The GMS Contract (2018) and the supporting Memorandum of Understanding 2 outlined a commitment to the development of HSCP led pharmacotherapy services to support GP workload. Core elements of the service include acute and repeat prescribing, medicines reconciliation and monitoring high risk medicines. Additional elements of the service include medication and polypharmacy reviews and specialist clinics (e.g. chronic pain)
Examples of Pharmacotherapy
There are numerous examples of services in Scotland who have used QI to improve pharmacotherapy services including:
- NHS Greater Glasgow and Clyde rapidly rolled out serial prescriptions to better anticipate demand and improve the capacity and workflow of medicines dispensing, whilst reducing unnecessary journeys for people. Over six months the proportion of medicines dispensed from serial prescriptions increased from 1.0% to 2.4%.
- NHS Forth Valley worked on acute prescribing resulting in a reduction in acute prescriptions and increased number of repeat prescriptions with a more stringent review and recall process.
Components of Pharmacotherapy
Pharmacotherapy services involve pharmacists and pharmacy technicians becoming embedded in primary care multi-disciplinary teams to deliver a range of services including:
• acute, repeat and serial prescribing
• medicines reconciliation
• monitoring high risk medications
• medication and polypharmacy reviews, and
• specialist clinics.
Resources to implement Pharmacotherapy
- Serial Prescription Toolkit - The Serial Prescription Toolkit supports the transferring of suitable patients to serial prescriptions ensuring medicines-related activity is dealt with by the right member of the pharmacy team, at the right time, safely and efficiently.
- Acute Prescribing Toolkit - This toolkit is designed to help primary care multidisciplinary teams, including pharmacotherapy services, safely improve their acute prescribing processes in line with the Essentials of Safe Care.