The desire to make greater use of the skills and specialisation of the pharmacist so that a more flexible system for the prescribing, supply and administration of medicines to patients can be developed has been the main driving force behind the introduction of pharmacist prescribing in the United Kingdom (UK).
Independent pharmacist prescribing was introduced in May 2006 in the UK, and an independent pharmacist prescriber can be defined as a practitioner responsible for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. This is in contrast with supplementary pharmacist prescribing, which takes away the ability of the pharmacist to independently prescribe drugs to patients suffering from an ailment within his field of specialisation.
Becoming an independent pharmacy prescriber in the UK requires interested pharmacists, who are registered with the General Pharmacist Council (GPhC) to complete a GPhC-accredited programme in any university within the UK that is accredited by the GPhC to carry out such programmes. On successful completion of such a programme, the pharmacist would be issued a practising certificate in independent prescribing thus affording eligibility to apply for annotation to the register.
To be a registered member of the UK GPhC, one must have successfully concluded a GPhC accredited Master of Pharmacy degree (MPharm). This is a full-time four-year course, followed by successful completion of one year’s pre-registration training which is a period of paid employment in a community or hospital pharmacy. During the pre-registration training, the trainee is required to build up a portfolio of evidence and demonstrate their competence while being observed at work. Furthermore, the individual is also expected to complete the GPhC’s registration assessment and also meet the fitness to practise requirements for registration as a pharmacist. It is worthy of mention, however, that under the Bologna agreement for educational equivalence across Europe, the MPharm programme is classed as an “undergraduate masters program” which is a lesser qualification than the traditional MSc degree. The reason being that possession of a bachelor’s degree is not necessary for the application to the program.
On completion of the aforementioned steps, an applicant can proceed to apply for registration with the GPhC as a pharmacist. It is to be borne in mind; however, that as part of the registration process, applicants have to make a health declaration and character checks are also carried out.
Currently, in the UK only 50 universities provide the GPhC- accredited pharmacist independent prescribing programme and amongst which include:
The University of Birmingham, University of Manchester, University of Bolton, University of Bradford, University of Central Lancashire, Cardiff University, University of Chester, Coventry University, University of Hull, University of Huddersfield, king’s College London, Medway School of Pharmacy, Open University, University of Portsmouth, University of Plymouth, University of Sunderland, University of Wolverhampton, University of York, Bangor University, University of Bath, University of Brighton, University of Cumbria, University of Derby and a few others.
An accredited independent prescribing course is typically run over a period of six months. The course is part-time and often delivered through a combination of face-to-face teaching sessions (usually one day per week) and self-directed study. Also, a few of these institutions offer a course with a more significant distance learning option. However, all courses would require a minimum of teaching and learning activity, and each pharmacist must complete at least 12 days of learning in a practise environment while being mentored by a medical practitioner.
- Applicants must be registered as a pharmacist with the general pharmaceutical council(GPhC) or in Northern Ireland with the pharmaceutical society of northern Ireland (PSNI)
- Applicants must be in good standing with the GPhC or PSNI and any other healthcare regulator with which they are registered.
- Applicants must have at least two years’ appropriate patient-oriented experience post-registration, in a relevant UK practice setting.
- Applicants must have an identified area of clinical or therapeutic practice from in which to develop independent prescribing practice. They must also have relevant clinical or therapeutic experience in that area, which is suitable to act as the foundation of their prescribing practice while training.
- Applicants must have a designated prescribing practitioner who has agreed to supervise their learning in practice, and such a practitioner must be a registered healthcare professional in Great Britain or Northern Ireland with legal independent prescribing rights, who is suitably experienced and qualified to carry out the supervisory role. It is the designated prescribing practitioner that would thus, certify that the applicant is competent to practise as an independent prescriber.
In November 2019, GPhc approved new guidelines for pharmacist prescribers to ensure that they provide safe and effective care when prescribing. As of November 20, 2019, there were 58,085 registered pharmacists on the GPhC register of which 9,142 are independent prescribers, thus, given the increasing number of pharmacist prescribers in the UK.
- Taking responsibility for prescribing safely: This entails that pharmacist prescribers must obtain all the necessary information about the patient before prescribing, they must only prescribe within the limits of their knowledge, skill and area of competence and there must be a follow-up on the patient after prescribing in order to ensure adherence to drug therapy.
- Keeping up to date and prescribing within their level of competence.
- Working in partnership with other healthcare professionals and persons seeking care to obtain the ideal therapeutic outcomes.
- Prescribing considerations and clinical judgement: Pharmacist prescribers must not prescribe medications for themselves or for anyone with whom they have a close personal relationship (such as family members, friends or colleagues). This is especially important for controlled substances. Furthermore, prescribing and supplying of medicines to the patient should be kept separate to minimise the risk of errors.
- Raising concerns: All pharmacy prescribers must speak up when they have a concern or when things go wrong.
In summary, for one to become an independent prescriber pharmacist in the UK, the applicant must firstly become a registered pharmacist with at least two years post-training practise experience, afterwards, the applicant is expected to successfully complete an independent prescriber pharmacist program in a GPhC-accredited institution where a practising certificate in independent prescribing would be issued to the applicant on completion of the program and the certificate can thus be used by the applicant to register as an independent pharmacist prescriber with the GPhC.