Spotlight on independent prescribing pharmacists during the COVID-19 pandemic

With pharmacists on the front-line and the NHS relying on them, Lizzie talks about how important their ability to independently prescribe has become.

The role that community pharmacists are playing in supporting the public during the COVID-19 pandemic has been much publicised. They have been at the forefront of the crisis, providing support and advice about symptoms to the public, and ensuring that those who are self-isolating have supplies of essential medicines. But there are pharmacists who are less visible, who are playing an essential role within the NHS, ensuring that patients get the help they need, when they need it.

In particular, pharmacists who are independent prescribers are stepping up and taking on new and expanded roles in this current crisis, in order to allow clinicians time to help those suffering with the symptoms of COVID-19. The role of the prescribing pharmacist is more significant than ever before. Indeed, Lizzie reports that there has been a significant increase in practising pharmacists signing up to become students on the School of Pharmacy’s Clinically Enhanced Pharmacist Independent Prescribing Couse (CEPIP). 

Prescribing pharmacists working in GP practices are taking on a lot of the work around repeat prescribing from GPs, leaving the GPs time to deal with more complex patients. Some qualified pharmacist independent prescribers estimate that around half of their current workload is related to the COVID-19 crisis. Some of this is prescribing work including repeat prescribing of inhalers and COPD rescue packs as patients are using more of these at the moment.

However, much of the workload is in ensuring the continuity of disease management for patients with long-term conditions such as diabetes, COPD, asthma and hypertension. This has involved identifying high risk patients and ensuring they are well supported, as well as quality improvement work around high risk drug monitoring. There has been a push to be autonomous in the workload, for example, running minor ailment clinics and supporting GPs in the acute presentation of COVID-19 related symptoms. 

Prescribing pharmacists in secondary care are having to work more independently than ever before as the multi-disciplinary team structure is not viable in the current situation. Consultants are needed to be focusing on COVID-19 patients, so pharmacists are having to make prescribing decisions that once would have been passed up to the consultant. One pharmacist independent prescriber described this as a ‘steep learning curve.’ Hospital pharmacists are developing new ways of working and pushing boundaries to achieve things that would previously have been thought impossible.

Talking to some of the alumni Dr Lizzie Mills has taught at UCL School of Pharmacy on the CEPIP course, she has seen some of the great work that is being carried out in the field currently – under considerable pressure.  

Lizzie said, “I recently heard from an ex-student who is now a GP pharmacist. Their role as a pharmacist who can prescribe is taking a lot of workload off the doctors. They are issuing repeat prescriptions and COPD rescue packs. In fact, I am told that to some extent doctors are doing a similar job to pharmacists at the moment – talking to patients on the telephone and giving video consultations. Meanwhile in the hospitals, the independent prescribing pharmacists are thinking of creative ways to facilitate the day-to-day workload. Some of my graduates have talked to me about having to make more decisions themselves. Their confidence is growing, and the consultant is getting fewer queries, and only queries for the more complex patients.” 

Every sector of pharmacy is stepping up and contributing to the NHS response to the COVID-19 crisis. With self-care front of mind as we mark Self-Care Awareness Week this November (16-22 November 2020), pharmacists have shown adaptability, and a willingness to push the boundaries of their practice in order to redefine the service they provide. 

Lizzie said, “They are supporting individuals to look after themselves and their families – and are often the unseen front-line workers, providing essential services for those with long-term and acute non-COVID-19 related conditions. They deserve a round of applause!”

Discover more:

UCL School of Pharmacy Clinically Enhanced Pharmacist Independent Prescribing Course

Images:  Lizzie Mills (UCL), and Sharon McCutcheon on Unsplash