Pharmacy
The Islington GP Federations pioneered the role of clinical pharmacists in general practice in its current model. Building on the success of earlier pilots, IGPF built a dynamic team of 55 pharmacists and pharmacy technicians; deployed across 3 PCNs in Islington, where they provide a range of clinical services.
Medicine management and prescribing are the biggest patients’ interventions in Primary Care and with increasing pressures on GPs, an alternative delivery model was required. The introduction of the Additional Roles Reimbursement scheme (ARRS) in 2019 presented an ideal opportunity for IGPF to build jointly with the Primary Care Networks (PCNs) a pharmacist’s team that has led on numerous initiatives to improve management of long-term conditions and proactive delivery of medicines optimisation in primary care.
IGPF developed a model of service delivery that provides central clinical leadership but allows for tailored outputs to meet the individual needs of practices. The central support structure provides overarching clinical governance, strategic direction and facilitates communication with stakeholders. It also promotes standardisation in processes and protocols, fostering consistency and quality in service delivery. The clinical leadership also ensures that projects align with our broader clinical goals and meet the need of our local population.
The main role of the clinical pharmacists is to work collaboratively with the wider practice teams to manage patients; with focus on achieving the best outcomes from their medication.
Functions that are offered by the clinical pharmacists include:
Structured medication review and tackling Polypharmacy.
Management of Long-Term Conditions: Asthma, COPD, Diabetes, and hypertension.
Repeat prescribing: The pharmacists support routine repeat prescriptions and deal with medication queries from patients and clinicians.
Medicines management advice: advise patients regarding side effects, dosing, interactions and how to take their medicines.
High risk drug monitoring and managing medicine safety: This may involve disseminating and acting on medicine safety alerts from MRHA and helping the practice maintain safe systems for monitoring high-risk drugs.
Other initiatives include:
Creating protocols and pathways to encourage safe prescribing and minimising prescribing errors.
Implementation of OTC and other NHSE/ local guidance
Reduction of opiates and benzos prescribing
Introducing a culture change around prescribing
Providing expertise around specialist areas of medicines such as: transgender
The pharmacy team also plays a crucial role in mobilising projects at scale, they provided a vital link in the implementation of several initiatives: providing valuable insights and guidance by leveraging their good working relationship with practices, and the wider NCL teams. For example, they collaborated with colleagues in neighbouring federation and local trusts to successfully deliver the first NLC integrated cross-sector training programme for pre-registration Pharmacy Technicians. Most recently, the team collaborated with Haringey Federation to establish the NCL CMDU service and continue to support its delivery to our most vulnerable patients. The team also work closely with the Medicines Management Team to tackle inappropriate prescribing, this year, Islington achieved the lowest percentage increase in ONS spend for NCL. This showcases our commitment to making improvements and delivering tangible results.