Prescribing pharmacists – the future
A doctor writes prescriptions! He checks you up, tests you, talks to you, looks at you from the outside as well as from the inside, and, at the end, he treats you! For this, he has to write prescriptions. You, as a patient, take that prescription to a pharmacy and receive the meds you need! The pharmacist, until now, was the best trained professional at reading the doctor’s handwriting. But things are changing, pharmacists are granted more professional responsibilities which are more suitable for their level of medical knowledge.
This article has been written by Johnathan Laird, a pharmacist from Scotland, with whom we already had the pleasure of collaborating. You can find his work here. Today, he is writing about the future in pharmaceutical healthcare: pharmacist that can prescribe independently.
What is an independent prescriber?
I wanted to share a little about the structure of the course and reflect on what it was like to complete the course. One of the ambitions laid out in the ‘prescription for excellence’ document is that all pharmacists in Scotland should qualify as independent prescribers. Therefore it is a path many pharmacists will walk so perhaps it may be interesting for those considering completing the qualification to read about what is involved.
I was lucky to be able to enroll on the course with The Robert Gordon School of Pharmacy in Aberdeen. This was particularly enjoyable for me personally because I studied pharmacy here a number of years ago. The course is fully accredited by the GPhC so once completed candidates can apply for annotation on the register as an independent prescriber.
If you currently practice as a supplementary prescriber you can complete a conversion course to qualify as an independent prescriber.
An independent prescriber must prescribe within their scope of competence. For this reason, the course is set up for you to choose a therapeutic area within which you can demonstrate the competence levels required to practice safely. I chose the respiratory system.
The course focuses on the competencies laid out by the National prescribing center. Details can be found here.
The course is basically divided into two parts…
- University-based training
- Period of learning in practice.
The university-based training involved a residential week in the School of Pharmacy as well as a number of assessed assignments. The training consists of a number of areas: therapeutics, consultation skills, public health and care planning. The training is fully accredited by the General Pharmaceutical Council (GPhC).
The five-day residential period was delivered in an excellent way. The teaching team brought in a range of professionals to share their insights on prescribing practice but also to provide situations to allow students to meet the standards required by the GPhC.
Most interesting for me was the use of actors to facilitate real life consultation skills training. The actor we had was really excellent and knew exactly how to test your skills in a safe/supportive environment. I took much of what I learned that day back to my practice in the community.
The largest piece of the course is a period of learning in practice in which you cover a list of competence areas under the supervision of a designated medical prescriber (DNP). My DNP and practice manager/team could not have been more supportive.
What do you have to do to able to prescribe?
The period of learning in practice must focus on your therapeutic area of interest. In my case, I chose respiratory so completed my time largely in my local respiratory clinic but also in part by using brief interventions in the community pharmacy setting. You must complete a minimum of 90 hours or 12 days in practice as part of the period of learning in practice.
The school of pharmacy at the Robert Gordon University in Aberdeen has always been, in my view, at the forefront of pharmacy practice in the UK and I feel grateful to have studied there now on two occasions. I believe they trained the first supplementary prescribers shortly after the law changed to allow this so have led the way for years.
The current independent prescribing course is delivered by the team there in an expert way remotely and face-to-face. Help or advice was always a quick phone call away. If you get the opportunity to complete your prescribing or other qualification I would highly recommend you do so. You can learn so many new things and also acquire new skills and knowledge that can allow you to become an independent prescriber.
For more details regarding the course and what it means to become an independent prescriber as a pharmacist, you can read more here.
My course fees were funded completely by NES (NHS education for Scotland). Below is a link to the NES website where you can find much more information on how to apply for funding etc.. A video explaining the process is available below.
I believe the application process is now open for the 2016 cohort of students so this could be your chance!
Although I studied at RGU, there is the choice to complete the course at Strathclyde school of pharmacy. Like RGU this course is fully accredited by the GPhC.
How will this impact the pharmaceutical profession?
The answer to this question is, of course, one of speculation. We cannot know how this will impact the health of the patients and what the financial implications will be. We can think that, maybe, this will increase the number of patients receiving medication, since many patients simply do not go to the doctor because it’s too complicated or because they are afraid of a possible negative outcome. On the other hand, we might expect to see an increase in adverse effects due to misdiagnosing a medical problem because of overstepping our professional capabilities. From the financial point of view, this change could decrease the money spent on complicated procedures for simple medical conditions and decrease waiting times for medical consultations. On the other hand, patients could be more prone to increase the number of drugs that the take. It is all a matter of debate and, as things will unravel, we will be faced with different situations, where the pharmacist will have to be covered by his professional capabilities and knowledge acquired during his education and his practice!
Finally, there is a psychological barrier that has to be crossed in order to go from doctors having the power to write prescriptions, to delegation some of that power to other trained medical professionals such as pharmacists. Changing people’s minds could prove more of a challenge than every other impediment in this transition.
We feel that this is the natural progression in the pharmaceutical profession. We have to become more specialized, more professionally competent and take on a bigger share of responsibilities.
The pharmacists at farmacist.info along with Johnathan support this course for development! For a smarter and healthier life!
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