PCN pharmacists complete more than 12,000 structured medication reviews in six months

Pharmacists working in primary care networks (PCNs) completed more than 12,000 structured medication reviews (SMRs) between April and September 2020, according to data published by NHS Digital.

The data, which was taken from the Calculating Quality Reporting Service — a reporting and payments calculation system for GP practices — found that practices recorded 813 patients as having received “at least one” SMR between April and June 2020.

A further 11,409 patients received an SMR between July and September 2020.

PCNs had been expected to start offering SMRs through their pharmacy teams from April 2020, but the start date was later delayed to October 2020 owing to the COVID-19 pandemic.

However, in May 2020, NHS England wrote to PCNs asking them to take “immediate steps to implement … provision of pharmacy and medication support to care homes”, including delivering SMRs “via video or telephone consultation where appropriate” to care home residents.

Of the 12,222 SMRs completed over the 6-month period, 943 patients aged 18 years or over and living in a residential or nursing home are recorded as having received an SMR.

The groups eligible to receive an SMR include patients who have been diagnosed with frailty; who are living in care homes; with complex polypharmacy; with multiple long-term conditions; and/or with high numbers of prescribed addictive pain management medication.

“Given the heavy workload that pharmacists have faced, it is a huge success to see that our profession has been able to carry out SMRs to better support patient care during the pandemic,” said Claire Anderson, chair of the Royal Pharmaceutical Society’s English Pharmacy Board.

“We welcome and continue to support ongoing work that is looking to involve the wider pharmacy workforce in these reviews, which are vital to the shared decision-making process and ensuring that patients take the medicines that are appropriate for them.”

According to a presentation by the British Medical Association (BMA), NHS England will clarify “addictive pain management medication” as opioids, gabapentinoids, benzodiazepines and Z-drugs in an updated PCN contract from April 2021.

“The update to the cohort is based on the principle of supporting patients with complex polypharmacy and medication-related issues,” said Krishna Kasaraneni, BMA GP committee executive team member.

“The delivery and numbers of SMRs will depend on the capacity of workforce available and will be contingent on the wider situation with COVID-19,” he added. “The delivery of SMRs requires time with patients and will be subject to recruiting challenges of clinical pharmacists to work in general practice.”

Pharmacy leaders had previously expressed concern in January 2020 that pharmacists working in PCNs would face an “unrealistic” workload if they were forced to complete SMRs for all patients in each group.

However, the PCN contract specification was later updated to state that “the number of SMRs that a PCN is required to offer will be determined and limited by their clinical pharmacist capacity”.

According to the latest data, only half of PCNs reported employing a pharmacist as of December 2020.