Corrinne Burns / The Pharmaceutical Journal
A work-based assessment of pharmacist prescribing, piloted in NHS Lothian, increased pharmacists’ confidence and ability to make clinical decisions, delegates at the Royal Pharmaceutical Society (RPS) Scotland 2025 conference heard.
Results of the pilot were shared by Gillian Cameron, lead pharmacist in non-medical prescribing at NHS Lothian, who spoke at the event in Glasgow on 22 August 2025.
Cameron took up her role at NHS Lothian in February 2024, and wanted to explore whether all the pharmacists in the region were prescribing safely and appropriately, given increasing numbers of pharmacist prescribers across different settings and levels of experience.
She took inspiration from a Royal College of General Practitioners work-based assessment of prescribing, published in January 2024.
Cameron sees this as “an educational intervention [rather than] a judgment, and it confirms good prescribing practice as well as highlighting any issues”.
She then went on to add metrics from the RPS’s competency framework for all prescribers to the assessment materials she was developing.
In addition, participants in the pilot were asked to consider three areas: prescribing errors with a significant reduction in the probability of the treatment being effective or causing patient harm; sub-optimal prescribing — where “you’re not necessarily going to have treatment failure or harm, but it’s less than the gold standard” — and legal errors.
Seven pharmacists from the primary care and hospital sectors took part in phase 1 of the pilot, all of which self-reviewed their own prescribing and two completed peer review.
Feedback came back with a resounding “yes: we need to do this”, Cameron reported, adding that participants said “we need to have time to pause, reflect and develop our prescribing skills”.
In phase 2 of the pilot, ten pharmacists from the primary care and hospital sectors reviewed a total of 181 prescribing episodes, with some self-reviewing and some peer-reviewing. The average time to self-review was three hours.
All pharmacists demonstrated evidence of good prescribing, with 50 examples in total, including patient-centred prescribing and appropriate safety netting, Cameron said.
Half of the pharmacists identified some sub-optimal prescribing, with 18 examples, while three pharmacists identified prescribing errors, although there was no patient harm associated with these.
Feedback from the pilot, Cameron said, showed that “everybody from both phases of the pilot would recommend this review of prescribing”, and “it gave everybody a personal assurance of safe prescribing”.
“One participant said, I haven’t reviewed my prescribing in eight or nine years, and it was great for me to do this and to have a peer assure me. It’s given me more confidence, and I’ve got areas of development as well,” Cameron added.
Looking ahead, Cameron said that she was “hoping to roll this out pan-Lothian” as part of annual appraisals and is “keen to involve community pharmacy”.
There is also “a lot of interest in this from other boards and from other non-medical prescribing leads”, she said.
“And why wouldn’t there be? Because we all, as prescribers, want to make sure we’re safe, effective, and we have the patient at the centre of care.”
The conference also saw Gail Caldwell, director of pharmacy at NHS Greater Glasgow and Clyde and a Fellow of the Royal Pharmaceutical Society (RPS), receive the RPS Charter Award, which was presented by Claire Anderson, president of the RPS.
Caldwell said it was a “great honour and privilege”. She added: “Success is a collective effort: I would like to thank my many colleagues, mentors, pharmacy friends, and my family.”
