Positive signs for future in Gloucestershire

29 June 2017

As he marks his first anniversary as full-time clinical pharmacist at the Churchdown Surgery in Gloucestershire, Ziad Suleiman is confident that the role has a big future.

Suleiman was recruited as part of NHS England’s clinical pharmacists in general practice programme. He says: “In some parts of the country it is taking some time [for patients to book appointments] but word is spreading. It is essential for GPs. The pharmacist can have an impact on almost every aspect of the practice. It’s not just about prescription queries – it’s seeing patients, running clinics and training colleagues.”

Suleiman estimates that his work reduces the daily GP workload by more than 3.5 hours – and that figure excludes most of the GP appointments he saves by running his own clinics.

It takes into account his work on:

  • Repeat prescription queries (90 minutes)
  • Hospital discharge medication changes (35 minutes)
  • Telephone appointments for medication queries from patients, pharmacies and carers (50 minutes)
  • Annual medication reviews (at least 20 minutes)
  • Home visits (five per month)
  • Batch prescriptions (20 minutes).

GPs are now dealing with around 20 medicine-related telephone queries each day – compared to 60 before Suleiman took up his post.

With those responsibilities taking up around half his day, Suleiman is kept busy running  poly-pharmacy, asthma, hypertension and anti-coagulation clinics. In his first year he saw more than 600 patients in those clinics. He is also first point of contact for pharmacies and for care homes with medication queries.

Responsibility for annual reviews of patients with rheumatoid arthritis is set to pass to Suleiman shortly.

“The GPs know that a lot of those patients are on massive amounts of medication and I obviously have the poly-pharmacy expertise.”

He has also trained the practice’s nursing team and up-skilled healthcare assistants (HCAs) and reception staff.

“Last June we had 62 asthma patients using 12 or more salbutamol inhalers a year – which puts them in the high-risk category. I did some work with the nurses and that figure had fallen to 23 by March.

“I knew the HCAs were doing a good job so I discussed with the partners the possibility of them running hypertension clinics. I developed a template for them and we did some joint clinics together and now the HCAs see 70% of the patients with hypertension and I see the rest, with any uncontrolled patients referred to me.”

Having independent prescriber status helped Suleiman hit the ground running but he says that other factors were also important.

He urges practices embarking on the process to ensure that partners, staff and patients are clear about the pharmacist’s role.

“I work for a forward-thinking training practice and I was welcomed into the team immediately. We made a real effort to explain why I was here with an article in the practice newsletter and leaflets and posters in the reception area.”

Perhaps that is why he has not encountered much patient wariness at seeing a pharmacist rather than a GP.

“When we invite patients to my clinics the letter is from myself and explains my skills and expertise so that probably helps as well.”

Suleiman is confident that his positive experience signals that the role is sustainable across general practice.

And having made his presence felt in the best possible way amongst the GPs, Suleiman says that cluster working across local practices could help provide some cover when he’s on leave.

He is keen to be part of building that future: “I wanted to be part of something that was new and from a professional point of view I really want to get pharmacists better-established in general practice.”

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