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What is a ‘post-reg’ or ‘clinical’ pharmacist?

"My colleague said they were a 'post-registration pharmacist'"

The use of the term “clinical pharmacists” risks dividing the profession, says primary care network pharmacist Harry Cotterill

When I was a newly qualified hospital pharmacist working on a night shift, I received a phone call from a fellow graduate working at another hospital asking to order a medication. When filling in the requisition paperwork, I had to submit their job title.

When I asked my colleague what their position was, they replied “post-registration pharmacist”, to which my fellow on-call pharmacist and I started laughing hard. The delirium of working at 10:30pm on your third 17-hour night shift in a row cannot be overstated, but the suggestion was ridiculous.

“Post-registration pharmacist,” I said, “so you mean a pharmacist?” The job is a protected term that can only be achieved by being registered. They thought about this, laughed, and said: “Well it’s what our trust uses as a title.” We moved on to getting the medications sent up the road.

Think about that title for a minute. Have you ever heard of a post-registration doctor, nurse or physio? I certainly haven’t. Including “post-registration” seems like an unnecessary quantification of the role. We shouldn’t need a title in front of “pharmacist” unless we are in extremely specialist roles.

Yet as pharmacists all we seem to do is differentiate ourselves from each other in ever more extreme ways. The title “clinical pharmacist” is something I cannot support. I think it is something we need to be aware of as both silly and dangerous. Just like with “post-registration pharmacist”, the point about a pharmacist being clinical is moot and should be laughed at.

We are the third-largest healthcare profession in the UK with our own regulating body. The General Pharmaceutical Council (GPhC) says pharmacists are responsible for “ensuring that the medicines prescribed to patients are suitable”. This cannot be done without the individual being clinical in both training and in action.

I have laboured that point to show just how toxic and damaging it is to start using the term “clinical” in job titles for certain members of the profession and not for others. The term drives a wedge through the profession.

To other healthcare professionals and, worse still, to the public, the term signals that some pharmacists are more qualified than others. If we stay collectively silent about the ongoing usage of “clinical pharmacist”, not only are we complicit in it becoming deeper embedded in the sector, but we signal how the profession can be split into tiers. This allows the argument for a five-year pharmacist apprenticeship scheme, which could lead to poorer wages and worse respect for all of us.

Harry Cotterill is a primary care network pharmacist based in Erewash, Derbyshire

9 Comments

Ronald Trump, Pharmaceutical Adviser

I dont see a problem with it to be honest. It's a recognised job term by NHS, CPPE , BMA etc There's jobs advertised for it. There's insurance policies for it. There's postgrad courses in it. Many pharmacists use the term to describe their role. If pharmacists want to call themselves a clinical pharmacist then I think that's fine. I agree all pharmacists are clinical to a certain degree. However, if you define clinical work in terms of direct examination and observation of parients, then I believe there are certain pharmacist roles that include much more of this. If you include checking a prescription as clinical work then you will say community pharmacists are predominantly clinical, as most of there work involves checking prescriptions. I think in 5-10 years the term will be redundant anyway as the foundation year and undergrad integrated prescribing training comes in and we start churning out new pharmacists who do less dispensing and more bedside examnation and observation. I think this only becomes a divide if you make it out to be. Because someone describes themself as a clinical pharmacist doesnt mean that they think theyre a better pharmacist than you. They may think they have a different role, skillset or knowledge which they feel may be more clinically defined. But again, it depends on what one defines as clinical. I think using the term clinical pharmacist can have benefit for patients and other healthcare professionals as it can help them understand that they may have a different to role to their community pharmacist (or chemist as alot of patient's call them). Doesn't mean theyre better or worse, just different. I would say on the whole GP based and Hospital based pharmacists have much more of a typically 'clinical' based role than community pharmacists-i.e. involves more observation and examination, blood tests, phyical examination, precribing, monitoring, consultation etc most community pharmacists are bogged down with checking prescriptions all day, managing a business, HR, planograms. I understand there are also some community pharmacists who have more clinical work than non-clinical work in there day to day e.g lots of clinical services but i think these are in the minority. I think as pharmacists we all have a similar set of core skills, however we also have jobs/ roles that vary quite considerably- which is the beauty of being a pharmacist. 

R A, Community pharmacist

Just another fancy title for a profession with zero respect for itself. 

I Scott, Community pharmacist

I object to the term clinical pharmacist on the grounds that all pharmacists are clinical.  I work in a GP surgery.  I have a clinical diploma and am an independant prescriber but refer to myself as the Practice Pharmacist as my role is purely within the practice.

Benie Locum, Locum pharmacist

Crabs in a barrel, shuffling deck chairs on the Titanic....

Bob Dunkley, Locum pharmacist

I'm glad I'm retiring 

A.S. Singh, Community pharmacist

If you speak to younger pharmacists, no one wants to be in community pharmacy. Rather be cosying up to GPs sitting behind a desk than getting shouted at behind some inept short staffed chain

Roger Schofield, Locum pharmacist

There lies the problem , company owned pharmacies should never have been allowed .They are not in patients interest nor Pharmacists.

Raymond Anderson, Community pharmacist

Agree entirely with article. Never hear of a "clinical doctor" or nurse. The idea is ridiculous. The profession is changing but that doesn't mean we put barriers between different roles. We have pharmacists working in hospital, community, GP practices etc. That should be sufficient. 

Pear Tree, Community pharmacist

It does really infuriate me the extent some in our profession go to differentiate themselves from their fellow colleagues in the community. We have all done the MPham degree and provide care to our patients regardless of where we work. Imagine the response if GPs were called a Community Doctor rather than a Dr from their hospital colleagues. Yet this "clinical" badge is flashed in evey profile and biography to show how more accomplished some in our profession are. 

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