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Emergency care expert: More pharmacy graduates needed in A&E

Dr Mann: Locate pharmacies in A&E departments and open “as many hours as possible”

An emergency medicine specialist has said there are not enough pharmacy graduates working in A&E “at the times we need them”.

Clifford Mann, clinical lead for NHS England’s accident and emergency improvement plan, told C+D that having more pharmacy graduates working in emergency departments over weekends and during public holidays would help alleviate winter pressures on hospitals. 

“We are being told there are lots of pharmacy graduates, but there don’t seem to be any [in A&E] on Saturday afternoon, Sunday morning, Sunday evening or bank holidays, which are the times we need them,” said Dr Mann, a former president of the Royal College of Emergency Medicine (RCEM). 

“I’m not asking [graduates] to do things that are outside of their comfort zones,” he stressed. “It is entirely feasible – surely everyone is a winner, particularly the patients,” Dr Mann said. 

Speaking at a King’s Fund event on winter urgent care provision last week (September 27), Dr Mann called for pharmacies to be co-located in A&E departments and open “as many hours as possible”. 

He told C+D he would “campaign” for every clinical commissioning group to ask their local A&E department to have a pharmacy on site, open 16 hours a day, 365 days a year. 

“It doesn’t have to be [overseen by] a hospital pharmacist – an independent pharmacist or a company such as Superdrug could run it,” Dr Mann said. 

Placing community pharmacies in emergency departments “circumvents a whole load of obstacles” when a patient needs a prescription, he explained. “Creating a hub [of health professionals], allows people to share their expertise and minimise the risk and inconvenience to the patient.”

Pharmacists also have an important role to play in managing patients on multiple medications, Dr Mann added. 

“The pharmacist is much better trained to look at the potential risks and benefits of drugs,” he said. 

Winter pressures in numbers

1,907,000 – The total number of A&E attendances in January 2016, an increase of 10.1% on the same month last year, according to NHS England.

485,000 – The number of emergency hospital admissions in January 2016.

Three – The number of hospital trusts – Gloucestershire Hospitals NHS Foundation Trust, Ashford and St Peter’s Hospitals NHS Trust and Colchester Hospital University NHS Foundation Trust – which C+D reported in November 2015 were advising patients to attend community pharmacies to alleviate A&E pressures.

20% – The proportion of people who attended A&E over the whole of 2014 with a non-urgent condition, according to Simon Abrams, an Everton GP who also spoke at the King’s Fund event.

How can pharmacists help alleviate winter pressures?

David Miller, Hospital pharmacist

Is the Lloyd's Pharmacy at North Manchester not providing this sort of service in their emergency department and the PIED study showed that pharmacists with advanced clinical skills and prescribing can deliver care to large numbers of patients beyond supply and medication management issues.

Barry Pharmacist, Community pharmacist

Correct me if I'm wrong but Lloyds offered to run this service for free. They soon realised they were being taken for "mugs" and pulled the service. The NHS wants to keep patients AWAY from hospitals so treat them in the community. In a community pharmacy perhaps? Open weekends, evenings? 

Clapton Chemist, Other healthcare profession

What's the pay like?

Abid P, Primary care pharmacist

Aren't Pharmacists the only healthcare professional that regularly work on a weekend. Ok for us to do it but when Doctors get asked they strike.

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