Ask the experts: Should pharmacists take on more responsibility or is it a stretch too far?

The move was made to help free up access to care for patients across pharmacies and dental practices and to give patients faster, simpler and fairer access to primary care.

This article follows on from a story published in OSP​ about how pharmacists will be able to intervene to help identify people at risk of liver disease. We asked some experts what they thought about more power being handed over and whether it would become burdensome.

Stefano Mirabello is a pharmacist at NowPatient​.

He said: “Pharmacies and pharmacists often find themselves facing increased demands and workloads, especially due to overall strains being placed on the NHS and wait times. Many people will visit their local pharmacy for medical advice rather than wait for a GP appointment. Pharmacists can offer help and advice on a range of conditions such as shingles, impetigo and UTIs, already doing their part in primary care and taking the strain off of GPs and doctors.

“They can acknowledge if symptoms can be eased through a course of prescription medication or whether the issue should be escalated to a GP or doctor. However, it is important to acknowledge that funding is crucial in this growing demand. Pharmacists are already stretched thin in their profession and capacity must be considered, so additional support would be beneficial if they are to widen their scope of service.”

Tara Thompson vice president of clinical services at Revelation Pharma​. She works in the US and is a compounding pharmacist and patient advocate with 11 years’ experience in sterile and nonsterile compounding at Innovation Compounding and Revelation Pharma.

Tara said: “As the experts in drug formulation and interaction, trained in chemistry and the pharmacokinetics and therapeutics behind medicine and drug delivery systems in both the human and animal body, pharmacists have one of the highest levels of insight when it comes to achieving optimal patient health. The pairing of patient-first advocacy with unique prescription understanding makes an increased level of power for pharmacists not just important, but natural.

“Frequency is also a significant factor that plays into the argument for increased power for pharmacists. Patients typically see their pharmacist eight times per year (versus only seeing their prescribers 1-2 times per year), which puts them at the forefront of public health. Pharmacists are frequently first in line as patients’ healthcare information sources.”

She explained that a patient leans on a pharmacist to receive the highest level of education around their prescriptions, trusts in their ability for proper filling and in making sure counterindications are understood. 

“In the end, pharmacists possess extensive knowledge like no other in drug-drug, drug-food, and other interactions, as well as drug level monitoring, not to mention pharmacovigilance - preventing adverse drug reactions - and drug shortage options. This all-inclusive expertise supports healthcare providers and prescribers in delivering comprehensive patient care,” she added.

Hussain Ahmad has more than 10 years of experience working with patients across Europe and, most recently, in the North of England. He is an experienced hospital doctor working primarily in A&E in the North West and has helped COVID patients who have been admitted to hospital. He currently prescribes for Click2Pharmacy​.

He said: “Pharmacists are a much more accessible option for blood tests to screen for liver conditions. Currently, we do offer these tests but they are privately funded and not available on the NHS. If our tests show any abnormal results, we refer to their GP to arrange an ultrasound, as this is not a service we provide. Depending on the results, we advise patients on lifestyle changes to lower their cholesterol or lose weight to support liver health.

“If this service were to be funded by the NHS, there is a concern that this increased demand could stretch our resources, so this would need to be carefully managed to ensure pharmacists aren't overloaded and patient care remains a high priority. While we can perform initial screenings and refer patients as needed, more complex diagnostics and treatments would still need to be handled by GPs.”