By Gareth Chapple, Senior Pharmacist for Patient Services and Joshua Lau, Prescribing Cardiac Pharmacist within the cardiology MDT, Morriston Hospital, Swansea Bay University Health Board
Pharmacy is undergoing a transformation. Across hospitals, pharmacists are moving from traditional advisory roles into proactive, clinical positions within multidisciplinary teams (MDTs). At Morriston Hospital, we wanted to take that next step — embedding a prescribing pharmacist directly into the cardiology MDT to ensure our expertise informed decisions at the point of care.
Our motivation was rooted in both patient benefit and professional evolution. Pharmacists in Wales complete a minimum of eight years of education and training before becoming independent prescribers: four years at university, one as a trainee, two on a postgraduate clinical diploma and one as a prescribing qualification. That investment is dedicated solely to understanding medicines, their safe use and their impact on health outcomes. It was time that depth of expertise was fully represented where prescribing decisions are made.
Placing pharmacy at the heart of care
Historically, pharmacy performance has been measured by process — turnaround times, discharge targets and items dispensed. While valuable, those measures overlook the real difference pharmacists make to patient safety, recovery and system efficiency. By embedding a prescribing pharmacist into the cardiology MDT, we shifted the focus from process to outcomes.
The results spoke for themselves. In the first eight months, the pharmacist prescribed 8,810 medicines — more than double the next highest prescriber for the health board at the time. Medication queries that once took hours were resolved within minutes. Discharge communication delays, previously totalling over 400 hours across four months, fell to zero once pharmacists prescribed directly.
The impact extended beyond efficiency. Deprescribing 567 unnecessary medicines, including 88 antibiotics, avoided approximately 284 kg of CO₂ emissions — equivalent to 2,840 washing-machine cycles — while optimised antiplatelet therapy delivered confirmed savings of over £46,000 and projected annual savings exceeding £70,000.
Just as importantly, the project fostered a behavioural shift within the MDT. As clinicians witnessed the pharmacist’s clinical insight and prescribing accuracy first-hand, perceptions evolved from viewing pharmacy as a support service to recognising it as an equal clinical partner. The visibility of these results also highlighted the power of data — working closely with the digital team allowed us to evidence pharmacy’s measurable impact on patient outcomes, an essential step in strengthening the case for national adoption.
Looking ahead
This initiative has shown that when pharmacists are fully integrated into MDTs as prescribers, this supports patients leaving hospital on the right medicines, at the right dose, for the right reason. The success at Morriston’s cardiology service has since inspired expansion into cardiothoracic, vascular, and endocrinology MDTs, to name a few, with each adapting the model to meet its team’s unique rhythm and needs.
Our learning has been clear: engage early, secure governance and don’t wait for perfection. Start, measure, refine and share success. As this approach spreads, we hope to see prescribing pharmacists embedded across more specialties, ensuring pharmacy expertise continues to shape care at the point of decision-making.
Pharmacy’s evolution into the MDT isn’t just about redefining our profession — it’s about improving patient outcomes and system sustainability. When pharmacists sit at the decision-making table, healthcare becomes safer, smarter and more connected.
Read more RPS blogs.