Ther pilot had two key objectives:
- Support the workload of general practitioners by providing additional clinical pharmacists based in general practice to work with patients and the wider primary care workforce.
- Utilise the knowledge and skills of pharmacists to deliver care to patients in general practice and support long term transformation of the primary and community workforce whilst addressing the pressing and critical issues facing the general practice workforce in the next few years.
Clinical pharmacists support patients to self-manage their well-being and long-term conditions, through optimising medicines, and enabling improved medicine related communication between general practice, hospital and community pharmacy, e.g. on admission and discharge and at other interfaces of care.
The pilots formed an integral part of the GP workforce 10 point plan Building the Workforce - the New Deal for general practice (NHS England, Health Education England, BMA and the Royal College of General Practitioners, January 2015).
An increasing number of GP practices are recruiting clinical pharmacists to address different aspects of workforce need. This pilot supported general practice by enabling recruitment of clinical pharmacists who can help alleviate some GP workload pressures, work directly with patients and provide long term opportunities to develop the wider primary care workforce.
The pilot launched in July 2015 and it was anticipated that clinical pharmacists would begin working in GP practices by early 2016. On 13 October 2015, NHS England announced an increase in the budget from £15 million to £31 million. This part-funded 403 new clinical pharmacist posts across 73 sites, covering 698 practices in England. Each pilot was based on one senior clinical pharmacist and up to five clinical pharmacists working together. This model enabled effective clinical supervision and professional peer support.
Initially, clinical pharmacists were recruited by GP practices in areas of greatest workforce need and employed by the practice to provide patient facing, clinical pharmacy services. Such provision was intended to ease pressure on access to general practice and aimed to lessen the workload of GPs.
Pharmacists were employed by and worked with practices, networks or federations of GP practices. Funding was transported via clinical commissioning groups (CCGs) and CCG engagement was essential.
Following NHS England's publication of the General Practice Forward View in April 2016,an additional of £112 million was committed to extend this programme and allow every practice in England to access a co-funded clinical pharmacist.
Development of clinical pharmacists
Pharmacists who participated in this programme were offered development and education from the Centre for Postgraduate Pharmacy Education (CPPE). The development programme was predominantly work place based learning, tailored to individual development needs dependent on prior experience and demonstrated competence.
There were two grades of clinical pharmacist working together:
- experienced clinical pharmacists who were prescribers or working towards prescribing qualifications and who began to see patients immediately, whilst developing additional skills such as leadership and change management;
- less experienced clinical pharmacists were employed as part of the same development programme.
They worked with and were mentored by the experienced pharmacists. They developed their clinical skills in the context of general practice with the intention of taking on prescribing responsibilities over the course of the programme;
A whole Practice Team development programme (up to four sessions) was provided as part of the pilot. This programme enabled the organisational development and team behaviour changes needed to support the new way of working within the practices.
For the initial pilots, NHS England part-funded the employment of clinical pharmacists for three years from 1 Oct 2015 to 31 Dec 2018 (dependent on recruitment date of the pharmacist(s):
- 60% for twelve months within the period 1 Oct 2015 - 31 Dec 2016
- 40% for twelve months within the period 1 Oct 2016 - 31 Dec 2017
- 20% for twelve months within the period 1 Oct 2017 - 31 Dec 2018
- 0% after this time
It was hoped that these posts would then be shown, through a comprehensive evaluation, to be of benefit to patients, GPs and practices. Thereafter, practices, networks or federations were expected to fund the clinical pharmacists themselves.
The pilot application period opened on 7th July and closed on Thursday 17th September 2015.
Clinical pharmacists were in post by early 2016.