The new Initial Education and Training Standards of Pharmacists where met with huge optimism when they were launched in the January 2021. Now, every single pharmacist would be an independent prescriber (IP) from 2024.
At last, we were now able to provide a more complete healthcare solution to our patients – provided there are commissioned services through which we can deploy our skills.
Some years ago whilst studying for my pharmacy degree, I recall sitting in the reception of the GP surgery working on my clinical case study which was part of my final assessment. As I saw patient after patient come in to the reception querying issues around their repeat prescriptions, I found myself thinking that there really ought to be a pharmacist working within the GP surgery, alongside the doctors, nurses and receptionists. Surely, a number of these queries may have been handled in a more efficient manner; after all, even I (a final year pharmacy student) was able to solve most of the queries.
Upon presentation of the case study to the examiners, my recommendations to enable community pharmacists who could also prescribe were met with puzzlement and polite curiosity. Keep exploring this idea- one examiner advised…
Later, when fully qualified and enjoying my vocation at the only community pharmacy in the neighbourhood, I was faced with another challenge. That, of numerous prescription queries. At closing time, I would sit and write notes to my local prescriber asking for either quantity, dosage or in some cases clinical amendments. At times, this led to further clinical discussions with the prescriber over the telephone, before, at last I was able to provide the required treatment to my patient. Why could I not make the necessary adjustment myself?
As our professional relationship grew, my conversations with the prescriber became part of our weekly routine. It was only a matter of time, when I was eventually called to join in the lunchtime meetings with the rest of the multi-disciplinary team. It felt that my dream of having the community pharmacist working with the GP surgery was beginning to become a reality.
The new community pharmacy contractual framework of 2005 included a community pharmacist undertaking services, such as smoking cessation and medicines usage reviews. What’s more, we now needed to install a private section within the pharmacy for a private conversation. This was unchartered territory for the profession but also a great milestone. It was now getting more exciting to be a community pharmacist and the future looked bright.
Fast forward to 2022 and we can see the sector has now moved on and done so in great strides. The list of pharmacy services has grown and the case has been made and accepted for community pharmacists to become IPs. However, despite the four statutory health education bodies making provision of IP courses, there still appears to be a slow uptake of this qualification. Is it the criteria for entry into this qualification that deters our pharmacists or is it the difficulty of finding the required Designated Medical Practitioner/Designated Prescribing Practitioner?
The GPhC has now addressed the issue around the mandated two-year practice, which leaves us with the issue around sourcing a DMP/DPPs? (The PSNI are currently consulting on this).
Early indications show that there are around 2500 IPs in community pharmacy across the UK. Surely, if they all become DPPs, that would solve our new challenge? What additional support is required? How can we the community pharmacy sector support the development of DPPs?
Is it further training or self-confidence that is the additional ingredient for our profession to become self-sufficient? The pandemic has shown us that when the going gets tough, the tough really get going. Together, as a profession we created new processes and patient pathways that supported our local communities through their hour of need and desperation.
And didn’t we do well? A bit bruised and battered but still standing tall.
Therefore, I urge my pharmacy colleagues; Let us once again come together, rise to this new challenge and find a solution to better help pharmacists gain their IP qualification through community pharmacy.
If you would like to share your thoughts about this topic and help influence NPA policy in this area contact Helga at [email protected]