Medicines specialists in GP practices helping support doctors and patients

Specialists with a wide range of skills are helping transform patient care in some Staffordshire GP practices.

Clinical Prescribing Pharmacists are now starting to be introduced into practices and are helping ensure patients have the right medicines to treat their conditions.

Most people are familiar with Community Pharmacists who dispense prescriptions and sell a wide range of over-the-counter remedies for minor conditions.

Clinical Prescribing Pharmacists however work within GP surgeries as resident medicines specialists. They can examine patients and prescribe medicines for a range of conditions, like GPs. They also advise GPs on medicines and available alternatives, and carry out medication reviews and other medicine-related functions.

Hannah Mitchell is the Clinical Prescribing Pharmacist at Mansion House Surgery in Stone. She has been at the practice for 18 months. Hannah studied at university for four years and then did 12 months of on-the-job training to qualify as a Community Pharmacist.

After working in a community pharmacy for five years she then did additional training to qualify as a Clinical Prescribing Pharmacist while at Mansion House, part funded for the first 12 months by Health Education England.

She said: “I’m really enjoying my role working with our GPs for the benefit of our patients here at Mansion House. I don’t dispense any medicines. In fact we don’t have a dispensary on the premises.

“Instead I work with our team of GPs to make sure patients have the right medicines and are taking them in the correct way.”

Her regular duties include:

  • Patient assessments – a prescribing pharmacist is qualified to prescribe a range of medicines for various conditions in the same way as a GP. The medicines they can prescribe depend on the training they have undertaken and can increase over time
  • Medication reviews – patients, especially those taking a range of medicines, should have these reviewed to make sure they are working correctly and providing the best results
  • GP advice – Hannah is the practice’s medicines expert. She can offer GPs specialist advice on the range of options available to treat a wide range of conditions in order to find the most appropriate for an individual patient
  • Patient advice – if they have any concerns about medication they are taking

Hannah said: “As my role has become more widely understood, increasingly patients are calling to arrange an appointment with me rather than a GP. Sometimes I can spend more time with them to make sure their medicines are really working as they should.

“Recently I examined a patient with severe asthma. She was concerned her condition was only partially controlled by her medication and was getting worse.

“I talked to her and suspected she had the correct medication but may not be using it correctly. I checked how she was using her inhaler, coached her in the best technique to use and provided her with a device called a spacer. I then arranged to monitor her progress. Within weeks she was feeling better than she had done for years. It was a relatively simple problem for me to solve, but one that GPs would struggle to dedicate the necessary time to.

“I also carry out medicines reviews with many of our patients. This allows us to make sure patients are receiving the right medicines at the best dose and in the optimum combination.  I also ensure patients who have been discharged from hospital with medications understand why they are taking them and that they are taking them correctly.”

Practice Manager Carol Rodgers said: “At Mansion House we are delighted to have a Clinical Prescribing Pharmacist on the team, and we sometimes wish we could clone another Hannah.

“The appointments Hannah carries out would previously have been performed by a GP. As an expert in medicines she is as qualified as a GP to carry out medicines reviews and to prescribe treatments for a range of conditions. She is also able to perform medicines-related administration previously carried out by GPs. Like all surgeries we are facing rising demand, and this has freed up our GPs to spend more time with the patients that really need them.”

Mansion House GP, Dr Jon Ballinger said: “Having a Prescribing Pharmacist based within the surgery is a great benefit for us. We can go to Hannah if we have any questions about prescribing, and she can often suggest alternative ways to approach dealing medications. We are confident this is providing a real benefit for patients.”

Dr Paddy Hannigan, a Stafford GP and Chair of Stafford and Surrounds Clinical Commissioning Group said: “Our priority is to make sure that patients get to see the right person with the right skills when they need support.

“Prescribing pharmacists are a good example of how we are developing our primary care workforce to adapt to the increasing demand we are facing. Highly skilled professionals like Hannah can support and complement our GPs, and will become increasingly common in practices.”