In April 2021, I hosted an episode of The Pharmacist Will See You Now podcast with three GP pharmacists. We called the episode What is a clinical pharmacist?

Our motivation was to discuss the consequences of the title for not only GP pharmacists, but the pharmacy profession in general. Earlier this year, we released the episode again and posed the question on social media to garner the opinions of other pharmacists.

We surveyed 124 pharmacists on LinkedIn about what they believed GP pharmacists’ job title should be. Almost half (48%) said ‘clinical pharmacist’, 17% said ‘pharmacist’ and 31% said ‘practice pharmacist’.

The clinical pharmacist title has become a pervasive catch-all term for GP pharmacists. Its ubiquity is a byproduct of the funded pharmacist roles for primary care networks (PCNs) through the additional roles reimbursement scheme (ARRS), with these roles being introduced in 2019.

I firmly believe that the term clinical pharmacist promotes an uncomfortable sense of us and them between pharmacists working in different sectors. If only some pharmacists are clinical, then it would imply that other pharmacists aren’t.

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That must surely be problematic. You finish your role at Boots on Friday as a pharmacist, you start your role in general practice on Monday as a clinical pharmacist. That must have been some Centre for Pharmacy Postgraduate Education (CPPE) course you did over the weekend.

I’m not the only one who thinks this. The former chair of the National Pharmacy Association (NPA), Ian Strachan, once called using the term a “deliberate attempt to be divisive and block the availability of community pharmacy [from playing] a central role in NHS policy”.

Since Mr Strachan made those comments in 2017, at least 5,000 pharmacists have moved into PCN or GP pharmacy roles, primarily from community pharmacy. That’s 10% of the entire pharmacist workforce in England moving into these roles, the repercussions of which have been hugely impactful on community pharmacy.

Following announcements of potential closures to some supermarket-based community pharmacies in 2023, NHS data shows that we have the lowest number of community pharmacies for seven years, and concerns about further closures continue.

There is a pervading attitude that community pharmacists, and by extension community pharmacy, are lesser than other parts of the NHS and therefore dispensable to the health service in general. They’re being squeezed out, but it’s fine because they’re not that important anyway.

Referring to GP roles as clinical is another tactic in proliferating that myth. That pharmacists are being used as foot soldiers in that particular war is disheartening to say the least.

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My fear is that the clinical pharmacist title is representative of an inescapable feeling of self-preservation, fostering sentiments that aren’t conducive to exploring the possibility of acting in the interests of the whole as opposed to the self.

Because many pharmacists enter general practice with feelings of inferiority, I feel that some have chosen to use the title as a way of manufacturing a sense of credibility among their clinical peers. I think it’s telling, for example, that none of the other ARRS roles have the word ‘clinical’ in their title – most notably paramedics, physiotherapists, and physician associates.

To my mind, the title is indicative of a profession that is unsure of its place and its purpose. It does a disservice to the level of specialism that a pharmacist has, a specialism that is vital to a well-functioning health service.

Pharmacists are the experts in medicines, you do this better than anyone. Millions of clinically significant medication errors occur in primary care every year and doctors are considerably more likely to make a prescribing error than a pharmacist, at least in hospitals. Those errors cost people's lives, as well as taxpayer money that is desperately required elsewhere. Pharmacists should be pioneers, leading the way in prescribing, not an afterthought or as a cheap alternative to remedy the dearth of GPs.

For some pharmacists wishing to make the move from community pharmacy to general practice, the feelings of inferiority can be intimidating. Does the title ‘clinical pharmacist’ make the role feel prohibitive to some? I’m not sure.

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But general practice can be an uncompromising and unwelcoming environment, entrenched in silo culture. To welcome the best and brightest in pharmacy talent to general practice, we have to make the role inviting to as many pharmacists as possible.

Not only that, but for too long the NHS has suffered from a lack of integration. Pharmacists have an opportunity to be an example of effective integration, to break down barriers and create links with community colleagues, to provide a safer, more efficacious service for patients.

Clinical pharmacist was a title bestowed on you by a higher power that neither understands, nor inherently respects, just how skilled you are. It’s an insult to your vocation. Your job title is 'pharmacist', own it, take pride in it, protect it at all costs.

That ‘pharmacist’ is a title protected by law under the Medicines Act 1968 should mean something. It means something to me – does it mean something to you?

 

Dan Read is the founder of the My Pharmacist Team app