In Health & NHS

Follow this topic

Bookmark

Record learning outcomes

An evaluation by the University of Manchester of NHS England’s community pharmacy independent prescribing pathfinder programme found securing indemnity to deliver pharmacist prescribing was “challenging” because insurance companies are not familiar with it. 

Researchers assessed the three models which were tested by the 200 pathfinder sites in England as they examined how pharmacist prescribing can be incorporated into community pharmacy clinical services.

The sites looked at existing services such as acute minor illnesses and contraception, as well as long-term conditions including prescribing for cardiovascular diseases, respiratory diseases and women's health and finally “novel services”, including reducing over-prescribing, reviewing antidepressants and menopause.

The evaluation found ICBs were “instrumental in guiding sites through assurance processes, developing clinical governance and fostering stronger relationships between GPs, community pharmacy and other stakeholders”.

However, the researchers said: “Securing clear indemnity to deliver pharmacist prescribing in community pharmacy was challenging due to insurance companies’ lack of familiarity with the new model.”

Researchers also said pharmacists who took part in the study “reported significant increases in job satisfaction” while many said the pathfinder programme “saved them from leaving” community pharmacy because it allowed “them to use their full clinical skills”.

Commissioning strategies needed to ensure financially viable service

Researchers found commissioning strategies were needed “to generate predictable patient volumes to ensure a financially viable service” while prescribing pharmacists with read-write access to patient records “found it easier to collaborate in a timely fashion with GPs and other GP practice-based healthcare professionals”.

“Having read-only access to patients’ medications and limited details of their medical histories made holistic patient care more challenging,” the researchers said.

They added: “A good skill mix is needed across the wider pharmacy team to ensure pharmacist prescribers have the capacity to deliver the service.”

The evaluation also found the implementation and long-term viability of independent prescribing hinged on five areas; clinical governance, clinical supervision, optimal skill mix, digital infrastructure and a financially viable funding model.

Researchers noted that clinical supervision “which is traditionally scarce in community pharmacy was usually provided by a GP through regular one-to-one sessions”. Those sessions, the evaluation said, were “highly valued by pharmacist prescribers as it helped to build their confidence and GP’s trust”.

The pathfinder programme concluded on December 31 although NHSE said it will continue to support integrated care boards (ICBs) until the end of March this year as they develop business cases to commission clinical services that incorporate independent prescribing.

The evaluation was also conducted by researchers from the consulting and technology services company ICF International.