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July 2008

Industry intelligence in association with star

The role played by pharmacy in the development of healthcare delivery in the UK is evolving. This
month Customer Insights focuses on the role of a Senior Pharmacist who is also qualified as an
Independent Prescriber.

What is your title?

Simon Lockley, Senior Pharmacist, North Yorks & York PCT.

What are the main objectives/responsibilities within your role? Why has it grown in importance in the past few years?

My main role is to facilitate and promote cost-effective prescribing within GP practices within my PCT area. Changes, and dramatic DT price reductions in recent years, have meant that prescribing costs can be significantly reduced by careful choice of a given drug within a class – for example ACE Inhibitors or Biphosphonates. A proportion of my time is also spent on supporting prescribing standards by running audits for practices following drug info updates and feeding the results back to GPs. For example, this could mean checking for patients with a poor renal function on certain statins. In addition I qualified some years ago as a Supplementary Prescriber, and more recently as an Independent Prescriber (IP).

What does a typical working week look like? With whom would you expect to liaise during a week?

I head a team of Practice Support Pharmacists plus a Technician, and between us we cover the GP Practices within the SWR and Selby & York areas. A typical week therefore involves quite a lot of travelling. During that time I liaise with various members of the practice staff, mainly GPs but also Practice Nurses (PNs). Discussions range from formal presentations at practice meetings to informal chats in the tearoom.

As an IP pharmacist, I also run a couple of half-day clinics each week, supporting practices in the management of long term conditions such as asthma and diabetes.

What and who are the major influences on the decisions you reach? How do you arrive at your priorities?

My PCT provides me with up to date information on potential costsaving drug changes. They in turn are largely influenced by national guidance such as NICE.

What contact do you have with people from pharmaceutical companies?

Direct contact with pharmaceutical companies is limited. My PCT, like many others, merged with neighbouring PCTs in 2006 to form a huge organisation – it is the third largest Primary Care Trust in England in population terms with a total population of 765,000. The Primary Care Trust has a budget of nearly £1 billion and employs around 4,500 staff.

With this size increase, there has been an inevitable specialisation of roles, with relatively few people shaping prescribing policy. My influence on prescribing policy is therefore limited, although I can, and do, feed back ideas to the PCT.

I have little contact from pharmaceutical companies in connection with my role as an Independent Prescriber. This is perhaps not surprising, given the relatively few patients that I see each week compared to a full-time GP or Practice Nurse.

How can the industry achieve greater access to people who perform your role? What kinds of information might they be able to provide you with that would help you within your role?

Thinking of my IP role, the industry could now include such ‘Non-Medical Prescribers’ (NMPs) in invitations to any presentations they make to practices. Information needs to be clear and concise and highlight potential advantages – in terms of clinical or cost benefits – over existing treatments.

Thinking of my IP role, the industry could now include such ‘Non-Medical Prescribers’ (NMPs) in invitations to any presentations they make to practices. Information needs to be clear and concise and highlight potential advantages – in terms of clinical or cost benefits – over existing treatments.

Consider providing general support to Non-Medical Prescribers within practices – perhaps, for example, sponsoring their training courses. The days when pharmaceutical representatives could just focus on one product are almost certainly gone.

What would be your top 5 tips for medical sales professionals on how to improve relationships, and therefore productivity, with this group?

I would suggest that they implement a process that focuses more specifically on Non-Medical Prescribers than has perhaps been the case previously. The process could operate along the following lines:

Create a database of Non- Medical Prescribers in your area (Practice Nurses and Independent Prescriber Pharmacists)

Detail the clinical topics that each Non-Medical Prescriber covers – this is not as straightforward as it sounds – some NMPs specialise in a narrow therapeutic area, for example diabetes, whilst others cover a very wide range and see patients with anything from earache to epilepsy.

Use the database to ensure that Non-Medical Prescribers are included in any invitations to relevant meetings or training events.

Try to be as selective as possible when targeting Non-Medical Prescribers. If you swamp them with paperwork they probably won’t read any of it!

Provide practical support – prescribers often struggle to obtain placebo inhalers, insulin pens etc. Being proactive and offering to provide such useful items (rather than a paperweight) is a good step towards building rapport!

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