In her latest guest blog, Lyndsey Stanley, Clinical Pharmacist, celebrates World Pharmacists’ Day on 25th September 2018, a global annual event designed to promote the pharmacists’ role in improving health.
The theme for this year’s event is, ‘Pharmacists are your medicines’ expert’. In this article we look back at the history of pharmacy and examine the evolution of pharmacy in the primary care sector.
Pharmacy in Britain takes its roots from the old spice traders whose goods included crude medicines and who evolved into Apothecaries in the thirteenth century. Apothecaries took on the role of diagnosing medical conditions and dispensing medicines. However, another group would soon develop who were interested in the manufacturing, package and sale of wholesale medicines.
By 1815, the Apothecaries Act confirmed apothecaries as general practitioners and the chemists and druggists became responsible for the sale and supply of medicines, although they would have to wait until the early 20th century before the professional registration of pharmacists. However, the real evolution of pharmacy came with the introduction of the NHS in 1948 and the subsequent introduction of large numbers of new drugs. Doctors became aware of the potent nature of many of the medicines and began to realise that they hadn’t been trained for this. Thus the foundations for the bridges between the professions were laid. However, pharmacy was still very much viewed as a dispensing mechanism and the two professions often worked independently of each other, only interacting when a pharmacist pointed out an error on a prescription to a grateful doctor.
Evolution in the NHS
Hospital pharmacy would develop at a quicker rate to community pharmacy with hospital pharmacists becoming integral to the health care team in secondary care and taking an active role in ward rounds. Although pharmacists have been employed by NHS Trusts to work in primary care for many years, it is only recently that politicians have started to realise the benefits of pharmacists in general practice. In 2014, a round table event held by The NHS Alliance and the Royal Pharmaceutical Society, identified, “A widespread inability to recruit GPs as practices face the challenge of rising demand for primary care from an aging, increasingly co-morbid population” and that, “GPs spend significant time managing prescribing, reviewing medicines, reconciliation of letters and discharge forms, addressing patient compliance and managing long-term conditions.” All of which are roles that are suited to the skills and expertise of pharmacists. So, began a pilot programme to introduce clinical pharmacists into GP practices in 2015 wherein NHS England recruited an estimated 490 pharmacists across 650 GP practices. Such were the results of the pilot that NHS England have pledged to invest over £112 million to get an extra 1,500 pharmacists into general practice to relieve GP workload by 2021.
Pharmacists in General Practice
In June 2018, the University of Nottingham published an evaluation of phase 1 of the pilot which examined the activities undertaken by clinical pharmacists in GP practices, the costs and effects, the satisfaction of medical practice staff with the innovation and potential barriers. An executive summary of a full copy of the report can be accessed here.
The results indicated that clinical pharmacists play a unique and valuable role in general practice and bring with them an expertise in medicines and prescribing that results in improved patient safety, increases capacity in practices and improved knowledge of medicines for the wider healthcare team.
The significant investment in placing clinical pharmacists in GP practices shows confidence in the abilities of clinical pharmacists and will mean that over 40% of surgeries in the country, representing a patient population of 34 million patients, will have access to experts in disease and medicines management. NHS England will part-fund the pharmacist’s salary on a reducing basis over a 3 year period and pharmacists will follow a national learning pathway. Practices can apply for funding here.
In addition the PMA is able to offer practices:
- Disease specific medication reviews
- Poly pharmacy medication reviews
- Medication reviews for housebound patients and patients in care homes
- Drug safety audits
- Disease management audits
- Medicines waste audits
- Education for your administration team including: how to deal with conflict, consultation skills, managing medicines waste.
