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- Title
New ways of working releasing general practitioner capacity with pharmacy prescribing support: a cost-consequence analysis.
- Authors
Johnson, Chris F; Maskrey, Margaret; MacBride-Stewart, Sean; Lees, Ann; Macdonald, Hector; Thompson, Audrey
- Abstract
<bold>Background: </bold>General practice in the United Kingdom is experiencing a workforce crisis. Greater multidisciplinary working, including more general practice pharmacists, is seen as part of the solution. However, it is unknown what impact and cost-consequences that pharmacists may have in freeing general practitioner (GP) capacity.<bold>Objective: </bold>To evaluate the cost-consequences of additional pharmacists in releasing GP capacity.<bold>Methods: </bold>This cost-consequences evaluation of a prospective observational cohort study in 15 urban practices involving 69 GPs in 1 locality serving a population of 82,000 people. GPs recorded the time they spent addressing key targeted prescribing activities during 5 distinct 2-week audit periods. Pharmacists performed these key prescribing activities to release GP capacity. An additional 225 h of pharmacists' time per week was committed to the locality. Standardized staff costings were used to estimate the financial impact. Prescribing indicator performance was assessed against the other 7 localities within the health board.<bold>Results: </bold>When compared with employing extra nonsalaried GPs this required an estimated additional investment of £16.73 (range £5.97-20.87) per h to free GP capacity. This achieved a sustainable 47% (73 h per week, F(4,56) = 16.05, P < 0.001) reduction in GP time spent on key prescribing activities; equating to 4.9 h (95% confidence interval 3.1-6.7) per practice per week. No significant step changes in locality safety and quality prescribing measures, and no negative effects on locality-level prescribing cost-efficiency work were observed.<bold>Conclusion: </bold>Appropriately resourced general practice pharmacy teams delivered prescribing cost-efficiencies as well as sustainably freeing GP capacity by performing key prescribing activities.
- Subjects
PHARMACOLOGY; HOSPITAL pharmacies; RESEARCH funding; LONGITUDINAL method
- Publication
Family Practice, 2022, Vol 39, Issue 4, p648
- ISSN
0263-2136
- Publication type
journal article
- DOI
10.1093/fampra/cmab175