Integration across Primary Care – Pharmacists in Care homes and GP Practices

With Graham Stretch MRPharmS

Graham StretchPharmacists are pioneering new models of integrated working across the primary care sector, including work in GP Practices and nursing homes. Increasingly the success of these models is being recognised; it was for this reason that Graham Stretch and team were awarded the 2015 British Medical Journal Primary Care Team of the Year.

What’s the model?

Graham is responsible for a service providing pharmaceutical care to 19 nursing homes, with a total of 900 beds, as commissioned by Ealing CCG over the past three years. Graham’s approach is to integrate care across GP practices, community pharmacies and nursing homes, removing the barriers to effective pharmaceutical care.

Unlike some clinical pharmacy models, the pharmacists involved do 95% of all prescribing, and after earning the trust of their GP colleagues they manage the clinical reviews and undertake the bulk of prescribing within nursing homes using a technician led service.


The results of this method speak for themselves: with 11% fewer prescribed items, 20% fewer hospital admissions, a 63% reduction in anti-psychotic prescribing in Dementia, and a 45% reduction in end of life admissions. Graham argues that when pharmacists are involved in prescribing and medicines management then fewer errors occur, resulting in better outcomes for all patients. He describes this model as nothing radical, stating that any pharmacist has the ability to have a positive impact on medicines management if given the opportunity.

The future

After having the contract extended a for further 2 years by Ealing CCG, Graham is now hoping to translate this model into other areas, publishing research and aspiring to replicate this success elsewhere. Describing the process as personally and professionally rewarding he argues that more pharmacists should have the opportunity to embark upon this journey.



Leave a Reply

Your email address will not be published. Required fields are marked *