Day 8: Fantastic Pharmacists (& where to find them)

It's definitely a Monday. I've got back from work with a crazy headache, hunger pains and bladder so full, I'd give a camel a run for its money! Today was the first day I signed some official paperwork as a PCN Clinical Director (*Ooooooo in a gameshow style). I signed off our Additional Workforce Analysis. We will be definitely looking to recruit a PCN Pharmacist and it's on the agenda for tomorrow's PCN Operational Direction meeting.

It's been four years since the launch of NHS England pilot scheme to have pharmacists in General Practice. I was one of the initial guinea pigs. At time of there was a lot of doubt and concern from all parties involved, the script was unwritten, pioneers had gone before me but I'd never had the ladder passed down. I signed on the dotted line all them years ago because I knew I could demonstrate what value pharmacists could bring to General Practice and potential opportunities to release capacity in GP workload. Now I'd like to think we have all learnt from the pilot pathway, what worked well and what didn't. Also my reflection of the pilot highlighted the gaps in succession planning as well as care and consideration not destabilise our allied healthcare sectors. The initial pathway was by no means perfect, but it was what we had and not forgetting it was a pilot after all.

Despite my little experience in General Practice before the roll out of NHSE pilot, I was fortunate to have had more exposure to the unknown, compared to most pharmacists on the same pathway. I do feel we all need appropriate support in our learning needs and provision of a safe haven to build resilience. Working in General Practice is not easy and can be very isolating, even for a bubbly, optimistic person like me. However it is one the most rewarding jobs I have ever had. I feel very privileged to be part of a dedicated multidisciplinary team and be involved in people's lives and their families.

Today I feel physically and mentally exhausted from just one day of clinic. However in greater measure I have received some lovely in the moment feedback from patients, their families and their carers about how refreshing it was to be seen by me. I'd been empathetic with their care and our conversations have left them understanding more about their condition. Of course there was a sprinkling of medication queries and patients felt we had made progress with finding treatment choices that suited them and care plans that paved the way for reducing medication burden. Some of these cases were complex and it's taken multiple appointments to change mindsets and give back a sense of patient control, not disease control. Ultimately quality of life was returned to the person sitting in the chair next to me.

So where do we find the next cohort of pharmacists to bring into General Practice? I don't have a magic pharmacist tree but having worked in various pharmacy sectors I do feel pharmacists from other sectors have transferable skills and gained experience that will equip them for General Practice. Do I feel that you can parachute one pharmacist, with no General Practice experience into surgery tomorrow and expect them to flourish? No, I don't. I think that would be grossly unfair and sets that pharmacist for a fall. Worst still, knock their confidence in their own ability and lose sight to realise their own value. If the right infrastructure is in place and the most appropriate mentor is offered, you could upskill any pharmacist to thrive in General Practice. It is essential that we provide individualised training and develop plans with realistic aims. Only then do I feel that the possibility of these 'additional workforce' roles to be truly attractive and likelihood of retention is strong.

The current PCN Additional Workforce Scheme does offer a 18-month training and development pathway, evolved from the initial pilot four years ago by CPPE (Centre for Pharmacy Postgraduate Education - University of Manchester). It's really positive to see how the overall plans of the pathway allows protected time for the prescribing course if required and acknowledgement for the NEED of local support and mentorship. I hope I can be of some support to future PCN pharmacists in my locality, not just my network. The creation of our local Primary Care tribe of pharmacists will help realise the vision of the Long Term Plan together.

CPPE 18 month pathway

There are fantastic pharmacists everywhere. It is important that pharmacists wanting to join General Practice for the first time understand the dynamics and politics of Primary Care and for prospective PCNs wanting to recruit, if you invest the right time and effort you will have added an absolute lifeline to your expanding team.

---

LINKS

University of Nottingham Evaluation

https://www.nottingham.ac.uk/pharmacy/documents/generalpracticeyearfwdrev/clinical-pharmacists-in-general-practice-pilot-scheme-full-report.pdf

CPPE Primary Care pharmacy education pathway https://www.cppe.ac.uk/career/pcpep/pcpep-training-pathway