Case Study 3
Integrated Pharmacy and Medicines Optimisation System Leadership
Programme - South East London ICS
The South East
London (SEL) ICS delivered sessions on expanding pharmacy leadership.
The leadership training programme aimed to bring together a cohort of
pharmacists from across the system to expand their leadership skills
together. Pharmacists from a broad range of care-settings
participated, meaning the cohort were able to meet and form
relationships with pharmacists in different sectors to their own;
useful in developing an understanding of the needs of pharmacists in
other sectors and mobilising pharmacists around a Primary Care
The approach was
a bespoke training programme delivered by the Kings Fund and
development of a cross-sector network of ICS pharmacists.
The programme had
impacts on the development of networking abilities, increased
understanding of ICS's and the integration of pharmacy, as well as
enhanced leadership skills. A network was enabled for course peers to
liaise outside the course to improve their local network and to
better support patients, across the primary and secondary care
By 2022, the
expectation is for each PCN is to have up to six pharmacists to
support their local neighbourhood, including one clinical pharmacy
lead to work closely with a PCN Clinical Director. The Pharmacy
Leadership programme was an opportunity to identify lead pharmacists
and develop their skills to start building relationships to create a
neighbourhood network of pharmacists and other health and care
professionals involved in supporting people with their medicines.
created the building blocks for a pharmacy network to deliver
excellence in medicine use and patient outcomes in all care settings
in SEL. The outcomes of the programme will help the system model
pharmacy’s leadership role in delivering the NHS Long-term plan.
Case Study 4
Integrated Mental Health Hub - Central and North West London NHS Foundation Trust
In Central and North West London NHS Foundation Trust, an 8B independent prescribing pharmacist worked within a consultant psychiatrist team covering one adult community mental health hub (17 GP practices) and a population of approximately 105,000 to help manage referrals and wait list for assessment and treatment as a result of the pandemic.
Referrals received from GPs, home treatment team and occasionally liaison psychiatry were triaged and allocated to members of the consultant psychiatrist team as appropriate. The prescribing pharmacist took on the responsibility of reviewing patients with complex medication needs, which released capacity within the team, allowing the psychiatrists to focus on non-medication related reviews. Within three months, this model reduced the wait time for assessment and treatment from 12-16 weeks to 4-6 weeks from the point of referral.
The pharmacist supported the team one day a week; each session comprised of reviewing 3-4 patients. These included conducting a mental state examination, risk assessment, doing a thorough medication review and prescribing as appropriate followed by any necessary paperwork; writing outcome letters to GPs/referrers; follow-up and reviewing physical health tests such as bloods and ECGs. The clinic is in the early stages of implementation but since starting in July 2021, the pharmacist has released 21 hours of psychiatrist time over a 3-month period by reviewing 40 patients.
Interventions included initiating, switching or stopping medication; medicines' optimisation; physical health monitoring; side effect management and referral to services such as social prescribing and psychology. On one occasion, the pharmacist was involved in organising an urgent admission following assessment of a patient who had significantly deteriorated in their mental state. Patients, staff and GPs are very satisfied with the service and the CMHT staff have reported feeling better supported as they have greater access to a specialist pharmacist for advice on medicines.