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A seat at the table, whatever the setting

So the rest of the world has finally caught up with me! When I initially qualified as a supplementary prescriber in 2005 I was convinced that I, and other like-minded pharmacists, would lead the way for the profession in the future. No more hiding in the back shop sticking labels on boxes and handing out occasional pearls of wisdom — but engaging directly with patients about their medicines and their chronic conditions in collaboration with their GP.

Converting to an independent prescriber seemed like the next logical step and some of us were engaging in this new role with enthusiasm. However, it slowly dawned on me that too few of us were doing so, there was never going to be a “critical mass” of pharmacist prescribers and the likelihood of continued funding for our cutting-edge clinics in all areas of pharmacy practice was slim.

Now it would appear that there is a light at the end of the tunnel, in Scotland at least, in the shape of the recent “Wilson review” and the subsequent Government response, “Prescription for excellence”, which proposes that all pharmacists in Scotland will be qualified as independent prescribers by 2023. This development will allow us to provide clinical care to patients in all settings, in particular those who have chronic conditions. We will have to work closely with our medical colleagues and become part of the team providing integrated care for these patients.

Yet achieving this may bring some challenges: there will need to be a massive investment in checking technicians and pharmacy teams to allow pharmacists the time to fulfil this extended role. Also there is still the problem of pharmacists gaining direct access to GP records — a crucial aspect of seamless patient care.

It may well be that some pharmacists are frightened of these new developments and might not be comfortable with the direction in which pharmacy is moving, and will seek not to be involved. It is to be hoped that they can be persuaded otherwise. As an independent prescriber and community pharmacist who is currently running clinics for chronic diseases, I know it is possible to deliver this vision and I would encourage all pharmacists in Scotland, and beyond, to look at the positive aspects of these recent proposals.

I have always enjoyed the confidence of patients and other healthcare professionals since I started prescribing. So I see no reason why our profession will not be able to take its rightful seat at the table with all those engaged in the direct care of patients, whatever the setting.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2013.11131206

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