Clinical Pharmacists in Primary Care Networks Nick Beavon Chief Pharmacist Wandsworth CCG June 2019

Background NHS Long Term Plan set out the plan to introduce Primary Care Networks Clinical Pharmacists to be included in the funding Approximately 2000 pharmacists expected to be working in practices by 2020 Some of the pharmacists currently working in GP Practices under NHSE pilot will transfer over to the new scheme for funding Other pharmacists that already support practices outside of these directly employed pharmacists include CCG Pharmacists, Community Pharmacists ( Dispensing Chemists), Community Ward Pharmacists, Care Homes Pharmacists All newly employed PCN pharmacists will be required to complete an 18 month CPPE course ( funded centrally) or other accredited training

https://www.bma.org.uk/collective-voice/committees/general-practitioners-committee/gpc-england/gp-contract-agreement-england/primary-care-networks ( see page 21 & link to Job Description)

https://www. england. nhs https://www.england.nhs.uk/publication/network-contract-directed-enhanced-service-des-specification-2019-20/ ( Clinical Pharmacist page 20-22)

DES Early Stage Delivery & Maintenance ( Year 1) PCN recruitment of a pharmacist PCN Pharmacist covering a population of 30-50,000 population Banding of a pharmacist 7 (< 5years qualified ) or 8a ( more experienced) Funding available for 70% reimbursement of the pharmacist is £37,810 with on cost ( Pension, National Insurance ) Future increase in pharmacists within the PCN in year 2 onwards? Depending on experience PCNs may choose to top up pharmacist contribution to get more experienced pharmacists?

Agenda for Change basic salary 2019 for purposes of comparison

NHSE Network Contract Directed Enhanced Service April 2019 Clinical Pharmacist described in DES Qualified pharmacist with Pharmacy degrees (MPharm, BPharm, BSc) In addition will have qualified from accredited training pathway or will be enrolled on Centre for Pharmacy Postgraduate Education (CPPE 18 month clinical pharmacy training programme) centrally funded More experienced pharmacists such as 8a may have a Clinical post-grad Diploma Band 8a clinical pharmacist could supervise up to 5 band 7 pharmacists ( NHSE model and this may vary as system evolves)

Key Responsibilities Work as part of an MDT in GP Practice and other key HCPs Patient facing role If they are an Independent Prescriber work within their area of competence Clinical medication review and reduce polypharmacy Includes care home, elderly, children and other vulnerable patient groups ensuring safe prescribing and monitoring Improve outcomes with medication

Key responsibilities continued: Supporting doctors is reducing antimicrobial resistance Linking with hospital and community pharmacy to resolve issues Link with other PCNs and pharmacists More senior pharmacists supervise junior ones Ensure they keep up to date and develop to give better support patients and the practice staff, GPs and Nurses Review medication for patients with LTC

Depending on their clinical qualifications, past experience and skills, they can support the following: Focusing on QoF Domains, improving disease registers Prescribing Safety, Clinical audit, Local Enhanced Services support Lead on prescription management (systems and processes, ensuring monitoring is being done, support clerical staff) but not issue all the repeat prescriptions! Provide training to other GP Practice staff

Any Questions ?