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Sheffield pharmacists provide pain relief for general practice
Community pharmacists are working in GP practices across Sheffield following a successful pilot programme.
Using investment from the Prime Minister’s Challenge Fund to improve access to GPs, the scheme releases GP time, improves medicines management and has been welcomed by the mainly elderly patients who have benefited from expert pharmacist advice and interventions.
After initially piloting the scheme in four practices in early 2015, Sheffield Clinical Commissioning Group has worked with local practices to match each with a local community pharmacist.
Although the arrangements and work undertaken are shaped by local needs and their skill level, the project typically sees them working one day a week in the practice and two days in the case of larger practices. With the supply of highly-trained pharmacists increasing, the CCG sees them as a specialist clinical resource that can help GPs and other practice clinicians such as nurses use their time more effectively.
Responding to referrals from GPs and practice staff, the pharmacists’ have largely focused on:
- Dealing with patient queries about medicines
- Medicine reviews
- Authorising repeat medication.
Pharmacists are doing home visits to patients at high risk of hospital admission.
The CCG allocated £730,000 of its £9m PMCF money to the programme, largely to cover reimbursement to the pharmacists’ employers and for locum cover. According to Sheffield CCG medicines management lead, Dr Peter Magirr, the CCG sees the main benefits of the programme as freeing up GP time while improving both the service to patients and the quality of medicines management.
Data gathered on PharmOutcomes suggests the pharmacists’ work so far has released 1375 hours of GP time as 92% of their activity would otherwise have been done by GPs. The pharmacists refer back only 6% of patients to GPs.
The pilot identified that pharmacists sometimes recommend cheaper medicines for some patients and other potential savings – such as patients receiving new prescriptions when they had failed to collect other scripts.
Matching pharmacists with 86 practices and encouraging their employers to see the benefits are among the challenges the CCG has faced.
“The logistics have been challenging because there is no infrastructure to get pharmacists working with 86 practices,” Magirr says.
The practice also has to invest some time initially in inducting the pharmacist into its way of working and its IT system – once considerations around confidentiality and information governance have been overcome. In most cases pharmacists signed confidentiality agreements and are able to access the full medical record – providing an overview that is itself helpful in medicines management.
“However the improved relationships and understanding benefit both the practices and the pharmacies – not least because they are local and see the same patients. That relationship is key for better patient care. The GPs really value the work that pharmacists are doing in and for their practices.”
While some pharmacists have had qualms about working in a practice, all have found it a positive experience, Magirr says.
“Some of the pharmacists were initially concerned whether they had the clinical sills to work in that environment but it is about reactivating and sharpening skills they have. They have gained great professional satisfaction from using their knowledge, visiting patients at home and undertaking very patient-focused work that is improving outcomes for patients and the patient experience.”
“There’s also a commercial benefit for the pharmacy employer if more patients see the pharmacists as professional clinicians rather than quasi-shopkeepers.”
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