Practice-based pharmacists have had a “significant impact” on the management of patients’ long-term conditions, according to an NHS England-funded evaluation published today (July 26).

According to the report, by academic researchers at the University of Nottingham, “the majority of [GP] sites, at a practice level, are seeking to employ their pharmacist when the pilot scheme funding ends” in 2020-21. “Clinical pharmacists should be an integral part of general practice,” the authors concluded.

One GP who took part in the study said: “We can’t survive without pharmacists, they are part of what we do,” while another said employing pharmacists in GP surgeries is “just common sense”as it is “excellent value for money and improves patient medication care”.

Reducing pressure on GPs

Researchers surveyed 78 GP sites where 373 pharmacists were employed as part of the NHS England scheme, as well as practice pharmacists themselves, and found “clinical pharmacists significantly increase patient appointment capacity and reduce pressure on GPs”.

Medication reviews were the “sole task” for 70% of the practice pharmacists in the study. “As part of these reviews, they were able to provide invaluable medicines education and usage advice to patients.”

“A large proportion of clinical pharmacists were responsible for streamlining the [hospital] discharge reconciliations process for patients, [with] 63% doing a discharge review every day,” researchers added.

Pharmacists also deprescribed medicines and provided support for healthy lifestyles. “Several” GP sites reported increased patient safety and a reduction in prescribing errors, the research found.

GPs’ “mismatch of expectations”

However, the research suggested that while “several” GP sites recognised the benefits that pharmacists bring to GP surgeries, “there is evidence of [a] mismatch in professional expectation, as some GPs expect clinical pharmacists to arrive in a state ready to conduct more patient-facing work than they actually are”.

GPs also suggested that the practice pharmacist role “is expensive to the practice, and financial benefits are not the main (or any real) motivation” for developing the role.

In future, “GPs wish to localise the role according to the demands of the practice and the specialisms of the clinical pharmacist”.

New career path

Dr Matthew Boyd, associate professor in patient safety and pharmacy practice at the University of Nottingham and lead author of the research, said: “Patients told us they understood their medicines in a way they never had, were now trying to follow lifestyle advice to help manage their health conditions such as diabetes, and had improved conditions following a medication review. 

“Now we know the positive impact this new pharmacist role can have, we need to ensure robust education and training is in place to respond to this new career path,” he stressed.

England’s chief pharmaceutical officer Dr Keith Ridge said: “Clinical pharmacists in general practice are playing an important role in the NHS…and we are confident that the benefits of the programme will continue across more GP practices as we continue the rollout.”

Royal Pharmaceutical Society (RPS) English pharmacy board chair Sandra Gidley said the “positive” research “clearly demonstrates overall how patient outcomes can be improved by thinking differently about how pharmacists integrate into the healthcare system”.

The RPS “supports better use of pharmacists’ skills to benefit patient care wherever they work”, she added.

Read a full copy of the University of Nottingham’s Clinical Pharmacists in General Practice: Pilot Scheme Evaluation here.