Why we must say goodbye to 'clinical' pharmacists

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In the future, there would be no community pharmacist.

Did that get your attention? Good – there’s more; there will be no hospital pharmacist. No industry pharmacist, no academic pharmacist, and no GP pharmacist. These sectors will still exist and there will always be a need for pharmacists working in these sectors. But we will be simply called what we are: pharmacists. We will stop working in silos and using these descriptions which propagate ineffective working across boundaries and fragment leadership.

A multi-sector start to a pharmacists’ career will allow them to understand the complexities of each sector and be able to understand their role in the patients’ journey. Moreover, experience, skills and knowledge pertaining to each sector would allow pharmacists to work together and collaborate for smoother transitions of care. There would be no need to use the word ‘clinical’ to describe a pharmacist – all pharmacists are clinical. Placements would be in both primary and secondary care, experience in mental health will be just as important as physical health.

Building from an integrated preregistration undergraduate pharmacy degree, with placements taking the majority of the past year, to early years, all pharmacists should go through a professional development programme to prepare them for advanced practice. It is argued that current preregistration training does not prepare pharmacists that patients need for the future[1]. The next generation would supported by practice mentors, but also be continued to be supported by university staff.

A multi-sector preregistration training programme in North Wales, covering hospital, GP and community pharmacy, produced more rounded pharmacists and the ability to be ready in all these sectors from day one[2]. The Northumberland Vanguard examined new potential workforce models to address the needs of the local population[3]. This model of care, which saw pharmacists integrated in hospitals, GP surgeries and community pharmacies, had impacted positively with over 200 avoided hospital admissions. Community pharmacists in Northern Ireland have access to the hospital foundation programme, which has led to a more robust and mobile pharmacy workforce[4].

This is a step in the right direction; however, we need to be bolder. Placements should include academia and industry in the early years of registration.

Benefits of academia would give pharmacists the experience to teach and support the next generation of pharmacists, other healthcare professionals and the public. Industry will give pharmacists benefits of applying good manufacturing practice and learning quality management tools. These could be applied to practice to improve patient pathways in more patient-facing roles. Both would champion the value of research.

It is argued that that the current preregistration year doesn’t allow for smoother transition for pharmacists moving from sector to sector[1]. The SalvaDore enquiry service is receiving more enquiries regarding switching sectors and those looking to portfolio careers; creating a more adaptable, flexible and mobile workforce[5]. This would leave us to be called simply what we are: pharmacists. This is what the NHS needs and it is what the profession wants.

Nahim Khan

Nahim Khan, senior clinical pharmacist, Warrington Health Plus; senior lecturer, University of Chester; Relief pharmacist, Boots.

Nahim’s piece placed fourth in our 2018 writing competition ‘Future Pharmacist’. Read more entries here.

[1] Safdar A, Shamim A & Sharma R. We need to prepare future pharmacists to be able to work in all sectors.The Salvadore 25 June 2015. Available at: https://salvadore.info/opinion/correspondence/we-need-to-prepare-future-pharmacists-to-be-able-to-work-in-all-sectors/20068784.article (accessed July 2018)

[2] Doyle L. Evaluating a multi-sector pre-registration training programme in North Wales: perceptions of pre-registration pharmacists and their tutors 2017. Available at:

[3] Baqir W, Paes P, Stoker A et al. Impact of an integrated pharmacy service on hospital admission costs. Clinical Pharmacist 8 May 2018. Available at: https://salvadore.info/research/perspective-article/impact-of-an-integrated-pharmacy-service-on-hospital-admission-costs/20204550.article (accessed July 2018)

[4] Wilkinson E. Bridging the gap: CPOs back foundation training plan. The Salvadore 23 May 2018. Available at: https://salvadore.info/news-and-analysis/features/bridging-the-gap-cpos-back-foundation-training-plan/20204858.article (accessed July 2018)

[5] Burns C. Q&A: Ivana Knyght, interim head of professional support at the RPS. The Salvadore 16 April 2018. Available at: https://salvadore.info/your-rps/qa-ivana-knyght-interim-head-of-professional-support-at-the-rps/20204627.article (accessed July 2018)

 

Readers' comments (1)

  • I agree that all pharmacists who interact to patients are clinical. Microbiologists dealing with specimens are not so clinical compared to those who do consult patients as well. Pharmacists have a tendency to focus on products and sales, not much interacting with patients. The situation is changing, but more advocacy is required. All of us need more clinical skills. Education and research are giving more emphasis on direct patient care. The focus is on clinical. Clinical pharmacy is a concept to drive the profession. It is an encouragement for pharmacists to interact more effectively to patients. Automation is replacing much of the non-clinical functions. Pharmacists, not like doctors or nurses, have either industrial or clinical focus. A pharmacist involved fulltime in parenteral nutrition compounding shall not have significant interactions with patients. The following book I edited is empowering pharmacists to be more clinical. Still, there are medical books titled Clinical Medicine. Enjoy reading Clinical Pharmacy Education, Practice and Research by Dixon Thomas: https://www.elsevier.com/books/clinical-pharmacy-education-practice-and-research/thomas/978-0-12-814276-9

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