Evolution of the general practice pharmacist’s role in England: a longitudinal study

Background
To address the growing GP workforce crisis, NHS England (NHSE) launched the Clinical Pharmacists in General Practice scheme in 2015. The NHSE scheme promotes a newer, patient-facing role for pharmacists and currently, there is little insight into the role and activities undertaken. All scheme pharmacists are enrolled on the ‘General Practice Pharmacist Training Pathway’ (GPPTP). Through evaluation of the GPPTP, we explored, longitudinally, the phase 1 cohort’s role evolution.

Aim
To investigate role evolution and integration of clinical pharmacists in general practice in England.

Design and setting
Online longitudinal survey administered to all phase 1 GPPTP registrants (n=457) at start of (T1) and six months into (T2) training, measuring perceived knowledge, skill and confidence (KSC), activities performed and perceptions of practice integration, environment and support. Descriptive statistics and non-parametric tests were conducted (SPSS v22).

Results
Response rates were 46% (T1) and 52% (T2); 158 completed both questionnaires. Perceived KSC levels increased significantly from T1 to T2 for all areas, except managing acute/common illness. Scope of practice increased significantly, particularly in patient-facing activities. Sharing office space with administrative staff was common and 13% reported no designated work area. Perceived integration at T2 was fairly high (median=5, 1-7 scale) but GP clinical support was “too little” according to a third.

Conclusion
Findings show patient facing role expansion, but also practice environment and support issues. Pharmacists may appreciate more GP time invested in their development. Practices need to be realistic about this support and not expect immediate reduction in workload.