Abstract

Description:
The role of pharmacists in General Practice has received increasing attention, with the RPS, RCGP and the NHS Alliance all coming out in support and promoting the role that pharmacists can play. However, in order for pharmacists to fulfil this role, it is important that they understand the general practice environment and the needs and opportunities for pharmacists. It is equally important that pharmacists practising in community pharmacy and hospital pharmacy also understand the general practice setting in order that they can optimise how they work with GPs to support transfer of care and enable patients to understand and effectively manage their long term conditions and medication. By understanding the processes and priorities of general practice, pharmacy students entering any sector of practice should be able to better work with general practice as part of a multidisciplinary and cross-care boundary team.

At the University of Sunderland, an Academic Practitioner post was created in collaboration with Sunderland CCG, enabling an opportunity for undergraduate professional placements to be delivered in general practice.

It was decided that the placement would fit best at Stage 3 of the MPharm programme at the University of Sunderland, linking with clinical topics such as diabetes which are introduced at this stage, and using a clinical topic which had been covered previously, COPD (covered in Stage 2) to introduce the new concept of the Quality and Outcomes Framework and to also contribute to spiral learning.

There had been previously been success in using a rotational ‘station’ based model of placement delivery as part of the MPharm programme with other providers and a similar model was adopted for the general practice placements. Students rotated around four ‘stations’ which included:
• Exploring the role of a general practice administrator
• Observing a practice nurse clinic for chronic conditions
• A diabetes case study utilising a general practice clinical system
• An introduction to the Quality and Outcomes Framework (QOF)

Process or Method of Implementation:
Requests for general practices to deliver placements were presented at local training events and via email using SCCG networks. A briefing sheet which included the requirements of the practice to deliver the placements was created and distributed to ensure that practices could deliver the placements as designed.

The format and materials for placement delivery were designed by the link post, general practices and a primary care medicines optimisation service provider which was procured to support placement delivery. GP practice support pharmacists facilitated the placements.

Challenges faced and learning points:
Learning points
• Protocols can be used to build patient profiles in EMIS Web for case studies
• Utilising a medicines optimisation provider enabled smoother and more authentic delivery of placements
• Students valued the opportunity to see patients in practice nurse clinics
• The opportunity to use a GP clinical system was noted by students as being a useful exercise
• Spending time with general practice administration staff provided insight into repeat prescription processes and appointments which they could reconcile with their community pharmacy placement experiences

Challenges
• Practice nurse clinics did sometimes not often run for long enough to accommodate all rotations of the placement
• Accommodating 2 students within a consultation room for observation was sometimes difficult due to space restrictions in rooms
• Students were often more proficient than anticipated at working through case studies, so these will be expanded for the next iteration of placements

Summary of perceived benefits to patients, pharmacy and the NHS:
Pharmacy undergraduates have had an introduction to the general practice environment which will support future multidisciplinary and cross-boundary working regardless of future setting. The placement may increase the number of pharmacists entering general practice based roles following registration.