Source: Mitesh Shah
Community pharmacies are one of the most accessible healthcare resources in the UK. Indeed, many patients feel more comfortable visiting their community pharmacy, where they may have built long-established relationships, than visiting their general practice. Without community pharmacists, it would be nearly impossible to provide a successful primary care network (PCN) that meets all of the specifications set by NHS England. Now, more than ever, collaborative working is essential.
That’s why South Central Ealing (SCE) PCN has set about creating a model that would integrate community pharmacies into PCNs, through a new ‘network community pharmacist’ (NCP) role, which we believe to be the first of its kind in England.
As a senior pharmacist for SCE PCN, I am leading the implementation of the new role, together with Ali and Mo Harb of Harbs Pharmacy, and Kashif Ismail of Remedy Pharmacy, in Ealing, London. This integration of PCNs and community pharmacies fills me with excitement as it stands to benefit not only the community pharmacy and the PCN, but most importantly the patient.
In practice, an NCP will be given remote access to medical notes to help provide increased capacity in the PCN, giving patients access to care out of hours and at weekends, in some cases. This would not only be to provide structured medicines reviews (SMRs), but also hypertension and asthma management. For example, NCPs will be offered Centre for Pharmacy Postgraduate Education pathway prescribing training, so they can prescribe and help implement the enhanced health in care homes framework — all while being employed by a community pharmacy.
Meanwhile, the host community pharmacies will inevitably also benefit from increased footfall through their doors. By having more exposure to the capabilities of pharmacists through their PCN, patients will have increased confidence in the expertise that is accessible in pharmacy and subsequently request more advice, which could ultimately see an increase in over-the-counter sales.
For the pharmacist themselves, the role will not only provide the opportunities that come with working at the PCN, but also the flexibility of working at the community pharmacy. They will be able to develop professionally, have access to training and obtain a prescribing qualification. Such an opportunity has not been afforded to pharmacists before.
The NCP role creates a win-win model of integration.
Pat Barbour, clinical director of SCE PCN, and Graham Stretch, lead pharmacist at Ealing GP Federation and clinical director of Brentworth PCN, first proposed the idea to SCE member practices in February 2020. At the time, there was very little resistance from GP partners on implementing the role, given that an NCP would redirect patients away from general practice — reducing workload — while not occupying rooms within the GP surgery, which are at a premium.
Any concerns about this role, which have arisen from GPs in other PCNs, are usually the result of a negative experience with a pharmacist, which may have caused them to view all pharmacists through the same prism.
Stretch has pointed out that this type of pharmacist role could provide unanticipated benefits. Currently, if a pharmacist has a problem with a prescription and needs to contact the GP, we sometimes get hassled by a receptionist when we call. Wouldn’t it be much easier to bring the query to another community pharmacist who has prescribing rights and the trust of the GPs to get it sorted? Pharmacist to pharmacist: we would talk the same language.
I know what pharmacists are capable of achieving, and this is a real opportunity for us to be recognised as innovative clinical providers moving away from the traditional model of dispensing and supply. We are hoping that after a six-month review of the NCP’s activity and outcomes, led by an independent academic team, we will be able to recruit another NCP to provide even more capacity.
But, for the moment, I’m focusing on interviews, recruitment, and introducing the successful candidate to their first few weeks in the job. They will have a weight of expectation on their shoulders, but the support of a collaborative, friendly team.
Mitesh Shah, pharmacist, South Central Ealing Primary Care Network