Clinical pharmacists in primary care general practices: evaluation of current workforce and their distribution

Abstract

Background General practices in primary care across England are increasingly employing clinical pharmacists to help tackle the workforce crisis and alleviate pressure. Clinical pharmacists can provide administrative and clinical duties, including non-medical prescribing, advice on polypharmacy and medicines optimisation. The aim of this study was to investigate the distribution of clinical pharmacists in general practice across England, and explore the relationship between the distribution and regional demography. Methods This study used publicly available government database from various sources pertaining to primary care general practice workforce and population demographics of England. The number and distribution of pharmacists working within general practices in England were analysed and compared across practices considering general practitioner (GP), nurse and patient population in the practices, patients age ≥ 65 years and over and the Index of Multiple Deprivation (IMD) scores. Results Twenty two percentage (1469 of 6674) of practices in England were found to have access to a clinical pharmacist, equating to 1358 full-time equivalent (FTE) pharmacists and a mean pharmacist FTE of 10.07 (95% CI 8.40, 11.75, SD = 9.84) per Clinical Commissioning Group (CCG). A significant relationship between pharmacist FTE and the number of patients 65 years and older [r (132) = 0.75, P < 0.001)] was observed; however, the distribution was not related to population deprivation scores. Conclusions Approximately one in five general practices in England have access to a clinical pharmacist. Further research is needed to ensure wider and equitable distribution based on workforce needs and practice population demography.

Protocol for a pilot randomised controlled trial to evaluate integrated support from pharmacist independent prescriber and third sector worker for people experiencing homelessness: the PHOENIx community pharmacy study

“…This study aims to address this gap. The inclusion of clinical pharmacists in the primary care team is embedded in NHS primary care framework and practice models in the UK [ 29 , 30 ]. These have been shown to improve: appointment access; medication adherence; patients’ understanding of long-term conditions; minimising illicit opioid use; and establishment of good quality networks with community pharmacy [ 31 ].…”

Pharmacists in Australian general practice: Discussion of the findings of an evaluation from 2016 to 2021

“…This compares to average FTE pharmacists per 10 000 patients in England ranging from 0.19 (95% confidence interval [CI] 0.13-0.25) FTE in the South-East to 0.25 (95% CI 0.20-0.30) FTE in the North-East and Yorkshire. 10 It should be noted that none of these FTE equivalents are based on economic evidence, and this is needed.…”

“…Training, including gaining an Independent Prescriber qualification, has been a component of this initiative, although there are reports that the impact of these pharmacists may be limited by a lack of role clarity 3 . Approximately one in five practices in England has access to a clinical pharmacist under this initiative 10 . Pharmacy services in general practice are more defined and widespread in Scotland, where most practices had some access to the government‐funded Pharmacotherapy Service by June 2022 11 .…”

“…3 Approximately one in five practices in England has access to a clinical pharmacist under this initiative. 10 Pharmacy services in general practice are more defined and widespread in Scotland, where most practices had some access to the government-funded Pharmacotherapy Service by June 2022. 11 In Scotland, general practice clinical pharmacists deliver advanced and specialist services (comprehensive medication reviews, high-risk medication monitoring, specialist clinics), while core tasks (including prescription management, medication recalls, compliance reviews) are mainly delivered by pharmacy technicians and support workers.…”

GPs’ and pharmacists’ views of integrating pharmacists into general practices: a qualitative study

“…[1][2][3] Pharmacists were introduced into general practices to alleviate some of the pressures within primary care (known as practice-based pharmacists; PBPs) by delivering a range of activities. 1,[3][4][5][6][7][8][9] Five-year PBP pilot schemes have been launched in both England and Northern Ireland (NI) to integrate PBPs into general practice. 7,10 Most emerging literature has focused on determining barriers and facilitators to the PBP role in general practice, however, there was little detail in relation to the context of the PBP role.…”