Examining the emerging roles for pharmacists as part of the urgent, acute and emergency care workforce

In the future urgent, acute and emergency medicine clinical workforce, new models of care and care delivery need to be developed, in order to maintain and enhance standards of safe and accessible patient care. A departure from traditional (doctor-led) approaches to workforce planning, and an understanding of scope and governance surrounding emerging clinical roles is necessary to develop a sustainable, multi-skilled workforce across primary, community and secondary care. Today's healthcare workforce includes an ever-increasing number of non-doctor professionals, undertaking clinical work in the medical domain. The traditional, medicines-focussed role of the pharmacist is being challenged by Health Education England (HEE), the organisation responsible for NHS workforce training and development in England, and its national stakeholders. It is argued that the clinical pharmacist of the future should be capable of confidently and competently managing patients at an advanced clinical level - with health assessment, diagnostics and clinical examination skills comparable with that of an advanced clinical practitioner. A recent three-year programme run by HEE, evaluated the potential for pharmacists to manage patients in the emergency department and across urgent and acute care. Evidence from the 'Pharmacists in Emergency Departments' (PIED) suite of studies suggests that pharmacists with advanced training may clinically manage up to 36% of patients attending emergency departments. This article examines these data and proposes enhanced clinical development pathways for pharmacists, and calls for a change in thinking around the future integrated clinical workforce across urgent, acute and emergency care.