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Scottish pharmacy chief: Delivering vaccinations not ‘best use of pharmacists' skills’

Asking pharmacists to deliver a vaccination programme is not making “the best use” of their clinical skills, Scotland’s chief pharmaceutical officer (CPhO) has told C+D.  

Over the course of the pandemic, Scotland has not used community pharmacy “as part of our [COVID-19] vaccination response to any great extent”, Alison Strath revealed in an exclusive interview with C+D.

While “not everyone might agree with it”, she added, “on a very personal level, I am not convinced that the best use of a pharmacist’s skills is actually in delivering a vaccination programme”.

Professor Strath, who became Scotland’s CPhO in August 2021, said that the pandemic “has allowed us to have some flexibilities around the use of, for example, pharmacy technicians, other registered members of staff, equally, pharmacy students and others”.


Read more: Government urged to let pharmacy technicians give COVID jabs under PGD


Currently, under a patient group direction, trained pharmacy staff – including pharmacy technicians – can undertake stages 2, 3 and 4 of the vaccination service, which involve vaccine preparation, vaccine administration and record keeping. However, they may not undertake stage 1 – the patient assessment.

If those flexibilities were to be retained, “I think I’d be much more supportive of seeing full-scale vaccination services in community pharmacies”, as other members of the pharmacy team would be “well placed” to take on vaccination duties, Professor Strath added.

However, a full-scale vaccination programme in community pharmacy “doesn’t  feel to me the right thing to do” if it “means taking our pharmacists, who are investing in prescribing training, who are developing their clinical skills further” away from these activities, she said.


Rural pharmacist vaccinators “makes perfect sense”


Her comments come as the Scottish government is due to roll out its vaccination transformation programme (VTP) by April 2022, which aims to modernise how vaccine services are delivered, moving away from a model based on GP delivery.

“On the VTP, there definitely are some health boards who are very keen to use the pharmacy network and I think I can particularly see in remote rural communities why that makes perfect sense,” Professor Strath told C+D.

But pharmacies need to be given the right resources to be able to deliver these vaccination services, so that they are not “so stretched” to the point where they cannot offer other clinical services at the same time, she added.

“As you embed these services, the public come to expect them. You have to be able to deliver them,” she said.


Read More: Pharmacies in Scotland start to pick up vaccine services as these are moved away from GPs


However, Professor Strath is “hopeful” that The Human Medicines Regulations 2012 legislation will change to allow other members of the pharmacy profession to provide vaccinations, she added.

“I think that would give us the flexibility to use the community pharmacy network in a much more productive way,” she said.


All pharmacists in Scotland to become prescribers


One goal for Professor Strath is to move pharmacies in Scotland from the NHS Pharmacy First service to NHS Pharmacy First Plus, investing in prescribing training programmes for current pharmacists to allow them to use further clinical skills. 

Last month, the Royal Pharmaceutical Society (RPS) in Scotland unveiled its vision for pharmacy in 2030, in which it described how all pharmacists in a patient-facing role should be independent prescribers.

“It’s definitely a shared ambition, right across all of the stakeholder bodies in Scotland,” Ms Strath said. “We’d like to see community pharmacists, in particular, having access to an independent prescriber to allow them to extend the range of services they can provide.”

Scotland’s ambition for all pharmacists to be qualified as independent prescribers was initially put forward in its Prescription for Excellent strategy, published in 2013 – in which the government anticipated that all pharmacists would be required to hold the qualification by 2023.

“Now, that probably was a little bit early for the profession,” Ms Strath conceded. “But I think now that people can see how to use the skills, there is a real desire for that,” she said.


Is getting an independent prescribing qualification worth it? Catch up with C+D’s latest Big Debate on the issue, on the C+D Community.


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