Clinical pharmacy for integrated neighbourhood teams
Clinical pharmacy for integrated neighbourhood teams
What the service covers
Our integrated neighbourhood team pharmacist service gives an INT remote clinical pharmacy support for the people on its caseload. Our clinical team reviews each patient’s medicines inside the practice’s own clinical system, consults the patient by phone or video, codes every change on the record and sends a short medicines summary to the team ahead of its multidisciplinary meeting.
The Neighbourhood Health Framework, published by DHSC and NHS England in March 2026, sets initial priorities for integrated neighbourhood teams that include people living with frailty or needing end of life care, people with multiple long-term conditions, children and young people, and cancer. Many people in the first two groups take several medicines. A structured review gives the team a current, checked medication list to plan care around.
- Structured medication reviews for people on the INT caseload, in the order the team sets
- Polypharmacy reviews and deprescribing for people living with frailty
- Medicines linked to falls, confusion or sedation, and total anticholinergic burden
- Co-ordinated medicines reviews for people with multiple long-term conditions, such as cardiovascular disease, diabetes and COPD, with condition-specific assessment or follow-up arranged where needed
- High-risk drug monitoring, with due tests and reviews identified and outstanding actions followed up or escalated
- Medicines reconciliation after a hospital discharge
- Prescription signing by our independent prescribers
- A written medicines summary for each patient ahead of the MDT meeting
- Reporting on patients reviewed, changes made and items referred
Who does the work
Reviews are carried out by our clinical team: more than 100 GPhC-registered pharmacists and pharmacy technicians working under one clinical governance framework. 85% of our pharmacists are independent prescribers. They can make prescribing changes within their competence and the agreed protocol, with the assessment and action recorded.
Technicians prepare each review by gathering the medication list, recent results and hospital letters. Pharmacists carry out the consultation and the clinical review. The same core team stays with the neighbourhood, so the INT works with names it knows from one meeting to the next.
How it works day to day
- The INT’s lead organisation tells us which patients to review and when the MDT meets. We agree the review protocol and the escalation route to each patient’s GP.
- Technicians prepare each record: current medicines, monitoring due, recent admissions and letters.
- A pharmacist consults the patient by phone or video, with a family member or carer where the patient wants one.
- Our independent prescribers make prescribing changes within their competence and the agreed protocol; other prescribing decisions go to the patient’s GP with the reason recorded. Every action is coded on the record.
- The team receives a written summary for each patient before the MDT meeting, and a pharmacist can join the meeting by video when the team asks.
- Outcomes that change a patient’s supply are sent to their community pharmacy in writing.
- You receive reporting for each practice and for the neighbourhood.
A managed service, not extra headcount
The organisation leading the INT commissions a defined programme of reviews, and we deliver it under our own clinical governance. The protocol, the clinical supervision, the quality checks and the cover all sit with us, with review schedules and cover arrangements agreed for the programme. The team sets the priorities, and each patient’s GP keeps every decision that needs a GP.
Delivery is remote. All work is done in the clinical system and consultations are by phone or video. Any patient who needs an in-person check is passed back to the practice team through the agreed route.
What our clinical team has delivered
These published results come from structured medication review work commissioned by PCNs. They are not INT programmes. They show one review method run to one clinical standard across a whole network:
- Norfolk and Waveney PCN: 1,000 structured medication reviews delivered, alongside a technician service, all under one governance. Every review was a real clinical encounter with a documented conclusion, coded on the record as it was done.
- Lincolnshire, nine-practice PCN: 315 hours of medication reviews in a first block, delivered to one pathway across all nine practices. The PCN then moved to a full-year contract covering the whole network.
- Somerset PCN: a 287-hour block of medication reviews, followed by an extension.
We have supported 375+ GP practices and 88+ PCNs, with practices and PCNs in 23 ICB areas across all seven NHS regions. Ask and we will arrange a reference call with a PCN doing similar work. Read the case studies.
Governance and data security
Virtual Pharmacist meets the NHS Data Security and Protection Toolkit standards for 2025-26, holds Cyber Essentials certification and is registered with the ICO (ZB127110). Reviews are carried out and recorded inside each practice’s own clinical system through secure, NHS-approved access. Read our clinical governance and data security framework.
Virtual Pharmacist won the Pharmacy Solutions Provider award at the General Practice Awards.
Related services and reading
Reviews in the team’s order
Structured medication reviews for people on the INT caseload.
Frailty and deprescribing
Polypharmacy reviews for people living with frailty.
Falls, confusion and sedation
Medicines linked to falls and anticholinergic burden checked.
Multiple long-term conditions
Co-ordinated medicines review, with further assessment or follow-up where needed.
A summary before the MDT
A written medicines summary for each patient ahead of the meeting.
Hospital discharges reconciled
Medicines updated after a patient comes home from hospital.
“The team is consistently reliable. Phones are always answered and emails come back the same day. It’s made a real difference to how we run our medication reviews.”
“Fast email replies and clinical input whenever we need it. They picked up our medicines work seamlessly and delivered from day one.”
“Excellent service from start to finish. Easy to reach, quick to reply, and they clearly know NHS workflows inside out. We couldn’t recommend the team more highly.”
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Frequently Asked Questions
What does a pharmacist do in an integrated neighbourhood team?
A pharmacist reviews the medicines of people on the team's caseload, especially people living with frailty or with several long-term conditions, to check that each medicine is still safe, effective and needed. The findings go to the multidisciplinary meeting. With Virtual Pharmacist, this work is delivered remotely by our clinical team.
Can this work be done remotely?
Yes. Our pharmacists consult patients by phone or video and work in the practice's clinical system throughout. The team receives a written summary before each MDT meeting.
Which patients do you review first?
The team chooses. Common starting points are people living with frailty, people taking many medicines and people recently discharged from hospital.
How do the findings reach the MDT meeting?
Each patient's review is written up as a short medicines summary and sent to the team before the meeting, and every change is already coded on the record. A pharmacist can join the meeting by video when the team asks.
Can the pharmacists make prescribing changes?
85% of our pharmacists are independent prescribers and can make changes within their competence and the protocol agreed with you. Anything outside that goes to the patient's GP with the reason recorded.
Who can commission this service?
The organisation that leads the INT: a PCN, a GP practice, a GP federation or a neighbourhood provider. The same service can cover one neighbourhood or several.
Which clinical systems do you work in?
We work in EMIS, SystmOne, Vision and Medicus, through secure, NHS-approved remote access arranged with each practice.
How is progress reported?
You receive reporting on patients reviewed, changes made and items referred to GPs, for each practice and for the neighbourhood, in one format agreed at the start.
