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CLINICAL PRACTICE


THE SCOTTISH GOVERNMENT HAS PROMISED THAT, BY 2022, EVERY GP PRACTICE WILL HAVE ACCESS TO A PHARMACIST WITH ADVANCED CLINICAL SKILLS. JOHN MACGILL REPORTS ON PROGRESS TOWARDS THIS GOAL, AND WHAT IT MEANS FOR PHARMACISTS AND PATIENTS.


THE PHARMACIST WILL SEE YOU NOW


‘There really is no typical clinical day in general practice,’ says Elaine Thomson, Locality Pharmacy Team Leader for the Dundee Health and Social Care Partnership. ‘There will be referrals from GPs and practice nurses with medication questions, arranging medication reviews, looking after complex discharges from hospital. Some people will run clinics, perhaps one session a week, and a series of patients will come to see them.’


Elaine Thomson is not new to the world of local practice-centred pharmacy. Tayside had the first practice pharmacist 20 years ago. Elaine, who also sits on the RPS Scottish Pharmacy Board, was appointed to a practice-based role 17 years ago. Even now, as a team leader, her clinical work still takes up much of her time.


20 - SCOTTISH PHARMACIST


‘There will be patients that I have on my own caseload that I need to follow up; patients that I need to go and see. I do care home reviews. I also cover the intermediate care unit one day a week as part of a multidisciplinary team, and will often talk to a person about their medication to see if there any things that we need to do to get it right before they go home.


‘The aim is to spend about 70 to 80 per cent of clinical time directly with patients and that varies a lot. I will spend time phoning people or seeing them face to face in the practice or at home, depending on what’s most appropriate.’


In a recent letter to the Scottish Parliament’s Health and Sport Committee, Health Secretary Shona Robison reported that 101


WTE pharmacists and twelve WTE pharmacy technicians have been appointed to primary care posts as part of a three-year £16 million programme, and that the NHS is on track to deliver the current target of 140 by March 2018.


NHS boards are expected to target resources towards priority areas at a local level based on patient need, including areas with a greater proportion of elderly patients, areas of multiple deprivation, and where there are patients with multiple morbidities who receive a significant number of prescriptions and who have been identified as being statistically more at risk of hospital admission or readmission.


Scotland’s Chief Pharmaceutical Officer, Rose Marie Parr, says the


recruits to the new General Practice Clinical Pharmacist posts are from a variety of backgrounds:


‘We thought there would be a lot of hospital pharmacists but 50 percent are from community pharmacy and some were already working in primary care, so a real mix and perhaps more from community pharmacy than we would have thought.


‘In essence what we have found is that GP practice support needs a number of different things, so we have worked to get a skills mix into GP practices that’s right depending on need. We haven’t set a target for pharmacy technician recruitment but we know that they are an important part of that skills mix.’


So how does the recruitment of pharmacists into roles supporting


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