No more white coats: pharmacists emerge from behind the counter

Writing competition 2018

Many members of the general public still perceive pharmacists as the white-coated individuals working in the back of the dispensary; many don’t even realise that a large proportion of our profession work within hospitals. The roles available to pharmacists have expanded tremendously in recent years and pharmacists are already working in general practice, local 111 urgent care centres, sexual health clinics and soon a further 180 pharmacists will enter the world of care homes^[1]
.

Hospital pharmacists are being offered more career development chances than ever before, from funded training to becoming advanced clinical practitioners (ACPs), to independent prescribing pharmacists providing post-operative care to orthopaedic patients in place of foundation year doctors. These opportunities are emerging because of multiple government and institutional reports stating that help is needed to ease the current strain on the NHS, but also because, behind that white coat, are professionals with medication expertise and a knowledge of multiple medical conditions and their clinical management. When considering that 5–20% of hospital admissions and readmissions relate to medication^[2]
, the need for better incorporation of the experts on medicines into the multidisciplinary team becomes obvious.

Let’s jump forward ten years. The introduction of automated dispensing and enhancement of the role of pharmacy technicians has freed up pharmacist time in the community, allowing for more patient-centred funded services. The children’s vaccination schedule is now conducted at all local community pharmacies, as well as regular check-ups for patients with chronic medical conditions. Independent prescribing community pharmacists are rationalising their patient’s medication therapy and monitoring responses more frequently, in addition to providing a walk-in minor ailments service. A new electronic patient care record is allowing GPs and community pharmacists to access and share data easily. Outside of the community sector, clusters of care homes now have their own dedicated pharmacists, who are regularly reviewing resident’s medication therapy, diagnosing and treating some common clinical conditions, and helping to reduce the £24m of medication wasted by care homes each year^[3]
.

Hospitals now have more specialist pharmacists, who are running some outpatient clinics and working as ACPs in a variety of fields; pharmacists are also regular attenders on consultant ward rounds each day. Furthermore, patients in primary care are now having their annual medication review with a practice pharmacist at their GP surgery, where the focus is on patient education and involvement in clinical decision-making. These new roles are all supported by broad multidisciplinary healthcare teams where the combination of each professionals’ expertise makes for the best patient outcomes.

So, let’s remove that white coat, maybe hang the odd stethoscope around our neck, but most of all, lets make sure patients know that pharmacists are more than just the individual found behind the counter at the local chemist. Pharmacists are already jumping at these new opportunities to help the NHS and generally the profession wants more of these roles, so to the government please, come and get us!

^[1]
NHS England. Medicines optimisation in care homes: programme overview. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/03/medicines-optimisation-in-care-homes-programme-overview.pdf (accessed July 2018)

^[2]
Pirmohamed M, James S, Meakin S et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18,820 patients. BMJ 2004;329(7456):15–9)

^[3]
Trueman P, Taylor DG, Lowson K et al. Evaluation of the scale, causes and costs of waste medicines. Report of DH funded national project. 2010. Available at: http://discovery.ucl.ac.uk/1350234/ (accessed July 2018)