Staffs GP federation counts the benefits

29 June 2017
In November 2015, North Staffordshire GP Federation was successful in its bid to take part in the pilot programme for clinical pharmacists in general practice. Lucy Minshull, who provides management support for the federation describes the progress made over the following year.
 
The federation was instrumental in liaising with its member practices to invite any interested practice to submit an expression of interest.  
 
Each practice presented a rationale for inclusion in the pilot. All the expressions of interest clearly demonstrated the considerable pressures on practices as well as their understanding of the value a clinical pharmacist could bring. 
 
Ten practices covering a registered population of 86,123 initially expressed an interest to be part of the pilot.  
 
The federation was instrumental in the recruitment process in both stage 1 (advertising and 
shortlisting) and stage 2 (interview and selection) with representation from the federation in 
terms of a director (Dr Medhat Guindy) and manager (Lucy Minshull), a practice manager (Alan 
Buckley, Norfolk Street) and practice pharmacist (Jayne Capper, Belgrave Medical Centre).
 
The first practices got pharmacists in post in February 2016 with others joining over the course of the next several months. Of the original ten practices a few withdrew for various reasons, including securing a GP or other clinical support, doubts about whether they could provide the necessary support to the pharmacist, or failure to agree contractual terms with the pharmacist.  Two further practices joined the pilot mid-way through the year.
Pilot practices
 
  • Mayfield Surgery 1 WTE prescribing pharmacist
  • Werrington Surgery 0.4 WTE prescribing pharmacist
  • Willowbank Surgery 0.5 WTE prescribing pharmacist
  • Harley Street Medical Centre 1 WTE   non-prescribing pharmacist 
  • Well Street Medical Centre 0.4 WTE non-prescribing pharmacist
 
Feedback on the pharmacy pilot
 
1. Scope of clinical pharmacists’ role
 
  • Management of discharge letters
  • Management of medication requests
  • Signing EPS electronically
  • Remotely reviewing medication reviews
  • Inviting patients for a face to face review
  • Bulk prescribing of certain items in the nursing and residential homes
  • Liaison with community pharmacists over complicated matters 
  • Amending complicated medication from discharge letters
  • Liaison with local care homes over medication issues  
  • Management of the  prescribing budget 
  • Reviewing practice prescribing polices 
  • Assists nursing team with travel health, namely malaria prophylaxis
  • Review of QOF medication indicators and PLIS areas. 
     
2.  Successes and success factors
 
  • Alleviating the growing GP workload pressures across the board
  • Integration and core member of the practice team
  • Transformation of the minor ailment clinics run by both the clinical pharmacist and the ANP  
  • Prescribing pharmacists have been able to adapt to the practice environment
  • Ability to come into practice with knowledge and experience to make an impact immediately and support the GPs 
  • Excellent mentorship by lead GP which provided increased support and confidence to the pharmacist
  • Appointment of a senior pharmacist to provide support and mentorship with other pharmacists within the pilot
  • Sharing of a pharmacist across two practices has worked very well and highlights the need if primary care is to survive, sharing of posts is needed
  • Desire to take control of own development and ownership of role in practice 
  • Good support networks from Deborah Howard, education supervisor for the general practice pharmacist training pathway
  • Good practice support and facilitation from Karen Merida at PCC
  • One of our practices would be keen to be a training practice for interested candidates and would be 100% committed to having another pharmacist.
 
3. What would we change or do differently next time?
 
  • Appointment of a full time pharmacist (budgets permitting) knowing now the impact of a  part-time pharmacist has had in general practice
  • More support to reduce the number of interested practices withdrawing 
  • Streamline the recruitment process and ensure practice involvement at an earlier stage
  • Earlier information on what the pharmacist can and can’t support
 
Our pilot practices have all highlighted the positive impacts of having a clinical pharmacist working in general practice, which has helped to relieve the growing GP workload.  However, it is to be noted that a clinical pharmacist is not a substitute for a GP. 
Due to the positive impacts practices have experienced practices would consider having another pharmacist working in general practice. One of our pilot practices has expressed an interest in having a further clinical pharmacist in any future pilots and would like to be considered as a teaching practice for pharmacists.  
 
The federation would be very keen to lead on any future pharmacy schemes to provide the support our member practices’ need to address the workforce crisis and highlight to practices the opportunity to diversify and work differently as shown by the successes of the first pilot.

 

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