Practice pharmacists being 'directed away’ from delivering SMRs

The Royal Pharmaceutical Society (RPS) is proposing the development of a position statement that would encourage 'greater transparency' around structured medication reviews (SMRs), following reports that the primary care pharmacy workforce is being 'directed away' from doing them.

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This comes as NHS England (NHSE) prescribing director Professor Tony Avery has said there is a 'strong rationale for the benefits of pharmacist-led, person-centred medication reviews, which are embedded in a multidisciplinary collaborative approach'.

In an upcoming RPS English Pharmacy Board meeting on Wednesday (19 June), members will vote on passing a position statement that ‘calls for greater transparency around SMR uptake and delivery' at a primary care network (PCN) and integrated care system (ICS) level, to 'ensure the pharmacy workforce is supported to deliver this important patient safety tool’.

In papers released ahead of its board meeting this week, RPS clinical fellow Clare Thomson and RPS Director for England James Davies said the RPS had ‘received feedback from PCN leaders and ICS chief pharmacists that the pharmacy workforce is being directed away from structured medication reviews, and instead being tasked with other activities.’

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‘Members have also approached the RPS and asked us to consider this topic. Our members are concerned that the focus of the pharmacy workforce in primary care is moving away from the delivery of Structured Medication Reviews in practice,’ they added.

‘As a result, we have drafted a position statement that captures the views that have been shared with us from members and advisory groups.’

The proposed statement recommends that:

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• ‘Medicines optimisation and SMRs, which remain part of the core PCN contract, are prioritised by pharmacy teams and PCN teams should be accountable for their delivery’;
• ‘SMR uptake and delivery should be monitored and reviewed regularly at ICS and PCN level, and this should particularly focus on the patient cohorts highlighted in the guidance published alongside the Network Contract DES (for example, those taking 10 or more medicines, referred to as hyper-polypharmacy, or on specific high-risk medications)’;
• ‘Efforts should be enhanced to ensure the correct coding and structure of SMRs to support evaluations’;
• And ‘Further patient outcome research should be funded to actively measure and evaluate the value of SMRs in England’.