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Pharmacists to monitor long-term conditions to ease burden on Scottish GPs

Community pharmacists in Scotland are to take on much greater responsibility for patient care, including monitoring and prescribing for long-term conditions under plans to ease the burden on overworked GPs.

In a report published this week, the Scottish government provided more detail on their strategy for extended roles for pharmacists working in both the community and GP practices.

It restated the commitment to ensuring that every GP practice has access to a pharmacist with advanced clinical skills by 2021.

And it outlined plans to widen the national minor ailments scheme to cover more conditions such as impetigo, uncomplicated urinary tract infections in women, and shingles following a pilot scheme in Inverclyde during 2017.

Annual medication reviews traditionally carried out by the GP will also become the job of the pharmacist who will have access to an enhanced Pharmacy Care Record, the report states.

Pharmacists will take on more management and prescribing for patients with long-term conditions.

The existing Chronic Medication Service will be expanded to include more monitoring and prescribing, the Achieving Excellence in Pharmaceutical Care report said.

‘This means that over time community pharmacists will be enabled to play a greater role in managing people with long term conditions, by prescribing, monitoring and adjusting medicines, working alongside pharmacists in GP practices, GPs and other members of the multidisciplinary team,’ the report said.

Other proposals under consideration include prescribing of long acting contraception by community pharmacists.

And for GP-practice-based pharmacists with advanced clinical skills, currently being trained through the Primary Care Fund, their role will include improving formulary compliance, and dealing with hospital outpatient requests, repeat prescribing, polypharmacy and medication reviews, including high risk medicines, as well as management of people with more complex, multiple conditions ‘monitoring and adjusting treatment prescriptions where appropriate’.

‘By taking on this role these pharmacists are improving clinical outcomes for people, reducing workload for GPs and other members of the multidisciplinary team, freeing capacity for them to focus on those with undifferentiated illness or other complex health needs,’ the report said.

Widening the primary care team is a key part of the new GP contract currently under negotiation.

Health secretary Shona Robison said: ‘This strategy is a vital part of our efforts to transform primary care, enabling more people to be treated at home or in the community and easing pressure on other services.’

Launching the report while visiting the pharmacy team within the GP practice at Port Glasgow Health Centre, chief pharmaceutical officer Dr Rose Marie Parr said: ‘In the community, we are making good progress in promoting local pharmacies as the first port of call for our most common healthcare needs and I want to encourage more people to see them as their initial point of care.’

Dr Hector Macdonald, clinical director at Inverclyde Health and Social Care Partnership added: ‘Pharmacy teams are making an important difference by working directly within GP practices’ multidisciplinary teams and consulting with patients on a range of medicine related needs.

‘The increased pharmacy contribution within our GP practices has led to improvements in quality and efficiency of patient care.’

It comes after Pulse reported this week that the first pharmacist-led GP practice is set to open in London.

Readers' comments (1)

  • I worry about this statement made in this report: ‘By taking on this role these pharmacists are improving clinical outcomes for people" as it sounds predetermined. That this is "improvement" to traditional holistic General Practice based on continuity, medical expertise and a wider approach to care than just pharmaceuticals.

    My view is that it is welcome that the Scottish Government are taking efforts, even if they are most belated, to address the "burden on Scottish GPs". The real issue, as we all realise, is lack of trained GPs compounded by low morale. The Scottish Government has to take responsibility for lack of workforce planning.

    I worry that this approach will not encourage "Realistic medicine". What of individuals on long-term medications that they might be better not taking? Just one of a number of concerns that I have. Might this approach facilitate longer term polypharmacy?

    It is interesting to read these responses to an associated PULSE post:

    http://www.pulsetoday.co.uk/your-practice/practice-topics/employment/first-pharmacy-led-practice-set-up-in-bid-to-counter-gp-shortage/20035093.article

    Dr Peter J Gordon
    (I worry that this approach will give specialist prescribing - I am a specialist - a freer reign to go unchecked by generalists who see the whole picture. I do not think pharmacists can do this. They do not have the training and are not governed or regulated to do so)

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