Ills, pills, and skills: developing the clinical skills of pharmacists in general practice.

Abstract

The recent national pilot — ‘Clinical Pharmacists in General Practice’1 — heralded in the General Practice Forward View, has enabled 500 pharmacists to potentially have patient-facing, practice-employed roles within general practice, with a further 1500 pharmacist roles planned by 2020. This staff-bolstering scheme, along with new opportunities for other allied healthcare professionals in primary care, comes in response to current concerns about general practice workforce capacity, where modelling around staff recruitment, retention, and retirement have raised concerns about shortfalls in GP numbers.2 Despite the optimistic assertions presented in the ‘next steps’ review of the Five Year Forward View regarding GP workforce,3 NHS data have recently identified an overall reduction of 96 (0.3%) in the numbers of full-time equivalent GPs in the 12 months to September 2016.4 Such GP workforce issues have led general practices to consider strategies for coping with increasing workload,5 including employing clinical pharmacists in patient-facing roles. Pharmacists have traditionally had dispensing roles, though their degree-level training suggests that their potential has not been fully realised. Research evidence indicates that they can contribute favourably to clinical outcomes in primary care.6 Furthermore, increasing multimorbidity and polypharmacy across the population is contributing to the complexity of clinical care.7 Given this context, it seems reasonable to suggest that having additional medication-focused expertise within general practice teams may be of potential benefit. The Royal College of General Practitioners (RCGP), in the context of describing the MRCGP Clinical Skills Assessment (CSA), …