Community pharmacists in GP practices can significantly relieve pressure on doctors and nurses by providing patient-focused services that help free up appointment times, according to a new independent report recently released.
The NHS England-funded report was undertaken by experts from the School of Pharmacy at the University of Nottingham. This pilot project was seeking to evaluate and understand the role that Community Pharmacist Independent Prescribers (CPIPs) can play in general practice and the impact they have at all levels.
The research examined the work of six CPIPs who were placed in different GP practices across Nottinghamshire and Derbyshire and analysed their work and the impact of it over the course of a year. Detailed analysis of their work was made through the evaluation of independent data including observational studies, one-to-one interviews with staff and patients, and through patient focus groups.
Dr Matthew Boyd, Associate Professor in Patient Safety and Pharmacy Practice, led the research, and said, ‘This pilot and report is very timely as it comes at a time when GP practices are under increasing pressure to provide services, with factors like an ageing population and management of a growing number of chronic conditions adding to the pressure they are under.’
A key area where the CPIPs made a significant impact was medication reviews which accounted for just over half of their workload. They undertook these on a regular basis, releasing capacity for GPs and alleviating appointment issues. As well as reviews and prescription queries on-site, the CPIPs were also able to visit care homes.
As part of these reviews the CPIPs were able to provide invaluable medicines education and usage advice to patients leading to increased medication understanding and adherence. Where appropriate they were also able to deprescribe medicines, which has potential for positive health and cost-saving benefits.
After working in a practice for six months, CPIPs were also able to support GPs with the management of chronic disease which is a growing area of need within GP practice. They were able to provide medication reviews and support patients who had been discharged from hospital with their medicine, helping to prevent readmissions.
The report also found that the CPIPs were able to spend more time with patients, personalising appointment lengths according to the needs of the patients, with CPIP appointments generally being twice as long as GP appointments. Practice managers often made comments, such as, ‘the medicine management side is really making an inroad into freeing up GP time and more appointments time.’
With additional time the CPIPs were able to provide holistic care by considering the person as a whole system of conditions, medicines and personal circumstances and give advice about and monitor lifestyle changes which can have positive impact on health and provide cost saving benefits.
Dr Boyd continued, ‘As well as the data we collected there were many individual patient cases which demonstrated the value of the service the CPIP was providing. For example, one practice manager reported that in their first week, the CPIP had identified a patient who should have been on warfarin but it had been missed; this would have greatly reduced the risk of a stroke and the consequences associated with that. GPs in the scheme also reported benefits, recognising that often the pharmacist will go into a lot more detail in their appointments adding another, but different, expert to the practice.’