prescriptions and reduce prescribing errors.

“It’s a win-win situation for everyone concerned. I am delighted that NHS England are investing in this pilot which will make best use of the NHS workforce. Working with the Royal College of General  Practitioners we will be doing everything we can to support the profession and make sure this pilot is successful. In time I hope pharmacists will be working in every GP practice in the country.”

Dr Krishna Kasaraneni, BMA Chair GP training, education and workforce subcommittee said: “It is important that we look at how pharmacists can work more efficiently within general practice and relieve some of the unprecedented pressure on GP services.  We will need to look closely at how these pilots operate and ensure that the clinical benefits of the scheme are clear. Alongside the new funding that the BMA’s Northern Ireland GP committee has recently secured for pharmacy services in its area, this is an encouraging sign that the potential and importance of the pharmacy sector is being recognised.”

Professor Ian Cumming, Chief Executive, Health Education England said: “HEE are delighted to be supporting clinical pharmacy pilot with a comprehensive training programme through one of our national delivery partners, the Centre for Postgraduate Pharmacy Education.

“The training programme will support the development of the clinical pharmacists in delivery of their face to face patient care and the wider role across the community. This programme will strengthen multi-professional teams in practices which should help give support to GPs in their day to day work

“This is one part of the vital work in the 10 point plan, underlining the importance of joint work between HEE, the Royal College of General Practitioners, the British Medical Association and NHS England to help develop primary and community care to provide the care patients will need now and in the future”

Background

• Examples of work that a clinical pharmacist may do in a GP practice could be as follows:
  • Providing clinical advice and expertise on treatments.
  • Developing bespoke medicine plans for individual patients.
  • Establishing ongoing professional relationships with individual patients
  • Assisting with communication across a patient’s care pathway, including with GPs, hospitals and social care.
  • Monitoring patients with complex long term conditions such as hypertension or diabetes.
  • Managing repeat prescription requests.
  • Increasing the uptake of new medicines.
  • Managing medicines shortages by suggesting suitable alternatives where appropriate.
  • Supporting innovation and clinical research where appropriate.
  • Mentoring newer pharmacists.

• Many GP practices are already employing pharmacists in patient facing roles.  The aim of the pilot is to build on these successes and integrate pharmacists into the general practice team.
• Case studies and more information about pharmacists working in general practice are available on the Royal Pharmaceutical Society website
• See also short video of Rena Amin, a pharmacist in a GP practice in NHS Greenwich CCG explaining her role.
• The model of each pilot site will be based on one senior clinical pharmacist and five clinical pharmacists. The senior clinical pharmacist will provide mentoring to the other pharmacists, including training support where needed to take on prescribing responsibilities during the programme.  The clinical pharmacists will undertake a tailored education programme throughout the first year. Around 300 pharmacists are expected to be employed in the first wave of the programme. NHS England will co-fund the new pharmacists alongside practices.
• NHS England will part fund the pharmacists pay costs for 36 months
  • 60%  for the first 12 months of employment
  • 40%  for the second 12 months of employment
  • 20%  for the third 12 months of employment
  • 0% after the first 36 months of support (or fewer months if recruited after 31 March 2016)
• Applications by general practices to participate in the pilot will be assessed against a set of criteria and will be considered by NHS England regions and Health Education England who can apply their local knowledge in support of applications.  The final determination will be made by the national moderation panel consisting of all partner organisations. For more information go to the Clinical Pharmacists in General Practice Pilot webpage.