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Header image for the current page Providing pharmacy expertise and capacity to Primary Care Networks and GP practices

Providing pharmacy expertise and capacity to Primary Care Networks and GP practices

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As the number of pharmacy professionals working within primary care increases, ensuring the vital patient-facing tasks they undertake are consistently fulfilled is key.

When Clarendon Lodge Medical Centre and Dene and Stour Valleys Primary Care Network (PCN) needed a period of fixed term pharmacy support, Arden & GEM’s medicines optimisation service was able to provide experienced professionals to deliver tailored support.

The support enabled practices to meet their prescribing incentive scheme and QOF responsibilities through diagnosis support and prescribing in key areas such as hypertension and high cholesterol. The support also covered a wide range of activities including medication reviews, prescribing requests and queries, drug monitoring, and administrative duties. The result was safe, appropriate and timely medications for patients which also alleviated GP access pressures.

The challenge

The positive contribution that pharmacy professionals can make within primary care – in both patient-facing roles and improving medicines management processes – has been well recognised over the past four years, with more than 8,500 pharmacists now working in general practice.

But as the reliance of primary care on pharmacists grows, so does the risk of gaps in service provision when professionals, from a skills shortage area, aren’t available. This was the risk facing practices in Leamington Spa and Dene and Stour Valleys when existing staff were on periods of long term leave. Without the ability to source temporary expertise and capacity, vital patient-facing tasks would be unfulfilled, potentially increasing the workload of GPs and compromising patient care.

Our approach

Arden & GEM’s Medicines Optimisation team has experience of working across all pharmacy sectors. Additionally, many of the team are independent prescribers and/or have been on specific training programmes such as the CPPE Primary Care Pharmacy Education Pathway.

To meet the needs of the PCN and Medical Centre, three pharmacists were tasked with providing tailored support. As a large and busy practice serving over 14,000 patients, a six month period of intensive support was agreed to support Clarendon Lodge Medical Centre, with an embedded pharmacist working with them over a five day week.

"The Arden & GEM pharmacist joined the team and fitted in really well. She got to grips with our systems and processes quickly and made a real difference in how we manage our medication."

Stephen Gallagher, Practice Manager at Clarendon Lodge Medical Centre, Leamington Spa

In Dene and Stour Valleys, two pharmacists worked directly for the PCN over 11 months, splitting responsibilities at Hastings House and Meon Medical Centres.

"The Arden & GEM pharmacist was very knowledgeable, clinically competent, had a good work ethic and was always keen to support us. Although working remotely she engaged with the clinical team and was appreciated as a valuable member of our team."

Dr Karen Clarke, GP at Meon Medical Centre

The tasks and activities undertaken were wide ranging and agreed in advance with each practice.

Supporting diagnosis and specialist prescribing
The pharmacists supported key workstreams linked to the Quality and Outcomes Framework (QOF) and national priorities, including identifying patients with high cholesterol and hypertension.

Patients could be referred for review through programmes such as NHS Health Checks or where targeted patient groups had been identified – by phone or text message – to have a blood pressure reading taken. Our pharmacists supported the diagnostic process by arranging home blood pressure monitoring and ordering tests, before prescribing and reviewing appropriate medications such as statins or antihypertensives.

Medication reviews
Undertaking Structured Medication Reviews (SMRs), general and annual medication reviews, new patient screening reviews, female health reviews and Direct Oral Anticoagulant (DOAC) reviews.

Prescribing requests
Authorising repeat prescriptions and online requests for common medications (such as contraceptives or for hayfever) including any necessary patient communication or onward referrals.

Dealing with queries and supporting colleagues
Answering queries on prescribing incentive schemes, drug information, Electronic Prescribing Systems (EPS) and medication, as well as answering questions and advice requests directly from patients and from GPs.

High risk drugs
Monitoring those patients on high risk drugs such as methotrexate, antipsychotics and antidepressants.

Administrative support
Administrative duties included medicines reconciliation for hospital discharge letters and clinical letters, through the Docman system.

The outcomes

As a result of the clinical pharmacist capacity and capability provided by Arden & GEM, practice patients were prescribed safe and effective medications in a timely manner by an experienced practitioner with the appropriate knowledge and expertise. For the practices themselves, valuable additional capacity helped to manage patient need, widen patient access and maximise income.

Over the 11 month period of support provided to two medical centres in Dene and Stour Valleys PCN, the following activity took place:

"We found working with the pharmacist specifically and Arden & GEM in general to be a very positive experience. The team provided a highly proficient, reliable and professional service. The monthly reports summarising the work completed and cost savings achieved was also beneficial. We would happily use this service again if the need arose."

Andrea Stevinson, Practice Manager at Meon Medical Centre