Prospective service evaluation of a pharmacist-led clinic shows reduced consultant workload in a UK cancer center, suggesting effective care redistribution.
Purpose UK oncology services face increasing demand alongside workforce constraints. This study evaluated the impact of a pharmacist-led breast cancer clinic on consultant workload and clinic utilisation in a UK district general hospital. Methods This was a prospective service evaluation conducted over 11 months following implementation of an independent prescribing pharmacist-led breast cancer clinic. Data were collected on systemic anti-cancer therapy (SACT) prescribing, clinic overbooking rates, and pharmacist-led consultations, including requirement for consultant input. Results The pharmacist prescribed 420 of 3135 (13.4%) of all breast cancer systemic anti-cancer prescriptions (95% CI: 12.2%–14.6%). Pharmacist consultations were conducted independently in 81.5% (95% CI: 77.7%–85.3%) of cases, without requiring consultant input. Following implementation, clinic overbooking rates remained stable (19.6% vs 21.7%; χ 2 = 1.783, p = 0.18), suggesting sustained utilisation of clinic capacity despite redistribution of patient care to pharmacist-led consultations. Requirement for medical input differed according to treatment type (χ 2 = 11.8, p < 0.001), consistent with anticipated differences in treatment complexity and clinical oversight requirements. Conclusion The pharmacist-led breast cancer clinic absorbed a significant proportion of routine prescribing and reviews of breast cancer patients, with the majority of consultations managed independently. Broader adoption of this approach may support redistribution of workload and maintenance of clinic capacity within oncology services. Further work is required to evaluate safety outcomes and cost-effectiveness.
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Mr Michal Sladkowski (2026) studied this question.
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