The skills of pharmacist prescribers, particularly in primary care, are not being used to the full, according to the results of this study in north-east England which confirms previous anecdotal evidence. So, what are the barriers?
A major stumbling block is the absence of clear organisational strategies (something that will be familiar to some nurse prescribers). Some pharmacists have never used their prescribing qualification. Organisations need to develop prescribing roles that are underpinned by policies and procedures. Some individuals have worked hard to use their skills to improve patient care and it is clear that pharmacists can set up and run innovative services that focus on patients. New roles need, however, to be ‘embedded’ in an organisation to be sustainable. Lack of funding, insurance costs, and controlled drugs regulations were also seen as barriers.
In secondary care, pharmacist prescribing seemed to be better established, with almost 10% of hospital pharmacists being prescribers, although preliminary results suggest that the overall number of items prescribed is small. In the absence of a strategic plan for how pharmacist prescribing should develop, the existing working relationships between hospital pharmacists and medical colleagues make it easier for individual services to develop as a results of those relationships. The logistics – access to medical records and prescription pads – are also more straightforward. Support from colleagues, networking and continuing professional development were also seen as easier to develop in secondary care as there is more teamworking.
Pharmacist prescribing in primary care is tiny – accounting for less than 1% of all items prescribed in this part of England. The picture is varied regionally, however, with pharmacists in some areas prescribing more than in others.
Baqir W, Clemerson J and Smith J. Evaluating pharmacist prescribing across the north east of England. B J Clin Pharm 2010;2:147-149.