The Royal Pharmaceutical Society (RPS) recently worked with the British Medical Association’s (BMA) Scottish GP Committee to agree on a joint statement on the Scottish NHS pharmacotherapy service.
In the statement they have drawn attention to the fact that whilst much progress has been made, with significant investment in general practice pharmacy teams, significant challenges remain.
Recommendations within the joint statement include the following:
- Appropriate skill mix has not been established in many areas resulteing in some pharmacists undertaking work that would often be more appropriately provided by pharmacy technicians or pharmacy support workers, resulting in an underuse of pharmacists’ clinical skills. The skill mix required to deliver all aspects of the pharmacotherapy service should be reviewed and that the roles of all pharmacy team members are clearly defined
- Pharmacists should be focused predominantly on patient-facing clinical roles: using pharmaceutical expertise and independent prescribing skills to deliver clinical medication review, support safer use of high-risk medicines, and improve complex pharmaceutical care.
- Further development of roles for pharmacy technicians to lead on the technical aspects of medicines management.
- A single shared patient medication record should be developed to improve medicines reconciliation.
- Further IT developments should be prioritised to make improvements to the serial prescribing system.
- The core team delivering the pharmacotherapy service includes pharmacists, pharmacy technicians and pharmacy support workers.
- Community pharmacists should take on some aspects of the pharmacotherapy service.
The pharmacotherapy service was introduced in Scotland in 2018 as part of the General Medical Services (GP) contract with ambitious aims to embed the role of pharmacists and pharmacy technicians in general practice.
An updated memorandum of understanding on the pharmacotherapy service in 2021 recognised the progress that had been made but also that further investment was required to achieve delivery o all levels of the service. At that time this included calls for further workforce investment.
The current joint statement raises similar issues once again principally around the need for further pharmacy team workforce investment.
“Much progress has been made, with significant investment in general practice pharmacy teams, however, significant challenges remain, and further investment is required in the workforce, skill mix and infrastructure to realise the full benefits of the service.
“These challenges are undermining the professional role of some pharmacists and have prevented workload reduction for GPs which would help to free up time to perform their role as expert medical generalists.
“These issues need to be addressed urgently to ensure that roles are, and remain attractive, to recruit and retain pharmacists, to provide positive patient care, free up GPs to spend more time as EMGs, and build a sustainable pharmacotherapy service.”
They have called for further investment in the general practice workforce, skill mix and infrastructure to realise the full benefits of the service.
RPS and the BMA believe that these challenges are undermining the professional role of some pharmacists and have prevented workload reduction for GPs.
They are jointly calling for these issues to be addressed ‘urgently’ to ensure that roles are, and remain attractive, to recruit and retain pharmacists, to provide positive patient care, to free up GPs to spend more time with patients, and build a sustainable pharmacotherapy service.
Clare Morrison, RPS Director For Scotland, said:
“We believe it is essential that use of pharmacists’ clinical skills is maximised in general practices. Pharmacists should be delivering clinical medication reviews, supporting safer use of high-risk medicines and improving pharmaceutical care.
“And they should be doing this in patient-facing clinical roles, using independent prescribing.
“But this is only achievable if the right infrastructure is in place: that means improving skill mix and the digital systems that underpin the pharmacotherapy service.”
In conclusion within the joint statement Clare Morrison and Dr Andrew Buist said:
“We have outlined recommendations in this letter that will help to address emerging issues and increase the pace of implementation. We believe that our recommendations are achievable and that together they would improve the wellbeing of both pharmacy and GP teams through the realistic workload, best use of skills and professional satisfaction. This will deliver a sustainable pharmacotherapy service for the future with resulting improvement in clinical efficiency and patient safety”.