Review of the funding model in Scotland for Community Pharmacist Supplementary and Independent Prescribing Clinics

In early October the NPA responded at very short notice to the Scottish Government Survey on the funding model for community pharmacy prescribing clinics.

The NPA called for a new funding model to provide sustainable clinics by including set up, service promotion, pharmacist back fill and administrative time over an adequate period to enable service development.

Please tell us what would enable you to provide/contract an independent or supplementary prescribing service

• The National Pharmacy Association Ltd representing our members as independent community pharmacy owners suggest the following criteria is required to enable an independent or supplementary prescribing service to be provided by a community pharmacist
• Sustainable funding model which enables pharmacist backfill to be arranged and paid fully for each clinic session. This funding should be confirmed at least six months in advance and rolling year to year to enable service development and continuity. The funding should not be dependent on the number of patients seen, as pharmacist clinics in practice often see those patients who frequently “do not attend”  surgery appointments. There should be allotted funding to enable the NHS Board to support the setup of any pharmacist clinic as to standard operating procedures, risk assessment, indemnity costs etc.  Funding should also account for pharmacist time in reviewing and updating patient notes. This time can be considerable especially if the clinic situation provides no timely access to medical notes.
• Community pharmacies are ideally situated to provide walk in and appointment led prescribing clinics, as they are accessible to patients in location and opening hours. The vast majority of pharmacies have at least one consultation room to provide privacy as a setting for a health clinic. For community pharmacies to be recognised by patients as a prescribing clinic, patients need to be aware of the service which requires funding to be used for the development of awareness materials for pharmacist prescribing clinics including patient leaflets, surgery and pharmacy posters.
• A sustainable clinic requires a steady flow of suitable patients. This requires reciprocal arrangements between health professionals, in particular patient referral from GP and practice nurses and  return referral from pharmacists if required. This is dependent on GP practice staff being aware and supportive of any pharmacist prescribing clinic suitable to refer their patients to, which requires funding set aside for GP staff training.
• For a sustainable pharmacist prescribing clinic there needs to be enough pharmacist prescribers to be able to provide the service. There also needs to be sufficient numbers of community pharmacists to cover the regular community pharmacist roles as backfill. The NPA is aware that many members are keen to become independent prescribers but are unable to secure funding or in some cases a mentor to support which is limiting the training of pharmacist prescribers. The NPA is also aware that a shortage of pharmacists may be developing in some areas of Scotland which could be exacerbated by the flux of pharmacists into GP practice supporting roles and the potential negative impact of Brexit on migration of pharmacists from the EU.

Do you have any other comments on the planning and delivery of Community Pharmacist Prescribing Clinics?

The NPA welcomes the commitment from National Education Scotland to provide fully funded bespoke independent prescribing courses for community pharmacists and also their commitment to Advanced clinical skills training for pharmacists, and Teach and treat models.

The NPA is in close contact with NPA members as the majority of independent community owners in Scotland, holding regular events including regular three month member forums in Glasgow. The NPA is available to Scottish Government on behalf of our members to discuss the development of  sustainable community pharmacist prescribing clinics, and can facilitate discussions with our members to provide informed feedback to Scottish Government.

Prepared by NPA Scotland Representation Manager and NPA Policy team 8^th October 2018