Pharmacy services and role development in UK general practice: a cross-sectional survey

Abstract

Background The ‘Clinical Pharmacists in General Practice’ (CPGP) pilot provided a template for general practice pharmacy professionals’ (GPPPs) roles encouraging NHS England to fund >2000 practice-based pharmacists. However, many GPPPs work outside the CPGP initiative and little is known about the services they provide. Objectives To explore services provided by all UK GPPPs (pharmacists/pharmacy technicians), including the types of services, perceived benefits and barriers to role development. Methods A 26-item electronic questionnaire was developed using SurveyMonkey and piloted during cognitive interviews. A cross-sectional survey was conducted via social media, primary care organisations and emails to CPGP pilot sites between November 2018 and March 2019. Three reminders were sent 1 week apart. Key findings Ninety-one complete responses were received (81 pharmacists; 10 technicians). Over 80% of pharmacists provided clinical services, such as medication reviews or management of long-term conditions. More pharmacists within CPGP pilot managed repeat prescribing requests (P = 0.035). Technicians took responsibility for primarily non-clinical roles, including commissioning or safety alerts/drug recalls. A third of GPPPs wished to develop care home services. Perceived benefits of GPPPs’ services included improved utilisation/development of professional skills, identifying medicines-related issues and reduction in medication waste. Respondents were satisfied with professional relationships but reported workload issues, limited patient awareness of their roles and restricted opportunities to contribute to service development, which was associated with unsatisfactory support/mentorship (P < 0.001). Conclusion General practice pharmacy professionals deliver clinical and non-clinical services which may benefit patients, general practice and the healthcare system. General practices and national organisations should provide GPPPs with tailored support and exploit the combined strengths of pharmacists and pharmacy technicians to tackle increased workload.

Evaluating the role and integration of general practice pharmacists in England: a cross-sectional study

“…Within the various clinical activities undertaken by GP pharmacists across England, medication reviews and medicine reconciliation remained as major part of their roles. These findings are consistent with the previous studies that evaluated pharmacists’ role within the pilot scheme [ 13 , 17 ] or across the UK [ 25 , 26 ]. A recent review from multiple countries and contexts conducted to inform the development of a comprehensive role description for practice pharmacists has detailed seven role sub-categories (medication management, patient examination and screening, chronic disease management, drug information and education, collaboration and liaison, audit and quality assurance and research) [ 32 ].…”

“…A recent review from multiple countries and contexts conducted to inform the development of a comprehensive role description for practice pharmacists has detailed seven role sub-categories (medication management, patient examination and screening, chronic disease management, drug information and education, collaboration and liaison, audit and quality assurance and research) [ 32 ]. Over 80% of responding pharmacists were IPs with scope of practice mainly in hypertension, diabetes and respiratory diseases similar to other studies [ 17 , 25 , 26 ]. This may reflects the significant funding provided for pharmacists across the UK to be prescribers and practice in the primary care settings [ 18 , 33 ].…”

“…To date, two studies suggest that the GP pharmacists recruited through the NHS pilot scheme were reportedly satisfied with their integration into practice and were involved in the delivery of a wide range of clinical and non-clinical activities [ 13 , 17 ]. However, little is known about the activities and integration of pharmacists who have been recruited into the GP outside the pilot scheme [ 25 ]. A recent Scottish survey reported the perspective of practice-based pharmacists about their role and integration [ 26 ].…”

Strategies supporting sustainable prescribing safety improvement interventions in English primary care: a qualitative study

“…This could additionally expedite the adoption of services in areas where pharmacists are not yet available to support general practice owing to recruitment issues for the pharmacy profession in general practice. 28 , 29 Taking a team approach with the training and implementation of PSI-based interventions importantly builds sustainability by not relying on particular individuals for the sustainability of the intervention by spreading ownership across healthcare professions. 30 …”

Evaluation of General Practice Pharmacists: Study Protocol to Assess Interprofessional Collaboration and Team Effectiveness

“…Total scores for the following CCS elements will be computed at the baseline and 12 months: professional interactions (range 1-4), relationship initiation (range 1-5), exchange characteristics (role specification and trustworthiness; range 1-5), and commitment to collaboration (range 1-5). The Kruskal-Wallis test, Wilcoxon-signed rank test, or Analysis of Variance (ANOVA) test, as appropriate, will be used to assess the differences in CCS variables within and between different participant groups at baseline and 12 months [70,71]. Total scores for TES will be calculated for the participant groups.…”