Sheffield pharmacists provide pain relief for general practice

3 June 2016

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.”

Download the June 2016 issue of Commissioning Excellence as a PDF.

Resources Briefings

Latest News

Grammar and effective writing

19 February 2019

Grammar and effective writing helps you to discover the underlying rules and conventions of writing, consider the impact of your writing decisions and develop your own writing and editing skills.

Read More

Is the health secretary shaking up NHS IT for the better?

19 February 2019

Matt Hancock has taken a close interest in NHS IT, banning fax machines, insisting that email should replace paper and most controversially championing the use of AI and other high-tech alternatives to face-to-face clinical consultations. Is his hands-on approach a good or bad thing? Vote at www.networks.nhs.uk

Read More

Digital innovation in general practice - why, what, how?

19 February 2019

In line with the NHS Long Term Plan and the GP contract, new tools and services are already allowing general practice to work in new ways. Patients already have access to online appointment booking and prescription requests. What else can we offer as a range of contact options?

This half-day event on 25 April in Birmingham, 4 June in Leeds and 13 June in London for primary care commissioners and general practice leaders highlights how digital technology is providing new ways to see patients. We will hear from guest speakers with case studies that illustrate the range of e-consultation products and services available and what is already being done today. We also consider the legal constraints that commissioners and providers should be aware of.

Read More

Correspondence management

18 February 2019

GP practices that have got to grips with correspondence management have realised impressive savings in GP time and increased the job satisfaction of clerical teams. This half-day workshop on 9 May in Manchester and 25 June in Birmingham shows you how it’s done.

Practices receive hundreds of items of correspondence each week. Up to 60% of this could be managed by the clerical team without involving a GP.

The savings can be impressive. A case study on the NHS England website looked at the example of a practice with a 13,000 population, which managed to save each of its five GPs around an hour and a half a day - the equivalent of a day a week - by redesigning correspondence workflows. NHS England estimated the cost saving at £20,000.

Read More

Daffodils set the standard for end of life care

18 February 2019

GP surgeries will now be able to display a daffodil mark as a sign of commitment to improving end of life care, as part of a new partnership between the Royal College of GPs and the terminal illness charity Marie Curie.

The mark, synonymous with the charity, is based on a new set of criteria called the “daffodil standards” – a set of eight quality improvement statements designed to support primary care teams in delivering care to patients living with an advanced, serious illness or at the end of their lives, and their loved ones.

Read More