The Role of the PCN Pharmacist & Pharmacy Technician

If you're looking to improve the performance of your PCN pharmacy team, this blog is for you.

This blog is also for PCN pharmacists who want more clarity on how their role could develop.

In our most recent THC / Best Practice webinar collaboration, we focused on the roles of the PCN Pharmacist and Pharmacy Technician.

Together with Dr Lavan Baskaran, a South London GP Partner (amongst many roles) and Shaun Hockey, Pharmacist and Managing Director of clinical pharmacy services provider Medacy, Tara breaks down:

➡️ Why pharmacy services are needed in Primary Care

➡️ The role of the pharmacist & pharmacy technician

➡️ How to get the best from your pharmacy team

➡️ How PCN Clinical Directors can best support their pharmacists

➡️ Network level versus practice-based pharmacists

➡️ The role of the Clinical Director when it comes to recruiting and retaining a pharmacy team

➡️ Using external providers

➡️ Top tips for pharmacists considering a move into Primary Care

➡️ Key questions PCN leaders should pose when reviewing service redesign

We urge you to check out the webinar, but if you're short on time and you’d prefer our summary of what was discussed, let's jump in!

1. Why do we need Pharmacy in Primary Care?

An average of 44% of our patient population is on repeat medication/s. That’s a lot of structured medication reviews, a lot of long-term condition reviews, and a lot of work on an already over-burdened system in demand.

With this in mind, employing professionals who can optimise the care of patients on repeat and acute medications (and often with long-term conditions) will streamline capacity in the long run.

While it’s true that primary care pharmacy services are still in their infancy, that’s not to say there isn’t an abundance of highly skilled and experienced pharmacists out there who aren't keen to make the transition. They just need to be given the opportunity and the confidence to show you what they can do.

2. What can a PCN Pharmacist do?

While pharmacists can certainly manage the more obvious IIF-related / Docman driven tasks, Shaun believes pharmacists can fundamentally change a practice.

With the correct training and support, they can:

➡️ Manage repeat and acute medications

➡️ Carry our structured medication reviews

➡️ Provide support and education to patients on their medications, enabling them to get the most from their medications with the minimum number of side effects.

➡️ Support the management of long-term conditions and can provide enhanced care for the following ( but this list is not exhaustive)

• Chronic kidney disease

• Metabolic syndrome

• Diabetes

• COPD

• Asthma

• Patients with cardiovascular risk

Training and supervision, variety and a long-term mindset is key. Take time to trial new approaches and measure patient well-being and health outcomes, as well as impacts on access and capacity.

And when it comes to structured medication reviews (SMRs), Shaun emphasised that if pharmacists are newly qualified, please ensure they are given the resources and the appropriate appointment time needed to effectively manage prescribing and de-prescribing.

3. What does a pharmacy technician do?

There is still a pretty sizeable gap in understanding when it comes to the role and remit of the pharmacy technician. As Shaun explains, they are vital to any pharmacy service, particularly in the support they provide to the pharmacist.

Pharmacy techs can:

➡️ Deal with any pharmacy-related administration and correspondence.

➡️ Book basic diagnostic testing such as blood pressure checks and blood tests.

➡️ Function as a central point between pharmacist/pharmacy team, GP, and other healthcare professionals.

For a more detailed look at the role, check out the blog above by clicking on the graphic.

4. How to get the best from your pharmacy team.

🎯 Allow your pharmacist to integrate and gain a full understanding of the PCN.

🎯 Involve them in meetings and give them time and opportunity to understand how things work and the roles everyone performs.

🎯 Add colleagues to your WhatsApp groups and hang out as a team, both inside and outside of working hours, from time to time.

🎯 Ensure there is training and supervision in place.

5. Network level versus practice-based pharmacy

During the webinar, we discussed what model of delivery was best when it comes to organising your pharmacy team. The answer, of course, is it depends.

Dr Baskaran doesn’t believe that a hub and spoke model is effective when embedding pharmacists. In his experience, many have reported feeling isolated and lonely as they are unable to build relationships or gain any mutual understanding when working remotely from their wider PCN colleagues.

Dr Baskaran recommends, where possible, ensure that your pharmacists can be based across multiple PCN practice sites (not to many though), to allow them to get to know everyone and have awareness of any subtle nuances between practices in terms of culture and working practice.

I personally have seen pharmacists work well in a hub model. The key to this is a robust process developed in partnership with the practices, pharmacist and PCN management team, excellent communication and regular reviews of the key performance indicators.

6. What if we can’t recruit a pharmacist or we want to explore different ways of managing pharmacy in our PCN?

Whilst we fully acknowledge the clear preference in most PCNs is to manage operations in-house, don’t immediately write-off the option of approaching external and / or commercial providers, as these can prove to be both beneficial and cost-effective.

One of our webinar attendees commented, there is no such thing as a free lunch. While this may be true, don’t let negative assumptions about industry be a barrier to effective collaboration.

Pharmaceutical companies are often open to providing sponsorship for a rep to undertake medication reviews. It doesn’t mean that they will go ahead and lumber you with their most expensive drug because it is simply not in their interest to enter into a short-term or negative relationship with the practice or the PCN. Dr Baskaran has ventured down this route with great success.

Shaun’s company, Medacy, is another great example of how a private organisation can complement primary care, offering a range of clinical pharmacist services, including remote pharmacy services, recruitment services and provision of advice and support to dispensing doctors, they support practices who are struggling to fill posts and / or in understanding how pharmacy can be embedded into their existing service structure and currently work with 40 PCNs.

7. What are the responsibilities of the Clinical Director when it comes to recruiting and retaining a pharmacy team?

Dr Baskaran shared, as a Clinical Director, you’d naturally be expected to:

🎯 Be involved with the recruitment process.

🎯 Have the bandwidth to consider new approaches and get involved with the design and re-design of clinical pathways and services.

🎯 Think strategically when it comes to embedding pharmacy into the PCN. Make sure you stand every chance of retaining your pharmacist by supporting them to integrate, to access personal development and to be able to flourish in their roles.

In terms of other requirements, Shaun, Lavan and I agreed that a culture of continuous improvement, embracing innovation and empowering everyone to think outside of the box (in this regard) is super important.

I also want to add that the management team need to carefully manage expectations about the role and to not make promises you can't keep.

8. Advice for pharmacists considering a move into Primary Care

If you are a pharmacist, newly qualified or otherwise, Shaun advises jumping in with both feet. Get a job, start getting experience and climb the primary care ladder.

You don’t have to be a PCN pharmacist right away, there are other practice-based pharmacy roles out there and in general, PCNs are largely supportive places to be.

You can expect to tap into PCN resources and training, as well as building relationships and developing your knowledge base.

That said, there is also an expectation on pharmacists to be proactive in directing where their needs lie; be it with seeking specific training, pursuing a special interest, and evidencing how they can positively make a difference. The PCN can’t be expected to design this all for you.

And finally, for PCN leaders….

9. When reviewing any changes in systems or processes, always consider these key questions:

❓ What did we achieve?

❓ What’s working well?

❓ What didn’t go well?

❓ How did our workforce feel?

❓ What did our patients say?

❓ Did we maximise our budget?

❓ What can we do differently?

We hope this helps! 😊

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About the Author

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 300 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 120 PCNs by providing interim management, training and consultancy.

 I have managed teams across multiple sites and countries, have an MBA in Leadership and Management in Healthcare, have been published in the London Journal of Primary Care, and am the author of over 250 blogs. 

 I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.