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The term ‘clinical pharmacist’ is ‘deliberate attempt’ to be divisive

Ian Strachan: All pharmacists are clinical pharmacists

Using the term “clinical pharmacist” is a “deliberate attempt” to block community pharmacy from playing a central role in the NHS, the National Pharmacy Association's (NPA) chairman has said.

The term is regularly used by NHS England to describe pharmacists being recruited into GP practices, and has drawn the ire of pharmacy representatives over the past year.

“A clinical pharmacist is used to differentiate high street community pharmacy from a more clinical profession,” Ian Strachan told delegates at the NPA’s fringe event at the Conservative party conference on Monday (October 2).

“It is a deliberate attempt to be divisive and block the availability of community pharmacy [from playing] a central role in NHS policy,” he stressed.

“All pharmacists are clinical pharmacists. Let’s put that one to bed.”

Sector being "pushed back"

Speaking exclusively to C+D before the fringe event, Mr Strachan stressed that the sector is being “pushed back” by those in government who do not share the view that “the community pharmacy network is the solution”.

“Leadership needs to be aligned and get behind community pharmacy,” he said. “We have the access and capacity to do more – it doesn’t make any sense [not to use us].”

Mr Strachan also emphasised the need to influence the political party in power. “[We have] to be positive and give them the answers and the position that puts pharmacy at the centre of NHS policy making,” Mr Strachan told C+D.

During the fringe event, Conservative MP Bim Afolami was asked why pharmacy was not being discussed on the floor of the Conservative conference. He responded it is currently "very difficult" to discuss the NHS as it is "so politically charged".

27 Comments
Question: 
Do you agree with the term 'clinical pharmacist'?

Interleukin -2, Community pharmacist

Just buy a green ball point pen and go round the wards making gruesome little marks on people's charts and annoying every consultant you come accross by suggesting that "tramadol and amitriptyline shouldnt be prescribed together ! due to risk of cns toxicity! and being ignored anyway absolutely makes you clinical ! Easy ! The problem is that too many of us wanted to study medicine initially and failed.....so they settled for pharmacy. Someone has to say it

Mohammed Patel, Community pharmacist

Using the defintion above, all pharmacists are clinical. We all care about our patients, and we use our ingrained scientific knowledge to assist the public as much as we possibly can. We are here to help people and improve the nation's health as far as is realistic, given our limitations. We are here only to do good.

However, I have also experienced hospital pharmacists touting themselves as "clinical pharmacists" because they think this is on a higher plane to your average pharmacist. It is not.

In my experience of working in 8 hospitals, pharmacists who refer to themselves as "clinical pharmacists" are often the ones who regularly dodge work in the dispensary, because they consider it to beneath their "clinical" status. Not all, I must add, I have met some amazing people, but in general this holds up.

I have also witnessed overweight "clinical pharmacists" sitting in their office eating jelly babies whilst all hell was breaking loose in the dispensary. They knew the dispensary had a backlog but because they were "clinical" they couldn't care less so just did nothing. Sat on their chair in their office at went home at 5pm.

As pharmacists, the last thing we need to do is be divisive, we need to stand together, prove our worth and stop being down-trodden by the people in charge because we are a soft target. Clinical pharmacists are still pharmacists, and if you are so hell bent on writing prescriptions then why don't you get off your backside and study medicine instead of trying to make "normal" pharmacists feel inferior?

We are pharmacists, not "mini" doctors. A GP friend of mine found it highly amusing that pharmacists were trying to break into prescribing but I won't say what she said,  as it was possibly quite derogatory. Although she said it how it was and I had to agree.

I studied pharmacy because I wanted to be a pharmacist, not spend my life wishing I could write scripts and be a doctor. And now, I am a pharmacist and get a great deal of satisfaction in helping my regular customers on a day to day basis, but the outrageous pressures on community pharmacists mean I can spare very little time to speak to them.

Don't take that the wrong way, I am all for pharmacists taking on new roles and responsibilities. But a pharmacist with a prescribing qualification is still a pharmacist, please don't think you are better and try to divide what is already a small and factious work force.

The term "clinical pharmacist" only seeks to create division in a profession which can ill afford it. Clinical pharmacists can still get in the dispensary and check even if they don't like it. It is not below you, that is your job as a pharmacist (you are NOT a doctor).

We are all pharmacists. Let's work together and show what value we can add to healthcare in the UK, because I know damn well that there are some amazing pharmacists out there.

Divided we will achieve nothing. Certain pharmacists thinking they are better than a "normal" pharmacist will only exacerbate the division of the pharmacy workforce in the UK.

community pharmacist,

 

Both hospital and community pharmacists are clinica imo. A pharmacist still needs to carry out a clinical check when checking prescriptions and goes through a similar process to hospital pharmacists regarding the most suitable dose any contraindications drug interactions etc. 

 

Freelance Chemist, Pre-reg Pharmacist

Lets be honest 90% of pharmacists do not now how paracetamol works! I think im going to do an undercover youtube film to expose them all!!

Interleukin -2, Community pharmacist

...especially the dim wit ones who spell "know" as "now"....

Gerry Diamond, Primary care pharmacist

I work as a practice pharmacist the same as a practice nurse, so don't think the title or role is superior in anyway to community pharmacist just a different job specification. I think community pharmacists have a crucial role just as important as any other pharmacist job in delivering a presciption dispensing service, medication review, public health , minor illness and health promotion, vaccination, travel clinics, compliance aids and pharmaceutical advice. It's not other pharmacists roles that are the problem but this governments terrible record on its lack of commitment to the NHS. Divide and conquer and they are succeeding too. Good luck!

Anonymous Anonymous, Information Technology

What is truly hilarious is seeing a hospital pharmacist doing a locum in community!!!

Richard Binns, Primary care pharmacist

I'm sure the same would be appicable in reverse, sorry the point you where making was?

Richard Binns, Primary care pharmacist

Just a quick question, dose anyone recall anyone getting their nickers in a twist about being branded a 'community pharmacist' before the advent of GP pharmacists?

The whole debate reminds me of a child wanting the toy his siblings just been handed.

Surely if the term was meant to be divisive then it has suceeded, if any sector of pharmacy is commited to surviving the current climate, then focusing on quality service and demonstrating a sustainable positive impact to the overall NHS is probably a more productive tactic than arguing about a Job title.

 

Ilove Pharmacy, Non Pharmacist Branch Manager

You're right. Pathetic and embarrassing.

Ronald Trump, Pharmaceutical Adviser

I think Mr Strachan is speaking a lot of sense here. All pharmacists in all sectors and jobs are clinical to a certain degree. Definition of Clinical: 'relating to the observation and treatment of actual patients rather than theoretical or laboratory studies.'

No doubt hospital pharmacists carry out more clinical work than community pharmacists in general. But we are all pharmacist. So lets call pharmacists who work in GP's 'practice pharmacists' or 'GP Pharmacists.' 

Its quite clear to me that the NHS and Government see the future of community pharmacies as mainly hubs for medicines supply and distribution (tieing in with advancement of technology and hub and spoke)- not for treating/monitoring patients- therefore believeing they can run it more efficiently with upskilling technicians and relaxing supervision laws. They see the excess supply of pharmacists in the UK to be able to ease the burden on GPs by taking away many of their roles such as clinical medication reviews, repeat prescribing and clinics for LTCs. This is not to say pharmacists are replacing doctors, they are just bringing there own skill set and maximising their potential. Not to mention the benefit of multidisciplinary learning and improved health outcomes for the patients. Its part of the natural evolution of the role of the pharmacist.
 

A Hussain, Senior Management

Switching to branded generics is hardly clinical.  I know that's not all practice pharmacists do, but there will be plenty where it is.  Good and bad in all branches of the profession.

Valentine Trodd, Community pharmacist

I'm a Cynical Pharmacist...

Chemical Mistry, Information Technology

I wonder is if is aiming his ire at Dr Ridge by any chance?

Ilove Pharmacy, Non Pharmacist Branch Manager

Titles used by paymasters to reflect importance of some sort and make the individual feel good. No difference to wages I'm pretty certain. Very clever.

Rubicon Mango, Academic pharmacist

I have met some hospital pharmacists that lack the deep scientific and pharmacological understanding but get by with superficial clinical knowledge. The very basic. The type of knowledge that fills the gaps for junior doctors at the very best but not much help. I wouldn't call these pharmacists clinical at all. At the same time I have met 'retail' pharmacists with deep clinical, scientific, pharmaceutical and pharmacological knowledge. It relates to the attitude of the individual at degree level. 

Former Cist, Pharmaceutical Adviser

Umm....are you being serious? I haven't worked in hospital for many years but know pharmacists who do. Sure if you work entirely in a specific area like sterile or non sterile production your expertise will be narrow but specialised (and you wouldn't ask a cardiologist how to treat hayfever). But generally the clinical knowledge of hospital pharmacists is way above that of community pharmacists simply because most of their day they are working in a clinical environment being challenged and challenging others on matters clinical and pharmaceutical. Compare that to the environment in most community pharmacies these days. The limited clinical role that pharmacists in this sector used to possess has been lost but claimed and rapidly developed by practice pharmacists with clinical diplomas and prescribing qualifications. When I was working in practices I never once had a call from a community pharmacist offering a clinical opinion or intervention but I had many trying to order (and over order) repeat prescriptions. However none of us will benefit by slagging the other pharmacy sectors off. I just feel that community pharmacy is in a bad place at the moment but to fight it's way out it needs to recognise where it is and why it is there, and avoid denial, then work out how the sector can be seen to make a valuable and valued contribution in primary care once again, that is recognised and trusted by patients, GPs, CCGs and the DH.

Rubicon Mango, Academic pharmacist

Having worked in a hospital setting 8 years ago, I can relate to the level of 'clinical' you refer to. If by clinical you mean guidelines and procedures, then yes, clinical indeed. I was in a meeting 6 months ago with the oncology department at a local infirmary. Academics, consultants, medical staff and nursing staff were present. The oncology pharmacist was also present and the understanding of disease states, local tumour homestasis which is an important factor in pharmacodynamics was absent. I expected a specliast in drug therapy in the area to be the focal of such knowledge. The pharmacist could not contribute anything medical/clinical but only safety guidelines of drug administration which was formulated by someone else. Yes a bit they are important but does it warrant a pharmacist to do that?

Ilove Pharmacy, Non Pharmacist Branch Manager

You both sound like drunks fighting over an empty beer can. Nobody care. Both branches of pharmacy in the doldrum. Salaries in both sectors for locums/employees are embarrassing. Community unlikely to ever recover.

Anonymous Anonymous, Information Technology

Locums earning £12 an hour in London. Simultaneously, Mcdonald's workers fighting for £10 an hour outside of London (and more in London). Thus we will soon be working for Mcdonald's-equivalent salaries!! All the while we will have wasted five years of studying for a hard degree (coming from experience I can say pharmacy is a harder degree than medicine) plus £50k in debt! In the words of a dragon - I'm out!!!

Ilove Pharmacy, Non Pharmacist Branch Manager

And you lot are agrguing about titles. LMAO.

Former Cist, Pharmaceutical Adviser

I guess I am trying to contribute to a debate that might help lift community pharmacy from the fate of oblivion. But before that can be achieved, the pharmacy community, like a downward spiralling alcoholic, has got to recognise that there is actually a problem. Ian Stachan, who I am sure is a decent, clever, hard-working chap, is frankly living a life of denial. Community pharmacy needs to change big time and sooner rather than later. The Government, DH, CCGs and many observing from the sidelines recognise it. The trouble is PSNC, NPA, LPCs and many blinkered contractors are trying to cling onto the last century.

Ilove Pharmacy, Non Pharmacist Branch Manager

I appreciate your point but community phamracy is led by corrupt liars and thieves masquerading as regulators and multiples. The Government have been bought off as well so there is not much hope to be fair. The PDA do their best but the game is over.

John Cleese, Production & Technical

Reminds me of the way Boots used to call pharmacists who were qualified for 18 months "Consultant Pharmacists". No evidence or extra qualifications required for the grander title. Do they still do that?

Pharmacist Pharmacist, Community pharmacist

I disagree. Every other profession has titles. A cardiac consultant. A practice nurse etc etc.

M P, Community pharmacist

Why not call them practice pharmacists? The issue is the use of the word clinical which implies pharmacists in other areas are not clinical. 

Call Me Cycnical, Senior Management

Do they study a different course to the pharmacists working behind any counter in any pharmacy? Clinical Pharmacist, Hospital Pharmacist, Retail Pharmacist, nothing more than a location title, not a qualification as far as I'm aware. Yes of course their are bolt ons in qualifications, but the core competency of a pharmacist is the same. May be a Clinical Pharmacist does things quicker and more ruthlessly? Like a footballer, clinical in his finishing. :)

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