@article{28125ede6ec64b5db5770bf562d4bf76,
title = "England local community pharmacists opinions on independent prescribing training",
abstract = "The National Health Service has recognized an increasing need for pharmacists to upskill as an advanced clinical practitioners to practice as part of the wider multi-disciplinary team in primary care but outside of the community pharmacy. This explored community pharmacists{\textquoteright} opinions on independent prescribing training that can equip them to meet the workforce needs. Two activities have undertaken an audit of the independent prescribing pharmacists{\textquoteright} current employability in Wolverhampton and community pharmacists opinion online survey. Only 21 out of 57 surgeries (37%) in Wolverhampton employed an IP. With only 7 out of 57 (12%) surgeries employing an IP on an FTE basis, the remaining employed IP mainly part-time. There were 70 IPs employed a total of 50.2 FTE. The most selected areas as highly confident were public health knowledge 19.6%, followed by pharmacology and routine biochemistry equally at 17.65%. There were 23.5% who reported not being confident in interpreting highly specialized diagnostics, followed by anatomy at 18%. The most selected as the first option of course of future studies was 1-2 days continuous professional development (42.55%), where Masters, professional doctorate and doctor od philosophy were selected as least favorable options (53%, 63%, 72% respectively) indicating that the majority prefer a maximum of 6 month PT studies. This study confirmed the need for rethinking the current postgraduate pharmacy independent prescribing education, the pharmacists{\textquoteright} independent prescribers{\textquoteright} integration into primary care, and the need to redistribute resources and responsibilities.",
keywords = "Community pharmacy, Independent prescribing pharmacists, Minor aliments, Non-medical prescribing, Pharmacy education, Primary care",
author = "Samaira Kauser and Hana Morrissey and Patrick Ball",
note = "Funding Information: Marriott et al. [1] discussed the need for significant clinical practice experience in the final year of the pharmacy undergraduate course for students to have a similar exposure to patients that students on a medical course have, to equip them to deal with complex patients. In Australia, the pharmacy curriculum is being evolved to help address the patient{\textquoteright}s needs facing experiential learning, hands-on activities throughout the 4-year course, intensified in the final years of study. It is believed that this would allow pharmacists to apply their knowledge and develop their competencies in an integrated way, similar to the way doctors have clinical placements [1]. Australia also led the pharmacist scope of practice evolution by introducing the home medicines review (HMR) program funded by Medicare Australia (the equivalent to the NHS in the UK). For a pharmacist to conduct HMR/s, they must successfully complete the coursework-based accreditation program, annual CPD equivalent to that required by General Medical Practitioners for their annual registration, and complete every 3-years an online clinical decisions examination. HMR is an outreach health service delivered at the patient{\textquoteright}s home (or in a care home). The GP formally refers the patient to an accredited pharmacist to initiate the service [1]. The UK undergraduate pharmacy training provides limited patient exposure (around 40 hours of shadowing/observations placement time) for the entire course. This is different from the medical curriculum where students complete 1400 hours of clinical placement in their final year of studies alone, across a variety of specialties such as primary care, hospital, and acute care, elective and students-selected components (SSC) settings, and a total of 119 weeks of clinical placements during their total undergraduate studies [13]. Similarly, nurses must have completed 2300 hours of clinical exposure during their undergraduate studies and a total of 4600 hours before they register as nurses [14]. Therefore, postgraduate pharmacist training that prepares them for patient-facing roles involving clinical diagnosis and treatment must consider their lack of clinical exposure. Jungnickel et al. [15] recognized that the future competencies of pharmacists could not be developed in isolation and would require the input of the National Medical Association. Despite evidence of higher patient satisfaction and better quality care in specialized clinics, e.g., anticoagulants clinics run by pharmacists [16], there has been limited research into the training needs of pharmacists to move into complex prescribing roles. Many studies were conducted on the use of inter-professional learning to enhance the relationship between the different healthcare professionals [17-19]. Sinopoulou et al. [20] was a study into the patient safety benefits when a pharmacist is present in the emergency department, and showed {\textquoteleft}a reduction of 80% of incorrect doses, 66% of unintentionally omitted medicines, 50% of missed doses for prescribed medications and 71% of discrepancies found on clinical review. On the admission wards, medicines reconciliation rates within 24 hours improved on weekdays from 77.9% to 96.43%.{\textquoteright} Other studies report similar benefits [21, 22]. There appears to be growing support for enhanced pharmacy-based management of minor ailments from pharmacists and associated professional and regulatory bodies across Europe, Australia, Canada, New Zealand, and the UK. It is well recognized that there is a burden of patients presenting with minor ailments to general practice and the emergency departments, therefore highlighting the need for further research to identify any gaps between policy and practice [4]. Patients (60 years or older, pregnant, or on income support and allowance) may present a minor ailment in a community pharmacy in Scotland. They can obtain over-the-counter (OTC) medicines at no cost, thereby increasing access to treatments for patients where affordability may be a barrier [23]. However, such a national service does not exist in England and has long been a conflict between policymakers and the public [4]. In addition to this, pharmacists are restricted to the prescribing and supply of OTC and pharmacy medications (P) when providing independent treatments for patients; this is despite the pharmacist having acquired a much broader knowledge of medicines as part of their undergraduate training [24]. Up to 20% of all GP consultations are for minor ailments, excluding consultations where a consultation for a more serious condition identifies a minor ailment [25]. Providing these services could reduce GP visits by approximately a third [26]. Publisher Copyright: {\textcopyright} 2022 Journal of Advanced Pharmacy Education & Research | Published by SPER Publication",
year = "2022",
doi = "10.51847/PANZ94AVTA",
language = "English",
volume = "12",
pages = "30--37",
journal = "Journal of Advanced Pharmacy Education and Research",
issn = "2249-3379",
publisher = "Society of Pharmaceutical Education & Research [SPER]",
number = "1",
}
