Interview and article by Christine Clark.
Pro-active case-finding to optimise treatment of long-term conditions is one the tasks undertaken by pharmacists working in GP practices. Shailen Rao, whose company Soar Beyond provides training and support services for practice pharmacists, explains more about this type of work.
A practice pharmacist can deliver benefits both for patients and for the practice.
Many patients in primary care have long-term conditions and drug treatment is a key part of their management. Practice pharmacists bring much-needed additional capacity to undertake pro-active management of these patients. This could involve case-finding and supporting patients to get the best out their medicines and also tailoring of treatments to meet patients’ needs.
Mr Rao says “You end up getting what the NHS long-term plan is all about – prevention, pro-active care, better patient experience and better clinical outcomes”.
Sometimes it can be with the same treatment as before, but with a dedicated pharmaceutical input to ensure that it is used to the best effect, he adds.
These are all positive benefits for the practice too, but there are additional benefits. The practice pharmacist is another member of the team who can deal with medicines and liberate GPs to do other work. The simplest thing that a practice pharmacist can do is to deal with repeat prescriptions and queries about medicines and this quickly extends to management of long-term conditions, explains Mr Rao. As their roles grow they become integral members of the multidisciplinary primary care team. In future patients could have the option to see a doctor, nurse or pharmacist depending on their needs, he predicted.
The additional roles reimbursement scheme (ARRS), which has been incorporated in to the GP contract, provides funding for 12 different roles including pharmacists and pharmacy technicians. The funding will be increased each year so that Primary Care Networks (PCNs) can grow their workforces over time. As an example, by 2024 a PCN serving a population of about 50,000 could have £1 million of ARRS funding, says Mr Rao. Many PCNs are only recruiting for pharmacist positions at present, he adds.
Measuring the impact
Practice pharmacists were introduced about five years ago to tackle a workforce crisis in primary care. One way to measure their impact is to look at the number of GP appointments displaced and how much GP time is liberated. At the next level, pharmacists could be pro-actively case-finding examples of suboptimal treatment in areas such as osteoporosis, diabetes, respiratory and frailty and actively managing treatment. This type of work is important for upstream prevention of serious health problems. For example, good diabetes treatment now can prevent debilitating and expensive health problems in future. In future, we can expect to see the development of pharmacist leaders in this field, says Mr Rao.