Its 10 years since community pharmacists have been able to acquire independent prescriber status.
The move was a recognition of pharmacy as an untapped resource in healthcare, with the potential to relieve pressures in both primary and secondary care – pressures that have only increased since the role was created.
The General Pharmaceutical Council (GPhC), recently published a report on a survey, which included the 2,500 independent prescribers on its register, to gain a “holistic picture” of this part of the community pharmacy sector.
Here’s some of the things C+D learned:
1. Independent prescribers need to extol their virtues – to everyone
The report highlighted that there is a “lack of awareness” as well as a “lack of understanding” about the role, both by patients and – perhaps in some ways more surprisingly – by other healthcare professionals.
While the GPhC acknowledges that this “can act as a barrier for pharmacist prescribers”, it is vague on possible solutions. It does suggest that working as an independent prescriber is an opportunity to “shine a light” on pharmacists’ in-depth knowledge of medicines.
2. Collaboration vs. competition
Independent prescribers, particularly those who work in primary care and GP practices, have opportunities to work even more closely and more often with other healthcare professionals than most community pharmacists.
The report says that when this works well, being part of a multidisciplinary team is “an empowering experience”. But when it doesn’t work so well, there can be “professional competition” between different prescriber roles, especially between pharmacist and nurse prescribers.
The GPhC says there’s a need for primary care colleagues to understand the specific strengths of a pharmacist and what the profession can contribute, as well as accepting pharmacist prescribers as part of their team.
3. Training can fall by the wayside when cuts loom
The survey highlights a “lack of financial incentives” associated with the role. Independent prescribers are being relied upon to take on “an enhanced role with increased responsibilities” – without any additional remuneration above their general salary.
It also touches on a lack of funding for posts, or training to run clinics ot provide primary care services. This means that “prescribers can struggle to find opportunities to practise”.
Even more gallingly, pharmacists who qualify feel they “might be overlooked for opportunities because of higher salary costs compared to some other non-medical prescribers”.
4. Hitting the glass ceiling
Some knowledge can be a bad thing. Once qualified, the GPhC says many independent prescribers still feel hamstrung by a lack of clinical expertise.
Others said they feel they lack clinical assessment skills after qualifying, and did not always feel confident diagnosing.
However, the survey shows this is far from the case for everybody – some 40% of respondents have moved beyond the clinical area they were trained in.
5. Is it still a fringe activity?
An earlier survey in 2013 showed 13% of independent prescriptions were issued by community pharmacists. But in the latest survey, conducted between August and October 2015, this fell to just 8%.
It appears that finding opportunities to prescribe is more difficult for those working in community pharmacy and in “other settings”, compared to those working in hospitals and GP practices.