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The president of the Royal College of General Practitioners (RCGP) Victoria Tzortziou Brown has said any expansion of pharmacist prescribing beyond Pharmacy First and the contraception service must be “evidence-led, properly resourced and independently evaluated” before being introduced across England.

Professor Brown (pictured) told Independent Community Pharmacist (ICP) independent prescribing (IP) should undergo an extensive evaluation to assess its impact on patient outcomes and determine “whether it genuinely reduces demand or simply shifts activity between different parts of the NHS” before being introduced to more complex conditions.

Professor Brown also said community pharmacies and GP practices must have “robust IT systems, clear referral and escalation pathways, appropriate training and reliable mechanisms for sharing information safely and efficiently” before IP is expanded.

The community pharmacy independent prescribing pathfinder programme was set up to assess the delivery of pharmacist IP and identify governance, reimbursement and digital requirements needed to integrate it safely and effectively into community pharmacy practice. However, professor Brown appeared to suggest further evaluation was needed. 

“Although many patient presentations may appear straightforward, some can be the first sign of more serious or complex underlying illness,” she said.

“Evaluation should consider its impact on patient outcomes, patient experience, continuity of care, safety, antimicrobial stewardship, cost-effectiveness, equity of access and workload across both pharmacy and general practice, including whether it genuinely reduces demand or simply shifts activity between different parts of the NHS.”

Professor Brown said community pharmacy “makes an important contribution to patient care but it complements rather than replaces the comprehensive, continuous and holistic care provided by general practice”.

Calling for “sustained investment in GP services” and recruitment and retention of “more GPs”, she said: “GPs and community pharmacists have a long history of working together to support patients, and community pharmacy can provide convenient, timely care for some common patient presentations where there are clear clinical pathways, agreed treatment protocols and appropriate safeguards.

“Multidisciplinary teams work best when every professional is able to contribute their unique expertise as part of a coordinated system of care.”

Royal College of Pharmacy president: Pharmacist prescribers ‘prescribe within their competence’ 

Last week, the British Medical Association warned expanding pharmacist prescribing to complex conditions such as mental health would risk “compromising patient safety” and insisted IP in community pharmacy should be restricted until “fundamental” safety measures are in place, with some GPs expressing concerns about pharmacists diagnosing when prescribing.

However, the Royal College of Pharmacy president Tase Oputu told ICP pharmacist prescribers “prescribe within their competence and refer or escalate patients when clinically appropriate”.

“Pharmacist prescribers are autonomous, trained and regulated healthcare professionals who work as an integral part of multidisciplinary teams, prescribing within their scope of practice and in line with professional standards,” she said.

“The care they provide complements that provided by GPs and other healthcare professionals, helping patients access the right care, from the right professional, at the right time.

"As pharmacist prescribing continues to expand, it's important that pharmacist prescribers are supported by appropriate clinical information, robust clinical governance and interoperable systems that enable joined-up care.”