Full roll-out of Scottish general practice pharmacotherapy service delayed

As reported by The Pharmaceutical Journal, progress on delivering a new pharmacotherapy service has been slower than expected, but “core” elements should be in place in GP practices in Scotland in around two years’ time

In a letter outlining amendments to the GMS contract, the Scottish government and BMA said the service will not be fully rolled out to GP practices until 2022–2023. 

The service, which was announced in the 2018 Scottish GP contract, is expected to provide pharmacist and pharmacy technician support to patients through “core” elements of the service, including authorising or actioning all acute and repeat prescribing requests, medicines reconciliation, non-clinical medication reviews and monitoring high-risk medicines.

Some practices will also offer medication reviews, polypharmacy reviews, and specialist clinics on areas including chronic pain and heart failure, as part of the pharmacotherapy service.

However, the letter — sent on 2 December 2020 — said that “regulations will be amended so that NHS Boards are responsible for providing a level one pharmacotherapy service to every general practice for 2022–23”. Level one covers the “core” elements of the pharmacotherapy service.

The letter added that the Scottish government “remains committed to investing an additional £500m per year in primary care by the end of this parliament, including £250m in direct support of general practice”.

In February 2019, pharmacy leaders warned that workforce shortages may affect how the service is implemented.

Speaking at the 2020 Scottish local medical committee conference on 4 December 2020, Andrew Buist, chair of the BMA’s Scottish general practitioners committee, said that “progress [towards delivering the contract] has been patchy and, overall, has not been good enough”, citing “a combination of issues, from insufficient workforce to lack of premises, inadequate management support and perhaps funding”.

Buist said it was “now clear it will not be delivered in full by April 2021”.

He added that the new timescales had been agreed, “with regulatory change for CTAC [community treatment and care] and pharmacotherapy in April 2022”.

Matt Barclay, director of operations at Community Pharmacy Scotland, told The Pharmaceutical Journal that the “postponement makes sense” in light of the COVID-19 pandemic.

“Although pharmacotherapy sits within the GP contract, the governance and workforce largely sits in pharmacy and it is right that, at this time, the workforce challenges in other sectors aren’t exacerbated at the moment,” he said.

“Community pharmacy in Scotland has a role to play in this space and we are looking at [the] Medicines: Care and Review [service], for example, and asking how this can support the aims for the patients through these linked contractual areas for those with long term conditions.”