Integrating clinical pharmacists into general practice significantly reduced medicine costs, opioid prescriptions, and anxiolytic use
The growing presence of clinical pharmacists in GP practices is driving improvements in in quality of prescribing and patient safety in primary care settings, a new study has revealed.
Published on 3 February 2025 in the British Journal of General Practice, the study examined changes in prescribing quality following the adoption of clinical pharmacist roles in English general practices between September 2015 and December 2019.
During this period, the proportion of practices employing a clinical pharmacist increased from 236 out of 7,623 practices (3.1 per cent) to 1,402 out of 6,836 practices (20.5 per cent).
The findings showed that the implementation of clinical pharmacists in GP practices resulted in “significant reductions” in the total costs of medicines, the total number of opioid prescriptions and the average quantity of anxiolytics per 1,000 patients.
Additionally, employing a clinical pharmacist contributed to reductions in the total number of prescriptions and antibiotic prescriptions per 1000 patients that “trended towards statistical significance.”
However, the study found no statistically significant differences in the share of broad-spectrum versus narrow-spectrum antibiotics and the oral morphine equivalence of high-dose opioids per 1,000 patients.
Although the analysis was limited by practice-level data, researchers concluded the findings “supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality”.
Commenting on the study, Graham Stretch, president of the Primary Care Pharmacy Association, told Pharmaceutical Journal: “These data illustrate the effectiveness of pharmacists, and the returns generated on investment in expanding the team in general practice.”
The study stressed that need for further research to determine the extent to which changes in clinical pharmacist employment processes—shifting from direct employment by general practices to employment within primary care networks (PCNs) in recent years— have maintained these improvements in prescribing.
Policy initiatives driving growth in clinical pharmacy workforce
Over the past decade, NHS England has introduced several policy initiatives to increase the number of pharmacists working in general practice, focusing on optimising medicines management, medication reviews, and independent prescribing and deprescribing.
In 2016, the General Practice Forward View was launched with the aim of employing 1500 clinical pharmacists to work in general practice over five years.
This was further expanded by the Additional Roles Reimbursement Scheme (ARRS), introduced in 2019, which aimed to recruit six clinical pharmacists for each primary care network (PCN) by 2024.
As of September 2023, more than 6,500 clinical pharmacists were working in general practice across England, either employed by a PCN or directly by a general practice.
An earlier study, published in theBritish Journal of General Practiceon 10 December 2024, found that the use of ARRS funding in primary care networks was “significantly associated” with lower prescription rates and higher patient satisfaction.
The ARRS scheme allows PCNs to claim reimbursement for the salaries of 17 additional roles within the multidisciplinary team to meet the needs of the local population.
Alongside clinical pharmacists, these roles include pharmacy technicians, physiotherapists, paramedics, podiatrists, and dietitians.
Helen Morgan's letter to Health Secretary, Wes Streeting.