Pharmacy technician-led general practice support hub: a feasibility study

Abstract Introduction Workforce pressures in general practice have led to Scottish Government initiatives integrate pharmacy teams into practice. The focus is completion of prescribing management-related activities releasing practitioner time for patient-focused workload.1 Activities include medicines reconciliation from immediate discharge letters (IDL), processing outpatient prescription requests (OPL) and special request prescriptions (SR). Pharmacists effectively mobilise GP capacity completing these tasks.2 However, pharmacists may aspire advanced roles including medication review case-load management. Therefore, alternative workload delivery models centralised technician-led support hubs complete IDL, OPL SR tasks must be considered. National guidance outlines that technicians autonomously with minimal supervision.3 Unknowns whether can lead this service the definition supervisory required. Aim To evaluate feasibility a hub SR, IDL OPL. Methods Feasibility was studied over 4 weeks (12 April – 7 May 2021) during routine across three medical practices (approx. 23 800 patients) NHS Greater Glasgow Clyde. Quantitative real-time self-reported data on volume (SR/IDL/OPL), task pharmacist referrals collected by analysed Microsoft Excel®. Qualitative describing why referred categorized using thematic analysis Excel® author. Ethical approval not required evaluation. Results 4485 total were completed: 87% (n=3917); 7% (n=323); 6% (n=245). Pharmacy completed most (71%; n=3181) tasks. A gap (21%; n=921 tasks) where exceeded technician resource, necessitated support. Referral rate beyond competence 11% (n=383). locally agreed 48-hour benchmark turnaround process achieved majority Breaches target noted: 53 (1%) SR; 10 (3%) 5 (2%) Technicians numerically similar times. 383 pharmacist. 134 (35%) could only due need decision or pharmacist-specific knowledge. 226 (59%) additional knowledge training. Examples queries requiring interpretation clinical parameters blood monitoring answering information enquiries. (n=23) uncategorised incomplete collection. Discussion/Conclusion This study provides new characterising role convincingly activities. Service gaps addressed maintenance periods authorised absence professional development time. Pharmacist referral improved upskilling technicians. drives managed more converting suitable controlled repeats. Health Improvement Scotland initiative developing work stream. Additional projects identify training understand needs analyse achievement exists. References 1. Government. Achieving Excellence Pharmaceutical Care: Strategy Scotland. Edinburgh. Government, 2017 2. Maskrey M, Johnson CF, Cormack J et al. Releasing New Ways Working: prospective observational cohort study. Brit Gen Pract. 2018;68(675):e735-e42 3. Practice Prescribing Advisers Association. Pharmacotherapy Specification V4, 2021