Abstract
Pharmacists have been employed in UK general practice for many years. Their numbers are now expanding and their roles developing. Clinical pharmacists are expected to alleviate workload pressures on GPs. Notwithstanding the COVID-19 vaccination programme, a new Structured Medication Review (SMR) service has been introduced in Primary Care Networks (PCNs). The long term drivers are clear: addressing problematic polypharmacy in the NHS, reducing avoidable hospitalisations, and delivering better value from medicines spending. SMRs are intended to improve the quality of prescribing, delivering improvements to patient care and outcomes.
Highlights
The roll-out of PCNs and the development of the SMR specification were both done at speed
Important changes with implications for the developing PCN clinical pharmacist role have been made at short notice, and a time when much of the NHS workforce has been focused on managing the pandemic
Content on how to incorporate brief advice for public health purposes in ways underpinned by shared decision-making principles is limited
Summary
The roll-out of PCNs and the development of the SMR specification were both done at speed. Important changes with implications for the developing PCN clinical pharmacist role have been made at short notice, and a time when much of the NHS workforce has been focused on managing the pandemic This raises questions about expectations, preparedness, and practice development.[7] SMR conduct is to be personalised, holistic, and conducted in line with the principles of shared decision making, attentive to health literacy, and likely to be largely delivered remotely for now.[6] Newly recruited clinical pharmacists conducting SMRs are required to have, or be in training for, a prescribing qualification, and to have advanced assessment and history-taking skills.[6] Many are coming from the community pharmacy workforce where such skills are not a requirement. Account must be taken of what is known about the nature of the person-centred consultation skills possessed by the new clinical pharmacist workforce within primary care, and the strengths and limitations of the existing evidence
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