Primary care pharmacists

Pharmacists working in general practice are increasingly referred to as primary care pharmacists and a separate arm of the pharmacy profession is emerging. This has probably been beneficial with respect to education, training and support. Pharmacists in both community and general practice settings are isolated from their fellow professional peers and this should be countered by peer support wherever possible. 

Pioneers of this new branch of the pharmacy profession were largely employed by fundholding practices, but more recently health authorities have identified funds to support the role. Evaluation of this has been largely on the basis of case study reports but more recently rigorous evaluations have also been carried out which clearly demonstrate the benefits of the primary care pharmacist approach.

Most recently there has been a further boost to pharmacists’ contribution to prescribing in the UK general practice setting. The reconfigured NHS introduced on April 1st 1999 is focussed on primary care. Within the primary care trusts, health care is delivered on a locality basis though Primary Care Groups (PCGs), or Local Health Care Co-operatives (LHCCs) in England and Scotland respectively. 

In Scotland particularly, there is a clear budget for each LHCC, which is cash limited, for prescribing. Pharmacists are being appointed to each LHCC to provide strategic advice at LHCC level, as well supporting individual primary care practice pharmacists and community pharmacists within the LHCC.

The recently published UK Crown Review (Crown 1999) of the prescribing, supply and administration of medicines, has facilitated the further involvement of pharmacists as both dependent and independent prescribers. The review recommends that individual groups of professionals should be able to apply for the authority to prescribe certain medicines. 

This could facilitate drug selection by a pharmacist for individual patients after initial diagnosis by the general medical practitioner, or greater autonomy in managing repeat prescribing after the initial prescribing decision has been made. Such activities would need to complement and not threaten the emerging role of the nurse practitioner, who is also seen as contributing to more efficient use of primary health care services. A triumvirate of doctor, nurse and pharmacist could be a very powerful and efficient combination for providing a previously unparalleled level of service to patients.


by Umaee
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