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The Royal College of General Practitioners would like a practice-based pharmacist in every UK GP practice within the next five years.

RCGP chair Maureen Baker described this scenario as €nothing other than a win-win for patients€. Speaking at The King's Fund on March 17, she said: €Healthcare services should be working together as a well-oiled machine to ensure information is shared and to ensure most efficient models of care. General practice in the UK is under an increasing strain and we have severe workforce pressures and this is set to increase even further with GPs reaching retirement age. There's a pressing need to increase capacity.€

Dr Baker cited a Royal Pharmaceutical Society estimate of around 1,000 €surplus€ pharmacists who could work as part of practices €in the same way as practice nurses€. By reviewing patients with complex medicine regimens, practice- based pharmacists could reduce medicine errors, cut medicines waste and lower prescribing costs, she said. €Colleagues in secondary care have relied on pharmacists' skills for years and it's well overdue for these skills to be available in primary care.€

Championing the joint RCGP and RPS initiative, David Branford, chair of the English Pharmacy Board, said: €It's absolutely essential that pharmacists and GPs work together to improve medicines use. Being part of the GP team is an absolutely fundamental building block in developing a clinical role.€

Independent Pharmacy Federation chair Fin McCaul called for a change in focus towards value outcomes rather than cost. €We have to think differently if we want to make a difference for patients and for the NHS,€ he said. €Instead of putting the stop at prescribing we need to put it at patient outcomes. For effective use of medicines we need better patient engagement, ownership of effective long-term condition management, and a feedback loop to GPs.€

Dr Bruce Warner, deputy chief pharmaceutical officer at NHS England, said that pharmacists must become an integral part of the healthcare team and that all healthcare should have an affordable patient-centred approach. €It's about dissolving traditional boundaries of how care is delivered. We need to stop thinking about care as separate entities and think of seamless care. When people pass between sectors it's a dangerous time for them and we need to think about inter- professional boundaries.€

Dr Warner called for improved public awareness and understanding of the role of community pharmacists and the services they could provide. Community pharmacy needed to demonstrate a clinical pproach based on the principles of medicines optimisation. And the commissioning system had to be unlocked to allow pharmacists to provide more patient-focused services.

But pharmacy was making progress, with over 100 pharmacists working in A&E departments across 53 trusts. And the time was right for further developments. €The planets are now coming into alignment. The Five Year Forward View simply isn't allowing us to carry on delivering care as before. The door is open but we do have to walk through the door."

Clinical roles for practice pharmacists

Most pharmacists already working with GP practices are carrying out clinical medication reviews, according to a survey by the Primary Care Pharmacists Association.

The survey also found that 51 per cent are carrying out care home reviews, 49 per cent are doing home visits, and 42 per cent are running chronic disease management clinics. Other services carried out by practice pharmacists include flu vaccinations, respiratory clinics and multi-morbidity clinics.

€Now is the time for primary care pharmacists to step forward and to think radically about developing clinical pharmacy services in primary care at scale,€ said Helen Liddell, PCPA chair. €We need to work at pathways that end up in patient outcomes rather than in prescriptions.€