Clinical Pharmacists

Clinical Pharmacists

Questions?

If you have any questions relating to clinical pharmacists, please send your queries to us at [email protected]

Clinical Pharmacists

"Clinical pharmacists work in primary care as part of a multidisciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas."

Source: HEE's Role Overview

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What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Are there any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

What employment routes are there?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do they need?

What should practice induction include?

What ongoing support is available?

What are clinical pharmacists?

Clinical pharmacists are primary care health professionals, who work in a patient-facing role as part of a multidisciplinary team (MDT) to clinically assess and treat patients using their specialised knowledge of medicines. They are responsible for medicines optimisation within their respective primary care network (PCN) and conduct clinical medication reviews for patients with complex polypharmacy, especially the elderly, care home residents, or individuals with multiple co-morbidities.

If not already able to prescribe, clinical pharmacists can achieve an independent prescribing qualification following completion of the Centre for Pharmacy Postgraduate Education’s (CPPE) 18-month pathway (completing this or an equivalent, approved course is necessary for clinical pharmacists receiving funding through the Additional Roles Reimbursement Scheme (ARRS)).

For more information:

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What benefits can clinical pharmacists bring?

Clinical pharmacists can help to ease the workload of and release time for GPs — as a case study provided by NSHEI suggests, the inclusion of a clinical pharmacist in an MDT can reduce the patient need for GP appointments to a significant degree (by 30% in the case of Wallingbrook Health Group, Devon). By extension, clinical pharmacists can help to decrease prescription error rates and medication-related, non-elective hospital admissions.

In short, clinical pharmacists can help to improve not only the quality of care provided to practice’s service-users, but also the efficiency and well-being of other members of staff.

Please read NHSEI Devon Case Study and Clinical pharmacists in general practice: a necessity not a luxury? below, for more information.

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

What is their scope of practice?

Clinical pharmacists are qualified to carry out the following activities, as part of their scope of practice:

  • Collaborate with care homes to provide support on medicines-related issues
  • Conduct clinical switching protocols and alternative prescribing policies
  • Conduct evidence-based Medicines and Best Practice reviews
  • Conduct structured medication reviews
  • Domiciliary reviews
  • Educate other members of their MDT and patients on the use of specific medicines
  • Manage polypharmacy and co-morbidity complexities
  • Provide high-risk medicines monitoring
  • Provide medicines information and advice to other members of their MDT, patients, and the general public
  • Provide medicines reconciliation, supporting safe transfers of care
  • Provide prescribing and clinic management (e.g., Minor Ailments Clinics)
  • Treat patients with complex long-term conditions, like “difficult” hypertension

Please note that this is not an exhaustive list, however.

For more information on the scope of practice of this profession, please consult HEE’s Clinical Pharmacist Role Overview and the Dorset Training Hub’s page on clinical pharmacists.

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

Is funding available for them?

HEE stipulates that from April 2020, clinical pharmacists will be reimbursed via the Additional Roles Reimbursement Scheme (ARRS) at 100% of actual salary plus defined on costs. This is up the maximum reimbursable amount of £55,670 over 12 months.

Source:

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

Are there any case studies?

NHSEI is able to provide a couple of case studies, focused on clinical pharmacists located in Devon and Norwich, and the valuable contributions they made to their respective practices.

For more:

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

What characteristics, training / qualifications, and competencies should they have?

Please find information on what you should look out for when employing a clinical pharmacist below:

Personal Characteristics

Clinical pharmacists should have personal characteristics that are in keeping with the Standards for pharmacy professionals provided by the General Pharmaceutical Council, with the most recent standards being published in May 2017. They outline what is expected from pharmacy professionals, and serve as a reflection of how pharmacy professionals view themselves and their colleagues.

In short, clinical pharmacists should adhere to these nine standards:

  • Provide person-centred care
  • Work in partnership with others
  • Communicate effectively
  • Maintain, develop and use their professional knowledge and skills
  • Use professional judgement
  • Behave in a professional manner
  • Respect and maintain patient confidentiality and privacy
  • Speak up when they have concerns or when things go wrong
  • Demonstrate leadership

To read the Standards themselves, which include a breakdown, please click here.

Training and Qualifications

Clinical pharmacists must have completed a General Pharmaceutical Council-accredited (GPhC) Master of Pharmacy (MPharm) degree. This is typically a full-time, four-year course, provided by a number of universities from across the country.

A clinical pharmacist should also be registered with the General Pharmaceutical Council (GPhC). To see what is required to register with the GPhC, please consult the guide linked below, published in January 2021.

To access it the guide, please click here.
For a list of all accredited courses and qualifications, please click here.

To be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that pharmacy technicians must meet.

For a breakdown of these, please click here.

Competencies

Clinical pharmacists should have experience with the following competencies:

  • Working with GPs and patients to address medicine adherence
  • Reviewing patients on complex medicine regimens
  • Triaging and managing common ailments
  • Responding to acute medicine requests
  • Managing and prescribing for long-term conditions (often with the practice nurse)
  • Holding minor ailment clinics
  • Prescription management
  • Dealing with medication for patients recently discharged from hospital
  • Helping the practice deliver on the patients recently discharged from hospital
  • Helping the practice deliver on the Quality, Innovation, Productivity and Prevention (QIPP) and Quality Outcomes Framework (QOF) agenda and enhanced services
  • Delivering repeat prescription reviews
  • Being the point of contact for all medicine-related queries
  • Overseeing the practice’s repeat prescription policy
  • Taking over clinical medicines reviews from GPs
  • Audit and education
  • Medicines management
  • In dispensing practices, pharmacists can take responsibility for the business management of the dispensary

This list has been sourced from HEE’s Clinical Pharmacist Role Overview. To see the original, please click here.

Are there any requirements to receive ARRS funding?

As noted under ‘Is funding available for them?‘, clinical pharmacists can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that clinical pharmacists must adhere to.

For instance, as stated in Annex B of the Clinical Pharmacist Direct Enhanced Service (DES) contract:

  • “B1.1. Where a PCN employs or engages a Clinical Pharmacist under the Additional Roles Reimbursement Scheme, the PCN ensure that the Clinical Pharmacist is enrolled in, or has qualified from, an approved 18-month training pathway or equivalent that equips the Clinical Pharmacist to:
    • a. be able to practice and prescribe safely and effectively in a primary care setting (for example, the CPPE Clinical Pharmacist training pathways);
    • b. and deliver the key responsibilities outlined in section B1.2.”

Section B1.2. relates to the key responsibilities that clinical pharmacists must undertake.

To read the full annex, please consult ARRS Minimum Role Requirements below.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What employment routes are there?

According to the General Pharmaceutical Council (GPhC), there are two routes to registration for clinical pharmacists intending to work in Great Britain. As laid out in their Criteria for registration document, the routes are:

  • Initial registration by UK- and internationally-qualified pharmacy technicians
  • Initial registration by an applicant not in possession of a relevant European qualification
  • Returning to registration after a period of absence

All three routes are detailed in the Criteria document, linked below. In addition to education and training checks, the registration routes also look at candidates’ health, character, identity, and grasp of the English language.

For more information:

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

Please note: to be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that clinical pharmacists must meet.

For a breakdown of these additional requirements:

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

Any example job descriptions?

NSHEI have developed a job description, in addition to a recruitment pack — these are both available on the FutureNHS site. Accessing the site requires you to create an account; once done, you can visit the role selection page to find the resources in question (click here to jump to the role selection page — remember, you will need to be logged in to access it).

Alternatively, you can download HealthWest’s job description by clicking here.

The Primary Care Pharmacy Association (PCPA) have also kindly provided several example job descriptions, for various bands of working, on their site, accessible via the button below.

Any sample interview questions?

The Primary Care Pharmacy Association (PCPA) kindly provides sample interview questions for clinical pharmacists on their website, accessible via the button below. The sample interview questions themselves are at the bottom of the page.

What clinical supervision do they need?

When employed in primary care under the Additional Roles Reimbursement Scheme (ARRS), clinical pharmacists must be part of a professional clinical network and receive clinical supervision. Specifically, they must have:

  • A minimum of one supervision session per month, delivered by a senior clinical pharmacist
  • Senior pharmacists should receive a minimum of one supervision session every three months, delivered by a GP clinical supervisor
  • All pharmacy professionals must have access to an assigned GP clinical supervisor, whom can provide support and development
  • There should be a ratio of one senior clinical pharmacist to five clinical pharmacists — and in all cases, appropriate peer support and supervision must be in place for each pharmacist

Sourced from:

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

The Centre for Pharmacy Postgraduate Education (CPPE) offers training to become a clinical supervisor for individuals supervising pharmacy professionals on the CPPE Primary Care Pharmacy Education Pathway. This is a half-day workshop generally, but it can be completed by attending two webinars.

Interested individuals can apply for a space via the CPPE website, here. If you are not a pharmacy professional, you will need to create an account on the site before you are able to book a place.

For more:

Primary Care Pharmacy Education Pathway

This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.

To read it, please click here.

What should practice induction include?

Practice induction for clinical pharmacists should include:

  • Signing them up on e-Learning for Health (e-LFH) to complete mandatory training | Please click here to access e-LFH
  • Signing them up on TeamNet, so that they can access relevant policies | Please click here to access TeamNet
  • Provide them with EMIS training, via the CCG
  • Familiarise them with the BNSSG Joint Formulary | Please click here to access it
  • Link with the CCG Medicines Optimisation Team, particularly if they should need Eclipse / Radar training
  • Provide them with Docman training
  • Set them up on the CPPE site and with access to Canvas, so they that can undertake the Centre’s e-Courses | Please click here for more information

Clinical pharmacists should be sure to meet and shadow your PCN’s current pharmacists and prescription team. They should meet practice manager(s), deputy practice manager(s), reception manager(s), reception lead(s), clinical staff, and their supervisor(s), in addition to the CCG’s Medicines Optimisation Pharmacist.

What ongoing support is available for clinical pharmacists?

There are various ways in which clinical pharmacists can receive support, including:

The ACP Forum

Organised and led by our ACP Lead, Kerri Magnus, The ACP Forum can assist clinical pharmacists on the journey to becoming an advanced clinical practitioner. The Forum can signpost to relevant education and training, provide 1-to-1 guidance, and facilitate networking with like-minded colleagues from across BNSSG.

To visit The ACP Forum’s site, please click here.

The Hub's Physiotherapy Lead

We hope to soon be welcoming a new member to our team: a Physiotherapy Lead. They will provide a point of contact for clinical pharmacists, helping you to set objectives and career goals, and to keep in the loop with our pharmacy-related work.

Please stand by for more.

Centre for Pharmacy Postgraduate Education (CPPE)

The CPPE is part of the Division of Pharmacy and Optometry in the University of Manchester’s Faculty of Biology, Medicine, and Health. It is dedicated to providing professional development opportunities and support to pharmacy staff, including through coaching and networking.

To find out more, please click here.

Literature
ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

HEE's Clinical Pharmacist Role Overview

Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.

To read it, please click here.

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

Primary Care Pharmacy Education Pathway

This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.

To read it, please click here.

Standards for pharmacy professionals

Regulated by the General Pharmaceutical Council, these standards outline what is expected of pharmacy professionals, including clinical pharmacists.

To read them, please click here.

A/V resources
I'd like to see the clinical pharmacist

Produced by NSHEI for the NHS’ 70th anniversary in 2018, this video explores the role of a clinical pharmacist in their primary care MDT.

To watch it, please click here.

[This video was uploaded on 07.05.19.]

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