This is a campaign letter for the 2021 RPS national pharmacy board elections. The views expressed in this letter belong to the author. Find out more about the RPS elections.
I am passionate that our profession has rewarding career pathways for pharmacists in increasingly clinical roles, and that practice-based pharmacists with advanced clinical skills are able to practice in a patient-facing role.
The pharmacotherapy service (PTS), as described in the 2018 General Medical Services (GMS) contract in Scotland, was unexpected for many of us. Once I qualified as a pharmacist independent prescriber, I intended to set up a specialist pharmacy-led clinic but, like many others, much of our patient-facing role had to be put on hold as delivering even just the level one PTS was impractical with the original small practice-based pharmacy teams. Pharmacists with advanced clinical skills were having to step back in order to provide level one services, while health boards tried to recruit increasing numbers of technicians and junior level pharmacists.
Releasing GP capacity is the priority, as detailed by the Achieving Excellence in Pharmaceutical Care strategy. While we have been improving patient outcomes, ensuring seamless care between interfaces and reducing potential medication-related problems, we are also spending a significant amount of time on ‘admin’ tasks that require very little clinical input, which, to some, is demotivating. While practice-based teams have grown significantly in the last few years, specialist pharmacist-led clinics in primary care are not routinely found in many general practices. Moreover, most local areas were not able to implement a full rollout of the PTS, and this has been delayed until 2022–2023. The current main national focus is ensuring all boards are providing cores services, but where does this leave pharmacists with advanced clinical skills?
I have been following the development from Health Education England, which is offering funding for Advanced Clinical Practitioner courses to clinical independent prescriber pharmacists, who are employed in a predominantly patient-facing role undertaking clinics. However, a SP3AA survey found that less than 25% of practice-based pharmacists’ time was spent on clinical, patient-facing roles.
Views from practice-based pharmacists were not gathered when the 2018 contract set out the responsibilities to deliver on the elements of the GMS contract, and I feel quite strongly that we need to hear those insights. This is why I am pleased that RPS Scotland is currently gathering views on what improvements could be made to deliver a high quality pharmacotherapy service, which utilises the clinical skills of pharmacists. We need to retain highly experienced pharmacist practitioners who can practice in a patient-facing role with a clear rewarding career pathway going forward.
Farzana Haq, election candidate, Scottish pharmacy board, Royal Pharmaceutical Society