title: Pharmacist independent prescribing in secondary care: opportunities and challenges.
abstract: In recent years a number of countries have extended prescribing rights to pharmacists in a variety of formats. The latter includes independent prescribing, which is a developing area of practice for pharmacists in secondary care. Potential opportunities presented by wide scale implementation of pharmacist prescribing in secondary care include improved prescribing safety, more efficient pharmacist medication reviews, increased scope of practice with greater pharmacist integration into acute patient care pathways and enhanced professional or job satisfaction. However, notable challenges remain and these need to be acknowledged and addressed if a pharmacist prescribing is to develop sufficiently within developing healthcare systems. These barriers can be broadly categorised as lack of support (financial and time resources), medical staff acceptance and the pharmacy profession itself (adoption, implementation strategy, research resources, second pharmacist clinical check). Larger multicentre studies that investigate the contribution of hospital-based pharmacist prescribers to medicines optimisation and patient-related outcomes are still needed. Furthermore, a strategic approach from the pharmacy profession and leadership is required to ensure that pharmacist prescribers are fully integrated into future healthcare service and workforce strategies.
authors.affiliation: Departments of Pharmacy and Critical Care, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK. richard.bourne@sth.nhs.uk.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Bourne
authors.affiliation: Pharmacy Department, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, North Shields, NE29 8NH, UK.
authors.forename: Wasim
authors.initials: W
authors.lastname: Baqir
authors.affiliation: Pharmacy Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
authors.forename: Raliat
authors.initials: R
authors.lastname: Onatade
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D011307:Drug Prescriptions; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000458:organization & administration; D010593:Pharmaceutical Services / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010595:Pharmacists / Q000331:legislation & jurisprudence; D011050:Policy Making; D024382:Professional Role; D063127:Secondary Health Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*
keywords: Independent prescribing; Medicines optimisation; Professional practice; Secondary care; United Kingdom