Abstract

Evaluating the Feasibility and Impact of Longitudinal General Practice Placements for Undergraduate Pharmacy Students in the UK

Background
The landscape of pharmacy education in the United Kingdom is undergoing transformative change. New General Pharmaceutical Council (GPhC) standards require that pharmacy graduates qualify as independent prescribers upon registration. This necessitates earlier and more structured clinical exposure within undergraduate education to ensure that students develop the requisite consultation, clinical reasoning, and patient-facing skills needed for modern practice.
Primary healthcare (particularly general practice) has been recognised as an underutilised yet valuable training ground for pharmacy students. Previous pilot studies and NHS England initiatives have shown the potential of primary care placements to enrich student learning, especially in areas such as clinical decision-making, interprofessional collaboration, and patient assessment.
However, large-scale implementation has been limited. Questions remain about whether general practices (GP) , already under considerable workload pressure, can accommodate undergraduate pharmacy students over sustained periods. There is a need to explore the operational implications, resource requirements, and educational value of longitudinal placements at scale.
Aim
This study aimed to evaluate the feasibility, sustainability, and educational impact of delivering longitudinal GP placements to the final-year cohort of pharmacy students at a UK university. Specific objectives were to:
• Understand the impact of student placements on workflow, staffing, and patient care.
• Explore the sustainability and scalability of such placements.
• Evaluate students’ learning experiences and perceived value.
• Identify enablers and barriers to effective multidisciplinary team (MDT) integration.

Methods
A qualitative and quantitative mixed-methods design was used to evaluate this educational intervention.
Placement Design
A total of 116 final-year pharmacy students undertook a longitudinal placement in general practice, attending for one day per week across 10 weeks during the academic year 2024–2025. Ten primary care (GP) sites hosted the placements, with each site accommodating two student groups who attended on alternating weeks.
The placements were supported by university-employed clinical link tutors who were experienced clinical pharmacists who coordinated placement activities, provided supervision, and acted as a liaison between the university and GP site. Students participated in a range of activities including:
• Patient-facing tasks
• Clinical audits
• Observational learning in clinics run by GPs, nurses, and other MDT members
• Tutor-led sessions and case-based discussions
Each site was supported with a placement handbook outlining objectives, activities, and assessment tools.
Qualitative Data Collection
Seven semi-structured interviews (involving eight participants) were conducted with representatives from seven GP placement sites, including GPs, pharmacists, and practice managers. The interviews, lasting 30–60 minutes, were guided by a phenomenological approach to understand the lived experience of hosting students.
Interviews were recorded, transcribed, and thematically analysed using Braun and Clarke’s six-step framework. An inductive coding approach was used to identify key themes and subthemes, with collaborative analysis among four researchers to enhance rigour.
Quantitative Data Collection
Students completed the Placement Evaluation Tool (PET) at the end of the placement. The PET includes 19 Likert-scale items, a global satisfaction score (1–10).
Results
Placement Site Perspectives
Four major themes emerged from interviews with GP site staff:
1. Placement Structure and Feasibility
o Hosting students was feasible but increased time pressures and required adjustment of clinical schedules.
o Sites varied in their capacity to provide physical space and IT access.
o Clinical link tutors were identified as critical to managing student supervision and workflow integration.
2. Student Support and Learning Environment
o Practices with a strong teaching culture adapted more easily to hosting students.
o Clinical link tutors alleviated supervision burdens on other clinicians.
o MDT involvement was inconsistent, often limited by student turnover and staff unfamiliarity with pharmacy training.
3. Student Development and Readiness
o Students developed greater confidence and clinical awareness, particularly in communication and decision-making.
o Some sites noted students lacked readiness for independent clinical tasks compared to medical trainees.
o Greater continuity and entrustment were needed to deepen learning.
4. Service and Patient Impact
o Students contributed to audit work, medication safety, and supported service delivery (e.g., hypertension case-finding).
o Patient feedback was positive, especially in training practices accustomed to learners.
Student Feedback
Of the 116 students, 105 completed the PET (91% response rate). The results demonstrated high overall satisfaction:
• Median global satisfaction score: 9/10
• Highest-rated items:
o “Patient safety was fundamental to the work of the unit” (M = 4.58)
o “My supervisors helped me identify learning needs” (M = 4.57)
• Lowest-rated item:
o “Opportunities to interact with the MDT” (M = 4.05)
Discussion
The findings of this student demonstrate that primary care placements are operationally feasible and educationally beneficial when supported by dedicated infrastructure, particularly clinical link tutors.
However, sustainability is not guaranteed. Practices reported that current funding and space constraints pose significant barriers to long-term delivery. Several respondents highlighted the disproportion between funding provided for pharmacy versus medical placements, despite similar supervision demands.
The role of the clinical link tutor was central to the success of placements, mitigating pressures on site staff, coordinating activities, and supporting student development. Without this role, most practices stated they would not be able to continue hosting placements.
Students clearly benefited from the extended exposure to real-world clinical settings, with measurable gains in confidence and understanding of primary care. Nevertheless, their ability to take on independent clinical responsibilities remained limited. Students were often hesitant, and MDT staff expressed uncertainty about their capabilities—suggesting a need for more structured entrustment processes and improved staff training around pharmacy roles.
Conclusion and Implications
This evaluation demonstrates that longitudinal primary care (GP) placements for undergraduate pharmacy students are both feasible and well-received, but long-term sustainability depends heavily on adequate resourcing, funding parity, and continued investment in placement infrastructure.
The clinical link tutor model is essential to managing placement logistics, supervision, and educational quality. Future strategies should focus on improving MDT engagement, supporting student readiness for more autonomous tasks, and enhancing continuity within placement teams.