The potential role of community pharmacists in care management

The traditional dispensing role of the community pharmacist is increasingly being questioned and greater emphasis is being placed on the provision of advice. Introduction of the NHS Community Care Act provides an opportunity to consider the potential role of community pharmacists in care management and in carrying out assessment of individual need. This paper describes the introduction of Community Care training for community pharmacists in Derbyshire and the results of a study to evaluate assessment and referrals that the community pharmacists routinely carried out. Fourteen pharmacists who participated in the study recorded assessments that they carried out over a 10-week period between January and April 1994. A total of 858 assessments were self-reported by the community pharmacists, of which 57% resulted from enquiries relating to physical symptoms, 27% relating to prescription medication and 8% from social problems. A further 7% arose from a combination of these categories. Nearly one third of all assessments were made at the request of a carer. Health care professionals had initiated 7% of the enquiries, with a greater proportion of these associated with prescription medication (46%) and social care (29%) compared with those initiated by patients (20% prescription medication, 6% social care) or carers (26% prescription medication, 6% social care). If a pharmacist intervened to initiate an enquiry, a greater proportion of assessments led to referral (33%) compared with 14-21% for other types of enquirer. This paper discusses the possibility of providing greater access to care-management, care planning and monitoring through making this process more widely available from community pharmacies on the high-street.