The Role of Pharmacist in General practitioner Surgery in the UK

Doctor In Consultation With Female Patient In Office

General practitioners are physicians that patients come to see on a regular basis. They can be the first contact with the patient in the primary care setting. They attend to most chronic or acute health issues of patients and are most times the first point of contact for patients who are seeking a diagnosis for an unknown ailment. More often than not, patients are typically required to get a referral from their general practitioner before going to see a specialist. If and when the patient’s health condition proves to be severe and out of the scope of the General practitioner, a referral can then be made to a specialist within that field. General practitioners may not have a speciality area but still have a broad enough knowledge to provide primary care.

General practitioners in addition to diagnosing and treating ill patients, also engage in minor surgeries. Minor surgeries by definition refer to those procedures which have as a common trait, the application of surgical techniques or other minimally-invasive procedures of a short duration which are carried out through the superficial or approachable tissues. These techniques may generally require a local anaesthetic and have few risks and complications. Common examples of such minor surgeries carried out by General practitioners include but are not limited to: repair of cuts or small wounds, removal of warts, benign skin lesions or abscesses.

Pharmacists can deliver safe, high quality, effective and efficient care to patients. As experts in medicines and their use, they play a crucial role in supporting patients to take those medicines as part of a shared decision-making process in a bid to promote patients compliance, as well as ensuring patients get the right medication.

Having a pharmacist as part of the clinical team within a practice can relieve work pressure on GPs to free up time for the GP to spend with patients with complex medical needs. Pharmacists play significant roles in managing patients with long term conditions such as asthma, diabetes and hypertension but can also be a resource in managing patients with complex medicines requiring frequent monitoring, patients with problematic polypharmacy or those with special medical needs, for example in patients with reduced kidney function. There are many examples of this occurring across the UK and feedback from the multidisciplinary team has welcomed the pharmacist’s expertise in managing risk in patients with complex care.

The roles played by pharmacists towards patient care in general practice surgeries are enormous, varied and can never be overstated. As described by the Royal Pharmaceutical Society (RPS) in the UK, these roles can be categorised into three, and they include Resolving problems with medicine, prescribing, audits and processes.

Pharmacists working with GP surgeries help resolve problems with medicine by:

  1. Working close to GPs to solve day to day medicine issues (similar to pharmacists working on hospital wards)
  2. Liaising with relevant hospital, community and primary care colleagues to ensure correct medicine follow up on the transfer of care.
  3. Working with GP teams to provide clinical medicine advice to care homes and domiciliary care support.
  4. Ensuring that problems highlighted during medicine use review in community pharmacies, particularly for those patients experiencing polypharmacy are followed up./li>
  5. Working closely with local community pharmacists to resolve problems with prescriptions.
  6. Running chronic disease clinics and liaising with practice nurses on changes in medicine prescribing.

The role of the pharmacist as a clinician has been strengthened by the development of prescribing rights, allowing both supplementary and independent prescribing for pharmacists. By utilising their license to prescribe, independent prescriber pharmacists in GP surgeries can:

  1. Manage a cohort of patients, if appropriate, within a particular area of expertise.
  2. Advice on polypharmacy, prescribe alternatives and help to reduce wastage within the practice.
  3. Respond to patient discharge from hospitals and liaising with local pharmacies.
  4. Educate and train GPs on common prescribing problems.
  5. Rationalise repeat prescription list to avoid waste and duplication.

The Royal Pharmaceutical Society considers that such roles will fundamentally improve the safety and integration of the medicines pathways, ensuring that excellent communication and collaboration between pharmacist colleagues working in both primary and secondary care helps to positively impact on the many medicines-related problems that occur especially in GP surgeries, particularly at the point of transfer between care settings.

Pharmacists in general practice can be a vital source of clinical care, especially if they are independent pharmacist prescribers. They contribute hugely to patient care and support the medicines optimisation agenda. Patient empowerment is enabled via the medicines optimisation clinics, and patients have a whereby complex medicines related queries are answered, thus supporting adherence and improvement in health outcomes.

Pharmacists are indispensable members of the medical team regardless of the practice setting. Their knowledge of drugs can always come in handy for the benefit of the patient and also to aid other medical practitioners in their decision making with regards to the drug of choice amongst treatment options.