Dr Andrew Power, head of medicine management at NHS Greater Glasgow, explains how the role marries medicine with pharmacology – and delivers cost-effective care.
How did you end up in your position?
I took up my current post as Medical Prescribing Adviser in the mid 90s after four years as a principal in general practice. I’m fortunate to have found a career combining medicine and pharmacology as my interest in medicines stems back to an intercalated B.Sc. in pharmacology on the mid 80s. Although there have been several changes in the organisation of primary services, supporting best practice in prescribing remains my remit. One of the advantages in working in this environment is the multidisciplinary approach to delivering this aim.
Although medical input into this area has reduced since the role was first implemented in 1992, there are opportunities as many Community Health Partnerships have sessional GPs supporting their prescribing work. CHPs are always looking for interested GPs to populate prescribing groups and to review formulary sections so, if you’re interested, it may be worth contacting your prescribing lead or clinical director.
What does it involve?
Pharmacy input has always been strong but increasingly it’s been focal to prescribing support and data analysts are core to the work of the prescribing team. From routinely available prescribing data they have developed tailored reports that meet the needs of practices, CHPS and Health Boards. For example, they provide benchmarking for the MED 10 (demonstrating change in up to three areas of prescribing) indicator in QOF and offer support to GPs who need prescribing data for appraisal.
Can the position effectively lead change?
I contribute to clinical governance issues where GPs may need support or guidance in order to deal with performance issues. Two current areas of my work illustrate the leadership required. The interface between acute and primary care is often a source for concern for GPs and they often use me as a sounding board for recommendations from specialists for drugs with which they are not familiar. The other area I’m leading my team on involves implementing a drugs formulary which is useful to the user and delivers on a cost effectiveness agenda. On the negative side, guideline development does demand a lot of patience.