www.england.nhs.uk
Clinical
Pharmacists
in General
Practice
Ravi Sharma
(Programme Clinical Lead)
Twitter: @RSharmaPharma
www.england.nhs.uk
• Pharmacists will form part of multi-disciplinary team team in a patient facing role to clinically assess and treat patients using their expert knowledge of medicines for specific disease areas
• Proactively manage people with complex polypharmacy – especially elderly, care homes, multiple co-morbidities
• Medicines advice – helping address both public health and social care needs
• Leadership on medicines optimisation and quality improvement
• Further integration of general practice with wider healthcare teams including community and hospital pharmacy
• Pivotal role to improving the quality of care and ensuring patient safety
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Overview of the role clinical
pharmacists will play in general
practice
www.england.nhs.uk
Further insight to the role of clinical
pharmacists in general practice
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Clinical patient facing
roles
Long term conditions
Clinical Medication
Reviews
Home visits/care homes
Others: common ailments,
care plans, triage
Clinical Post/Pathology
Checking and reviewing
Action
Signposting/triage
Medicines optimisation
Repeat prescribing
Medicines
queries/requests
Liaising with others
Patient safety
Reducing admissions
Signing prescriptions
Productivity and access
Leadership/Management
Research
Health and social care
Vulnerable population
QOF/DES/LES
Extended hours
OOH
Medicine support
Telephone
Medicines related issues
Discharge/ reconciliation
Medicines information
Clinical effective audits
CQC
Education for staff
Integration
Further integration of GP
with primary and
secondary care
Community Pharmacy
Hospital pharmacy
www.england.nhs.uk
• Launched in November 2015
• Investment of £31.5 million over three years
• In February 2017: >490 pharmacists in >650 practices across 90 pilot sites
• Deadline for practice involvement in pilot has ended.
• Evaluation
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Clinical pharmacists in General
Practice Pilot
www.england.nhs.uk
• Conducted two internal and external
lessons learned workshops with key
stakeholders and pilot sites
• Key outcomes:
• Clear guidance on roles
• More engagement
• Application support
• Flexible models
• Better communications
• Indemnity Insurance
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Challenges and lessons learned
from pilot
www.england.nhs.uk
Background
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• The GPFV includes a commitment to
deliver an additional 5,000 clinical
and non-clinical staff in general
practice.
• A commitment to have ‘a pharmacist
per 30,000 of the population
• Central investment of £112m to
extend pilot programme.
• Additional 1,500 clinical
pharmacists in general practice by
2020/21
www.england.nhs.uk
• Criteria developed defines the model
• Sufficiently flexible to allow for innovation and ability to test out different approaches of deploying pharmacists in general practice that suit local circumstances.
• Able to apply via online portal which opened on 9th January 2017.
• All providers of general practice medical services will be able to access help and advice so that all general practices in England are in a position to benefit from programme.
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The criteria for phase 2
www.england.nhs.uk
• The criteria to be applied are:
1. Providers must demonstrate working at scale; minimum population of at least 30,000.
2. Role of pharmacists MUST be clinical patient facing
3. Pharmacists MUST be integrated members of general practice team
4. Professional network and supervision support
5. There will be one full-time senior pharmacist to a maximum of five pharmacists (i.e. 1:5 ratio)
6. Senior clinical pharmacists to have >5 years experience. Clinical pharmacists to have >2 years experience.
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The criteria for phase 2
www.england.nhs.uk
• Financial contribution
• NHS England will contribute towards the costs of recruitment
and employment will be tapered over a 3 year period
• 60% in year one
• 40% in year two
• 20% in year three
• The amount of funding is based on an assessment of the
reasonable overall costs of recruitment and employment
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The offer
NHS England contribution Total
contribution from
NHS England Yr 1 Yr 2 Yr 3
Clinical
Pharmacist
29,000
20,000
11,000
60,000
Senior
Clinical
Pharmacist
36,000
24,000
13,000
73,000
www.england.nhs.uk
• Wave 1 applications were submitted by 10th February 2017
• Announcement of successful wave 1 sites in March 2017
• Ongoing waves of applications over the next three years.
• Should applications be unsuccessful, the local teams will provide feedback to suggest improvement for re-submission
• Profile of 500 pharmacists in general practice each year over the next three years
• Jobs to start being advertised from March/April 2017.
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Timeline
www.england.nhs.uk
• NHS England website - https://www.england.nhs.uk/gp/gpfv/workforce/cp-gp/
• Guidance/narrative/videos/case studies
• State of readiness checklist: recruitment stage
• FAQs – continually updated
• Link to online application portal
• GPhC updated indemnity insurance information - https://www.pharmacyregulation.org/professional-indemnity-requirements
• Updated Primary Care Pharmacy Association guidance – http://pcpa.org.uk/assets/documents/gp_guide.pdf
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Useful resources