Clinical Pharmacy in General Practice
Following the success of the clinical pharmacy in general practice pilot in West Wakefield, the programme was been rolled-out across the whole district as part of the MCP vanguard.
NHS Wakefield CCG’s medicines optimisation team worked closely with practices to develop and roll-out the service. The model focuses on using GP Federation-based clinical pharmacists and technicians who split their time across practices within the Federation they are part of.
Within the model, each Federation has the following staff, covering around 50,000 of the patient population:
- 1x Band 8A Pharmacist
- 1x Band 6 Senior Pharmacy Technician
- 1x Band 5 Pharmacy Technician.
The service supports local patients who have long-term conditions or complex care needs to receive regular planned reviews to ensure they are on the correct medications, and to receive expert advice and support as to how to better manage their medications. Both the pharmacists and technicians working under the model are also on hand to resolve everyday prescription queries and their role further includes:
- Undertaking face-to-face annual medication reviews with patients on repeat medication
- Offering advice on how to manage medications safely and effectively
- Supporting transfer of medications on discharge from hospital
- Working with community pharmacists
- Avoiding unplanned admission to hospital through intensive drug monitoring
- Reauthorising of prescriptions
- Resolving medication queries and shared care requests from secondary care
- Providing urgent care support
- Working with local care homes
- Evaluating and streamlining repeat prescribing procedures.
From May 2017 to January 2018, the programme saw £630k in prescribing savings, with over 1,650 face-to-face medication reviews, and of these:
- The average age of patients seen for medication reviews was 70-74years old
- 10% of medication reviews resulted in redundant items being removed from a patients repeat medicines list
- 15.5% of medication reviews identified an unmet prescribing need
- 11% of medication reviews identified an inappropriate dose
- 10% of patients had demonstrated poor compliance with their medicines
- Cost-effective medication switch was made in 13% of all medication reviews.