What Does a Clinical Pharmacist Do in General Practice?

Clinical pharmacists work differently from those in high street pharmacies. They see patients directly and support medicines management and medicines optimisation as part of GP practice teams. Many patients meet these professionals without knowing what they actually do.

The clinical pharmacist role has grown as NHS England brings pharmacy expertise into primary care. Understanding what they do helps practices decide if this investment works for their patients.

Direct Patient Care

Clinical pharmacists consult patients similar to  GPs. They can see patients face-to-face, consult over the phone, and via video calls where applicable. 

Patients with Long Term Conditions can see clinical pharmacists. This includes people with diabetes, hypertension, cardiovascular disease, and respiratory conditions. The  clinical pharmacist monitors how these conditions change over time. They adjust medications based on symptoms and test results. They also teach patients how to use their medications properly.

This frees up GP appointments for patients who need broader medical assessment. Patients with medication-focused problems get expert care from someone who knows pharmaceuticals inside out.

Medication Reviews

Medication reviews form a significant part of what clinical pharmacists do. These become particularly important for patients taking multiple medications or experiencing medication-related complications.

Clinical pharmacists identify medications that may no longer be appropriate and deprescribe where necessary. They also notice when one medicine has been prescribed to counteract adverse effects from another medication.

They work with patients to safely discontinue medications that provide minimal benefit. At the same time, they make sure useful treatments work as well as possible.

Research shows medication reviews by clinical pharmacists identify clinically significant problems in approximately 75% of cases. Many of these lead to therapeutic changes that improve patient outcomes.

Many patients don’t take medicines correctly. This often happens because they don’t understand how to use them, not because they choose not to. Clinical pharmacists address these barriers by:

• Showing the right way to use inhalers for example
• Explaining when is the best time to take medicines during the day
• Making complex medicine routines simpler
• Solving side effects that put patients off taking their medicines

Prescribing Rights

Most clinical pharmacists in general practice can prescribe medicines independently if they have the completed the required training. 

Being able to prescribe changes everything about appointments. Clinical pharmacists can sometimes complete entire treatments in one visit within their scope of competence. They don’t need to assess a patient, write notes, then ask a GP to write the prescription. They start new treatments (where applicable), change doses, and stop medicines that aren’t working. This creates extra appointment slots rather than just another step in the process.

Specialist Clinics

Many clinical pharmacists run special clinics for conditions where medicines are the main treatment:

• Anticoagulation clinics monitor patients taking warfarin or newer blood thinners. They adjust doses based on laboratory results and manage bleeding risk assessments.
• Cardiovascular prevention clinics assess patients’ heart attack and stroke risks. They adjust cholesterol medicines and monitor blood pressure using current medical guidelines.
• Respiratory clinics focus on asthma and lung disease. They assess inhaler technique and adjust preventer therapy based on symptom control and lung function tests.

These specialist clinics allow clinical pharmacists to apply their pharmaceutical expertise with specific patient groups. This creates more appointment space for GP teams.

Safety Work Behind the Scenes

Clinical pharmacists do lots of safety work that patients never see. They watch for dangerous drug combinations flagged by computer systems, they check risky prescriptions and coordinate responses when medicine safety warnings come out.

When medicine regulators warn about specific drugs, clinical pharmacists search patient records. They find affected patients and arrange proper follow-up care. This systematic approach reduces medicine-related harm and prevents hospital admissions.

They help practices manage prescribing budgets too. They review expensive medicines and suggest cheaper alternatives when it’s safe to do so. Local health boards increasingly rely on clinical pharmacists to keep prescribing costs down whilst maintaining quality.

Working with Practice Teams

Clinical pharmacists share their pharmaceutical expertise with entire practice teams. They advise GPs about complex prescribing decisions, answer practice nurses’ questions about giving medicines and assist healthcare assistants with patient medicine queries.

In multidisciplinary meetings, clinical pharmacists contribute pharmaceutical knowledge when discussing complex patients. They identify medication-related reasons for hospital admissions, suggest stopping unnecessary medicines for frail elderly patients and highlight when poor medicine-taking might be affecting treatment outcomes.

Reducing GP Workload

Practices with clinical pharmacists report substantial reductions in GP medication-related workload. Prescription queries, medicine review requests, and repeat prescribing issues all become the clinical pharmacist’s responsibility instead of consuming GP time.

One practice serving 34,000 patients reported a 99% reduction in medicine-related GP workload after employing clinical pharmacists. This freed up hundreds of GP appointments for patients requiring complex diagnosis and treatment.

What This Means for Practices

Clinical pharmacists provide specialist pharmaceutical knowledge plus genuine additional clinical capacity. Patients receive expert assistance with medication-related concerns without extended waits for GP appointments. Practices gain clinical capacity, prescribing capability, and medication safety expertise.

This addresses current workforce pressures whilst improving patient care quality and also access to healthcare services. As NHS primary care evolves towards multidisciplinary care delivery, clinical pharmacists offer both immediate practical benefits and long-term strategic value.

Their role represents an effective response to general practice workforce challenges. It ensures patients get appropriate specialist care for medication-related health needs whilst optimising every team member’s clinical expertise.