NEWS
SINCE ‘THE VISION’ PROPOSES THAT, IN 2020, PHARMACISTS WOULD BE RELEASED FROM ROUTINE DISPENSING TO WORK AS NHS ACCREDITED CLINICAL PHARMACIST INDEPENDENT PRESCRIBERS DELIVERING PHARMACEUTICAL CARE, THE RESULTS OF THE RECENT GENERAL PHARMACEUTICAL COUNCIL’S SURVEY INTO THE EXPERIENCES OF PHARMACIST PRESCRIBERS MAKES FOR INTERESTING READING.
GPHC IP SURVEY MAKES FOR INTERESTING
READING L
ast year, the Scottish government announced that £16.2 million would be made available over three years to recruit up to 140 whole time equivalent additional pharmacists with advanced clinical skills training, or those undertaking the training.
These pharmacists, the government said, would ‘work directly with GP practices to support the care of patients with long term conditions and so free up GP time to spend with other patients. By year three all of these pharmacists should be independent prescribers with advanced clinical skills’.
All very positive, but the recent GPhC’s recent ‘Prescribers’ Survey Report’ would seem to indicate that there’s quite a gap between the theory and the practice.
There’s no doubt that, in many areas, the GPhC heard many positive accounts of survey participants’ professional experiences as pharmacist prescribers, with many respondents outlining how the role was a source of great personal satisfaction, which had defi nitely enhanced their career.
The survey did, however, highlight how support, or rather the lack of it, was also formative to their professional experience, with many respondents highlighting that the organisational culture as well as the
16 - SCOTTISH PHARMACIST
more immediate environment – for example working in a multidisciplinary team – could play an important role both in enabling and acting as a barrier to prescribing practice.
There were mixed views with regards to training, with some respondents having the perception that undertaking practical training within the independent prescribing course in one clinical area could be restrictive, while others valued having a defi ned scope.
There also appears to be a general agreement that there is already a lot of guidance and advice available to pharmacist prescribers, but some respondents suggested there were further opportunities to enhance access to those resources.
Support and assistance provided by other healthcare professionals and managers was also seen to play an important role in pharmacist prescribers’ professional practice. Although most of those who responded to the survey had positive experiences, some had, however, encountered a lack of awareness of the pharmacist prescriber role or because of ‘competition’ between different prescriber roles.
One of the main areas in which GPhC received substantial feedback, however, was that of the knowledge
and skills associated with the role of a pharmacist prescriber. One particular area of interest was in relation to clinical assessment skills, with a number of respondents reporting that they lacked such skills and did not feel confi dent in making initial diagnoses.
In particular, it was highlighted that, in terms of their overall background and training, pharmacists are generally not equipped with physical assessment skills as part of their journey in becoming pharmacists. (This feedback was particularly prevalent among pharmacists based in GP practice settings.)
In response, GPhC was quick to point out that the new MPharm has more emphasis on clinical skills, so this would be likely to as much of an issue for newly graduating pharmacists.
There was also a perception among some respondents that the narrow clinical focus of the practical element of independent prescribing training courses was limiting and not helpful. Some respondents expressed how, in their view, having to choose a specialist or specifi c clinical area was not refl ective of pharmacists’ underpinning medicines’ knowledge across a breadth of areas.
Other respondents, however, told of how they valued having a defi ned scope of their prescribing training, which they would then take forward into the professional practice. It was, in fact, felt necessary to have sound knowledge of a specifi c area to fi nd prescribing opportunities.
‘To utilise prescribing qualifi cations,’ said one independent prescriber from
a GP practice in Scotland, ‘it is now necessary to become competent in a different clinical speciality to that in which I was trained. IP training should be tailored to areas where pharmacists can actually eventually practise, and not in areas already provided in GP practice by practice nurse teams, eg, respiratory.’
Another respondent from a similar background agreed.
‘The current courses do not allow for someone to be a generalist,’ the respondent said, ‘and also (maybe because of this) the roles for pharmacist prescribers are tailored for chronic disease management - my GP mentor felt this was not the best use of a pharmacist’s skills/knowledge.’
The GPhC survey heard from other respondents how, in their professional practice, pharmacists prescribers could be put into positions they were not comfortable with and were unprepared for. Some respondents referred to a limited knowledge of certain conditions, others – to diffi culties in managing patients with co-morbidities.
The GPhC acknowledged that the mixed feedback on the issues highlighted the need to explore the issue further as part of its reviewed of independent prescribing guidance, which is scheduled for 2016/17, as well as considering how better to communicate that the focus of the training is ‘prescribing’ rather than a specifi c clinical area.
The full Prescribers’ Survey Report can be viewed at
www.pharmacyregulation.org
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