GP mythbuster 81: Pharmacy professionals in general practice

Pharmacists and pharmacy technicians (pharmacy professionals) work in multidisciplinary teams in general practice. They work in a variety of clinical and non-clinical roles. The General Pharmaceutical Council (GPhC) regulate pharmacy professionals.

To meet the regulations providers must make sure pharmacy professionals:

• have the skills, knowledge and experience to deliver effective care and treatment
• work within the scope of their qualifications, competence, skills and experience
• receive support, training, professional development, supervision and appraisals.

Practices must be sure staff meet these requirements even if they do not employ their pharmacy professional directly. This is particularly important. More pharmacy professionals are working across Primary Care Networks. They may not be directly employed by the practices they work in.

How we inspect

During our inspections of GP practices, under the effective key question, we ask:

E3. How does the service make sure that staff have the skills, knowledge and experience to deliver effective care, support and treatment?

We consider the competency and development of all staff, including pharmacy professionals. We ask the following questions:

• Do people have their assessed needs, preferences and choices met by staff with the right skills and knowledge?
• How are the learning needs of all staff identified? Do staff have appropriate training to meet their learning needs to cover the scope of their work and is there protected time for this training?
• Are staff encouraged and given opportunities to develop?
• What are the arrangements for supporting and managing staff to deliver effective care and treatment? (This includes one-to-one meetings, appraisals, coaching and mentoring, clinical supervision and revalidation.)

Providers must be able to show how they:

• Make sure pharmacy professionals are, and continue to be, competent
• Have systems in place to support clinical supervision
• Support them to fulfil their annual GPhC revalidation process. This assures their ongoing fitness to practice.

What does a practice based pharmacy professional do?

Practice based pharmacy professionals must follow medicines optimisation and NICE Medicines Optimisation Guidelines.

Within these, they may provide:

Clinical services

• Work with GPs and other surgery clinicians to resolve day-to-day medicines issues
• Consult with patients for medication reviews
• Manage and prescribe for long-term conditions (see below, 'Pharmacists as non-medical prescribers')
• Triage and manage common illnesses
• Respond to requests for prescriptions
• Take part in case reviews

Prescription management

• Work with the practice team to deliver repeat prescription reviews
• Point of contact for medicines-related queries for healthcare professionals and patients
• Liaise with other services to make sure patients get the correct medicines when they move between care providers

Audit and education

• Carry out systems to monitor medicines use
• Lead audits and quality improvements programmes involving medicines
• Contribute to clinical education of other healthcare professionals

Medicines management

• Work with GPs and practices nurses to agree and manage practice formularies. These should improve the choice and cost effectiveness of medicines.
• Carry out NICE guidance through:
  • audit and feedback
  • formulary management
  • educational sessions with the healthcare team and patients

Pharmacists as Advanced Clinical Practitioners

Advanced clinical practitioners in general practice may be pharmacy professionals. GP mythbuster 66: Advanced Nurse Practitioners (ANPs) in primary care covers the advanced practitioner role.

Pharmacists as non-medical prescribers

Pharmacist independent prescribers must have completed a GPhC-accredited training programme. Pharmacist independent prescribers:

• can prescribe any medicine for any medical condition. This includes controlled drugs and unlicensed medicines.
• must work within their own level of professional competence and expertise.

The GP practice and pharmacists must agree the range and extent of this prescribing practice. The practice must be sure, and have evidence, that the pharmacist is competent in those areas. For more information see GP mythbuster 95: Non-medical prescribing.

Professional registration

Pharmacy professionals must be registered with the GPhC to practice in the UK.

You can view and search the GPhC register online. The register shows if a pharmacist is an independent prescriber. It does not show any other distinctions on areas of specialism or competence.

Practices must check pharmacy professionals have appropriate professional registration before and throughout employment. This includes for those in locum or temporary positions.

Professional indemnity

From April 2019 the Clinical Negligence Scheme for General Practice in England and Wales covers everyone providing NHS services for general practice. This includes pharmacy professionals.

The indemnity scheme does not cover non-NHS work. It does not provide legal representation for inquests and disciplinary investigations.

All pharmacy professionals must have professional indemnity arrangements. This is to cover their role and scope of practice (under article 32 of the Pharmacy Order 2010. It is part of their professional registration with the GPhC).

If a pharmacy professional is engaged in non-NHS work on behalf of the general practice, the practice must check that they have sufficient cover.