Pharmacotherapy
Pharmacotherapy aims to “introduce a new service to allow GPs to focus on their role as expert medical generalists, improve clinical outcomes, more appropriately distribute workload, address practice sustainability and support prescribing improvement work.” This means some tasks will be carried out by members of a wider primary care multi-disciplinary team – where it is safe, appropriate, and improves patient care.
Lanarkshire ensures governance and safe patient care in relation to medicines and allows an enhanced service to be offered ensuring patients are prescribed the safest, most effective and cost efficient medications whilst adhering to quality care principles.
The pharmacotherapy model supports GP based multidisciplinary teams (including pharmacists, pharmacy technicians and other roles) in every general practice in Lanarkshire or as defined by the workforce allocation model; to ensure that this model provides patients access to the ‘right person at the right place at the right time’ within the most appropriate and safest pathway of care; to increase the pool of relevantly qualified pharmacy professionals in order to staff the pharmacotherapy model and deliver this within defined timescales and to improve the efficiency of repeat prescribing.
Hubs
Pharmacotherapy hubs are a centralised service providing remote support to GP practices. This is in addition to the pharmacotherapy support that GP practices receive directly from their practice pharmacist.
The hubs provide support to multiple practices in a locality and offer a sustainable 5-day service, 52 weeks a year. Even when a practice pharmacist is on annual leave or sickness absence, the pharmacotherapy continues to support practices to carry out all primary care pharmacy team suitable medicines reconciliation work. Staff working in the hubs include pharmacy support workers (PSW), pharmacy technicians and pharmacists.
Hubs support practices with pharmacy-appropriate Docman activities such as actioning immediate discharge letters and outpatient requests from hospital. Pharmacy support workers and pharmacy technicians complete the technical aspects of medicines reconciliation and pharmacists work in the hubs on a rotational basis to complete the clinical checks.
Roles
Pharmacy Support Worker
Role
Pharmacy support workers (PSWs) assist pharmacists and pharmacy technicians by carrying out routine non-clinical tasks such as making technical changes to medicines reconciliation letters before passing to a pharmacist for an accuracy and clinical check.
Medicines reconciliation is compiling an up-to-date-list of a person’s medication to check if it is still appropriate. PSWs also work to standard operating procedures to ensure safe and effective use of medicines.
They are a key part of the administrative process to record information about medicines and medication related activities in general practice. PSWs have an important role in improving patient care and they also create more time for pharmacists and pharmacy technicians to review and complete more clinically complex pharmacy and patient-centred tasks.
Roles/Responsibilities
- Support medicines reconciliation through following standard operating procedures
- Non-clinical medication review under the direction of pharmacist and/or pharmacy technician
- Co-ordinate and analyse prescribing information
Primary Care Pharmacy Technician
Role
Pharmacy technicians work with the primary care clinical pharmacists and multidisciplinary team to contribute to the effective and efficient use of medicines. They are healthcare professionals, registered with the General Pharmaceutical Council (GPhC). Pharmacy technicians work within specific protocols to help patients get the best from their medicines and promote high quality, evidence based and cost effective use of medicines.
Pharmacy technicians provide an invaluable service to GP practices with a range of activities that include processing medicines reconciliation to a high standard that is then passed on for a clinical check. While technicians don’t clinically check prescription requests, their role supports the pharmacist to do so.
Over the coming years, it is anticipated the role of pharmacy technicians will develop further.
Roles/Responsibilities
- Review of repeat prescribing processes
- Manage medicines shortages
- Non-clinical medication reviews
- Medication compliance reviews
- Medication queries from patients and other healthcare professionals
- Review of unlicensed medicines requests
- Work with community pharmacies, hospitals and patients to resolve medication enquiries • Reconcile medicines after hospital discharge or hospital clinic appointment
- Action acute prescription requests within agreed clinical protocols and training
- Support initiatives to assist the safety of prescribing and use of medicines
- Generate, analyse and interpret prescribing data and audits
- Plan and implement initiatives to support the cost effective and efficient use of medicines
Primary Care Pharmacist
Role
Pharmacists work within the primary care multidisciplinary team in general practice leading on safe, cost effective and evidence-based prescribing of medicines. They use their clinical knowledge and judgement when review prescribing requests, medicines reconciliation and medication review clinics.
This involves reviewing patients’ medications, completing clinical examinations and analysing patients’ results and symptoms to support patients to get the best outcomes from their medicines, for example – HRT reviews and diabetes clinics.
Pharmacists also support improvement in clinical care through engagement with the prescribing quality and efficiency work that covers practice-based audits, safety reviews and implementation of prescribing improvement initiatives.
Roles/Responsibilities
- Deliver clinics that focus on complex clinical medicines reviews
- Provide medicines information and answer medicines-related enquiries
- Management and monitoring of high-risk medications
- Reconcile medicines after hospital discharge or hospital clinic appointment
- Action medication requests from patients
- Implement drug safety alerts and take action on drug shortages and withdrawals
- Review use of unlicensed medicines prescribing and requests in primary care
- Work with community pharmacies, hospitals and patients to resolve medication enquiries
- Review prescribing patterns, data analysis and monitoring of prescribing data
- Audit and project work to improve quality, safety and cost effective prescribing
