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Clinical Pharmacists in General Practice
Funding to support the creation of clinical pharmacist posts in general practice.
£112m nationally. This in addition to the £31 million pilot project previously announced by NHS England in 2016. See below for further information about individual practice funding.
What is the timeframe?
Practices were initially able to apply for funding from 9 January 2017. The first cohort of successful applicants was announced in April 2017. There have since been six further funding application rounds. The deadline for the current application wave, wave eight, is 22 February 2019. The intention is to have 1,500 clinical pharmacists in GP practices by 2020.
Who decides allocation?
NHSE (NHS England). For the pilot scheme, there were regional panels with representatives from NHSE, local health education England offices and local patient voice followed by a national moderation panel.
What is the role of the clinical pharmacist in a general practice?
Clinical pharmacists work as part of the general practice team to resolve day-to-day medicine issues and consult with and treat patients directly. This includes providing extra help to manage long-term conditions, advice for those on multiple medications and better access to health checks.
How this scheme can help
The intention is that by having a clinical pharmacist in GP practices, GPs will be able to focus their skills where they are most needed, for example on diagnosing and treating patients with complex conditions.
If well-managed and clearly structured, the clinical pharmacist role should help GPs manage the demands on their time. The feedback from the independent pilot evaluations indicate that it is making a positive difference.
What else do we know?
The aim is to provide a pharmacist per 15,000 population for all practices not in the initial pilot.
The things we know are:
- Practices must offer a permanent employment contract, i.e. not a fixed term contract. The intention is that the practice pharmacists should become an integral part of the general practice team beyond the end of the funded period
- Groups of clinical pharmacists are intended to work together - a supervising (Band 8a) pharmacist with up to five junior pharmacists (Band 7). This is for shared learning and support and to enable all practices to take advantage of clinical pharmacists even if they may not be able to employ a full-time pharmacist on their own
- The pharmacists must be patient-facing
- Bids can be from practices across more than one CCG area where that makes sense
- There is a training commitment for the pharmacists of 28 days over an 18 month period including a four day intensive induction. The expectation is that all the Band 7 pharmacists will work towards becoming prescribers
- 90 hours of GP supervision are required for the prescribing course. This does not need to be from a GP trainer
- Organisational development training is available for practices for up to four days over a year, about how best to incorporate clinical pharmacists into the practice team.
What the scheme is not
A chance for you to apply for funding for a Clinical Pharmacists just for your practice. There is a clear expectation that groups of practices will work together on bids. Bids from two practices working together may be considered if they meet the criteria but bids from a single practice on one site will not make it through the selection process unless there are exceptional circumstances for your practice, e.g. remote or rural areas of particularly high deprivation etc.
It is also not free. Practices can apply for 60% of costs in Year 1, 40% in Year 2 and 20% in Year 3. Practices have to meet the remaining costs themselves, although some CCGs have put in additional funding as well to reduce the initial amount payable by practices.
The scheme is not a replacement for community pharmacy and is not about focusing on minor ailments.
What are the criteria?
Applications are assessed against the following criteria:
- Providers applying for the programme must demonstrate that they are working at scale;
- Co-funding is available for 1 WTE clinical pharmacist per 15,000 of the population;
- NHS England will contract with and provide funding to providers of general medical services to support the establishment of a clinical pharmacist service in general practices, and federations;
- The role of the clinical pharmacists must be clinical and patient facing and will support people living in the community including those in care homes settings. The role must be in line with the narrative outlined above and roles/responsibilities in agreed job descriptions;
- Clinical pharmacists must be embedded within the practices and be fully integrated members of the clinical multi-disciplinary team, having access to other healthcare professionals, electronic `live` and paper-based record systems, as well as access to admin/office support and training/development opportunities. They will be involved in the practice’s review and appraisal process;
- All clinical pharmacists will be part of a professional clinical network and will usually be clinically supervised by a senior clinical pharmacist and GP clinical supervisor. NHS England recommends that the following supervision must be in place for senior clinical pharmacists and clinical pharmacists:
- Flexible and innovative approaches to the formation of clinical networks can be adopted and promoted to enhance collaboration/integration across healthcare interfaces;
- There will be one full-time senior clinical pharmacist to five (total number not WTE) clinical pharmacists. Clinical pharmacists must be working a minimum of 0.5 WTE in general practices;
- Senior clinical pharmacists will be independent prescribers (or will be working towards an independent prescribing qualification) and will be independent prescribers by 2020/21. They will have been qualified for 5 years or more;
- NHS England recommends that clinical pharmacists will have been qualified for at least 2 years and will be independent prescribers by 2020/21.
Need more information?
Providers participating in the programme will receive funding for three years to recruit and establish clinical pharmacists in their general practices for the long term.
Applicants from provider organisations are able to submit applications through an online portal, which opened on 9 January 2017.
Various resources are available from the NHS England website including guidance for applicants, an example application form, the pilot evaluation report, written and video case studies and blogs.
The resource A Guide for GPs considering employing a practice pharmacist includes job advert and job description templates and outlines the different functions that clinical pharmacists can perform in practice.
This role does have the potential to genuinely support doctors and free up GP time. In the absence of enough GPs to go round, this is worth considering.
To really get the benefit, practices should to set out their own aspirations and goals in advance. You can then measure whether the appointment of a clinical pharmacist has helped you achieve your goals or not. For example, through the use of a clinical pharmacist, you could seek to:
- Increase your appointment times from x minutes to x minutes (for all patients or for a specific group of patients)
- Reduce use of locums to x (or by x)
- Reduce waiting time for routine appointments from x to x
- Generate x amount of additional capacity for GP telephone appointments
- Any other appropriate measure that is relevant to your practice - it could even be
trying to ensure that your GPs manage to get time to eat lunch each day.
Being clear about your goals may help you focus the work of the clinical pharmacist to ensure that each activity they undertake is targeted towards achieving your practice's objectives.
Pharmacists begin to take the weight - read Dr Mike Parks' blog
Clinical pharmacists in general practice pilot
This pilot supported general practice by enabling recruitment of clinical pharmacists to help alleviate some GP workload pressures, work directly with patients and provide long term opportunities to develop the wider primary care workforce.
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Working with clinical pharmacists
Read about the next phase of the Clinical Pharmacists in General Practice programme, and get advice about why and how to employ a clinical pharmacist.
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