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Primary care

Welsh government urged to evaluate role of pharmacists working in primary care

Primary care pharmacists’ roles should be re-evaluated, and their long-term funding and recruitmentment scrutinised, the Welsh government has heard.

The Welsh government is being urged to evaluate the role of primary care pharmacists who have the potential to transform medicines management.

The scrutiny, recommended by the Welsh Assembly’s public accounts committee, should also include looking at their long-term funding and recruitment.

The recommendation follows evidence, presented to the committee’s inquiry into medicines management, showing that these cluster pharmacists (pharmacists employed to work directly with a group or “cluster” of GP practices ) are making an impact in primary care, but are often unable to plan long-term, as their funding is short-lived.

The committee was told that there was a real appetite for this kind of pharmacist, and that every hour spent by a cluster pharmacist in a practice saved an hour of GP time.

The committee’s inquiry report, published 20 March 2018, admitted: “We are concerned that the current funding model does not provide enough certainty for clusters, and there is a clear need for this model to be given a more sustainable footing if it is to develop to its full potential. To which end, we believe this evaluation should consider the funding model and recruitment model for pharmacists within the cluster model.”

The committee had been told during its enquiry that cluster pharmacists were taking on roles which had traditionally been delivered by GPs, thus freeing up family doctors to take on more complex cases. They were, for example, carrying out medicines reviews of practice patients and running respiratory clinics in primary care, or reviewing the medicines of nursing or care home residents within the cluster boundary.

The committee’s report said: “We believe that, given the increasing role of clusters, there is a need for an evaluation of cluster pharmacists. This should help to establish the value and sustainability of the cluster model.”

The call for an evaluation of cluster pharmacists was welcomed by the Royal Pharmaceutical Society Wales. Its director, Mair Davies, told The Pharmaceutical Journal: “While feedback on this role from patients and other health professionals has been extremely positive, no formal evaluation of the role on a significant scale has been undertaken. The limited evidence that we do have clearly shows the value of these roles.

“However in order to justify sustainable funding and to reassure patients, GPs, and the pharmacists themselves, of the long-term security of the role, a large scale evaluation is needed.”

The public accounts committee made 15 recommendations following its inquiry, which are now being considered by the Welsh government. It reiterated the need to reform the community pharmacy contract, switching its focus from quantity of prescriptions to quality.

The committee said that the current contract “creates a system which does not encourage pharmacists to consider whether it is necessary to dispense a prescription, which should be the aim to achieve the stated goal of increasing medicine management.”

The inquiry report said it was time for the Welsh government to maximise the resource of pharmacy — including the role of independent pharmacists in primary care — to help address the 46% rise in the number of prescription items dispensed in the community in the last decade.

Committee chair, Nick Ramsay, said: “What we found during this inquiry was a system needing to change and a system not able to maximise its potential.

“Despite the Welsh government support for greater use of pharmacists in primary care, this is not being realised.”

He revealed that only 1,000 pharmacist consultations were taking place every month, adding: “These levels are nowhere near enough to achieve real system change.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20204584

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