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Pharmacists’ perceptions of their emerging general practice roles in UK primary care: a qualitative interview study

Jo Butterworth, Anna Sansom, Laura Sims, Mark Healey, Ellie Kingsland and John Campbell
Br J Gen Pract 2017; 67 (662): e650-e658. DOI: https://doi.org/10.3399/bjgp17X691733
Jo Butterworth
Primary Care Research Group, University of Exeter Medical School, Exeter.
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Anna Sansom
Primary Care Research Group, University of Exeter Medical School, Exeter.
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Laura Sims
Primary Care Research Group, University of Exeter Medical School, Exeter.
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Mark Healey
Primary Care Research Group, University of Exeter Medical School, Exeter.
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Ellie Kingsland
Primary Care Research Group, University of Exeter Medical School, Exeter.
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John Campbell
Primary Care Research Group, University of Exeter Medical School, Exeter.
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    Figure 1.

    Pharmacists in general practice roles.

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    Table 1.

    Timeline of the developing role of pharmacists in UK primary care

    WhenReport/policy released5–8Outcomes generated
    1986The Nuffield Report highlights dramatic underutilisation of UK pharmacists6Suggestions that collaboration between GPs and pharmacists could improve effectiveness and reduce costs of prescribing
    1990sNHS health reforms result in the allocation of drug budgets to individual health authoritiesInterest from general practice to use clinical pharmacists within primary care
    2005NHS Community Pharmacy contractIncreases the range of services community pharmacists can provide
    2008The pharmacy workforce censusSeven per cent of pharmacists are already working within general practices or for local health authorities
    2015NHS England, the General Practitioners Committee of the BMA, Health Education England, and the Royal College of General Practitioners reveal their Ten Point GP Workforce Action Plan 8The Clinical Pharmacists in General Practice Pilot aims to utilise pharmacists’ knowledge and expertise surrounding medications, in order to complement the knowledge and roles of GPs and practice nurses in general practice surgeries
    2017RCGP GP Forward View Interim Report 8NHS England reports that >85% of pharmacy professionals have received training in the use of the patient Summary Care Record, and that all pharmacists will have received training by March 2017
    By 2040The Centre for Workforce IntelligenceEstimates that oversupply of pharmacists could reach 11 000–19 000 due to increased numbers of pharmacy students over the last decade
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    Table 2.

    Participants’ characteristics, n = 16

    VariableNumber
    Sex
      Male5
      Female11
    Age
      21–303
      31–404
      41–506
      51–602
      Not given1
    Job role on course applicationa
      Community pharmacist7
      CCG pharmacist working in general practice5
      CCG pharmacist not directly working in general practice4
    Postgraduate awards held
      Clinical diploma5
      Independent prescribing certificate6
      Other6
    • ↵a Community pharmacist role included dispensing; over-the-counter minor ailments advice; advanced services such as medicines use reviews, new medicine service, emergency hormonal contraception, and chlamydia screening; general practice role included conducting minor illness and long-term condition clinics, telephone consultations, liaising with community and hospital colleagues, and pain medicines optimisation clinics; CCG role included prescribing management planning, practice audits, assessing practice compliance to formularies and guidelines, and reconciling prescribing problems with GPs. CCG = clinical commissioning group.

  • Day 1
    Valuing the primary care pharmacist:
    • The skills and role of the primary care pharmacist in a primary care team

    • Leading on prescribing quality improvement changes

    Managing the patient with respiratory infections
    Managing the patient with eye symptoms
    Day 2
    Clinical skills training 1: ENT and asthma/COPD annual reviews
    Day 3
    Principles of chronic disease management
    Hypertension annual reviews
    Cardiovascular risk and lifestyle modification:
    • Using CVS risk profiling in practice and preventive prescribing

    • Communication skills for encouraging lifestyle changes

    Day 4
    Medicines management and optimisation in practice:
    • Medicines management and patient enquiries

    • Quality improvement of prescribing practice and systems

    • Applying optimisation principles in polypharmacy and multimorbidity

    • Assessments to aid medication reviews and de-prescribing

    Day 5
    The diabetic annual review
    Common dermatological conditions
    High-risk drugs, rheumatoid arthritis, osteoporosis, and blood test interpretation:
    • Rheumatoid arthritis annual reviews and osteoporosis medication

    • High-risk drug reviews, audits and interpreting blood results


    Day 6
    Clinical skills and communication training 2: successful integration of pharmacists in primary care roles/local networks and continuing professional development
    • COPD = chronic obstructive pulmonary disease. CVS = cardiovascular. ENT = ear, nose, and throat.

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British Journal of General Practice: 67 (662)
Br J Gen Pract
Vol. 67, Issue 662
September 2017
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Pharmacists’ perceptions of their emerging general practice roles in UK primary care: a qualitative interview study
Jo Butterworth, Anna Sansom, Laura Sims, Mark Healey, Ellie Kingsland, John Campbell
Br J Gen Pract 2017; 67 (662): e650-e658. DOI: 10.3399/bjgp17X691733

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Pharmacists’ perceptions of their emerging general practice roles in UK primary care: a qualitative interview study
Jo Butterworth, Anna Sansom, Laura Sims, Mark Healey, Ellie Kingsland, John Campbell
Br J Gen Pract 2017; 67 (662): e650-e658. DOI: 10.3399/bjgp17X691733
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  • Article
    • Abstract
    • INTRODUCTION
    • METHOD
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Appendix 1. Training course programme for pharmacists interested in extended roles in primary care
    • Notes
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Keywords

  • extended roles
  • general practice
  • pharmacists
  • primary care

More in this TOC Section

  • Access to primary health care for asylum seekers and refugees: a qualitative study of service user experiences in the UK
  • Management of depression and referral of older people to psychological therapies: a systematic review of qualitative studies
  • Efficiency versus thoroughness in medication review: a qualitative interview study in UK primary care
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