The end of the year is a time to take stock of what has changed over the past 12 months, and to consider the high and low points. As 2021 ends, how does the situation in primary care compare with that of December 2020? Throughout this year, COVID-19 has continued to overshadow events, and has remained an obstacle to the recovery of healthcare services from the effects of the pandemic. General practice is under greater strain than ever as the backlog of delayed care increases, waiting lists for specialist care grow, and GPs struggle to meet demand for their services.

This year also saw a reform of the structure of the NHS in England, with the introduction of primary care networks (PCNs) and integrated care systems. Under PCN service specifications, new ways of working across multidisciplinary primary care teams are set to become the norm; two articles in this issue examine the benefits for general practice of the introduction of clinical pharmacists to the primary care team. Vishal Mashru discusses how medicines optimisation can contribute to success in achieving the reforms, and Eoin Moroney and Anja St Clair Jones describe the outcomes of a mentoring scheme for junior pharmacists transitioning to work in a PCN. 

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Mentor PCN pharmacists to harness their potential

Eoin Moroney and Anja St Clair Jones

Also in this issue of Guidelines in Practice

  • Dr Alix Rolfe outlines the role of primary care in implementing the updated Scottish Intercollegiate Guidelines Network (SIGN) guidance on epilepsies in children and young people, with patient scenarios
  • Dr Maggie Keeble offers 10 top tips on providing good-quality end of life and palliative care in frailty
  • Dr Claire Davies questions the backlash against GPs during the pandemic in the View from the ground.

Guidelines Live returned this month as an in-person event—many thanks to the delegates and expert speakers who helped to make it such a great success. With more than 36 hours of clinical content available to the 1266 total attendees, the presentations dealt with a diverse range of topics related to guideline implementation. Highlights from the event will be covered in the January 2022 issue, and digital resources from the independent sessions will be available to all delegates at

Early next year, we will also feature an article on implementing the updated guideline on managing the long-term effects of COVID 19, jointly published in November 2021 by NICE, SIGN, and the Royal College of General Practitioners.1 Any complacency that the pandemic is becoming more manageable has been rapidly dispelled by concerns about the potential impact of the omicron variant; sadly, COVID-19 looks set to continue dominating the agenda in 2022, both in terms of the long-term effects of infection with the virus and the repercussions of the pandemic across society as a whole.

Here at Guidelines in Practice, we will continue to cover the issues that matter most to your daily practice in 2022 and beyond, with expert articles on new guidelines as and when they are published. As always, we would love to hear your thoughts—if you have any suggestions for topics that you would like to see covered, please get in touch via


  1. NICE, Scottish Intercollegiate Guidelines Network, Royal College of General Practitioners. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE Guideline 188. NICE, 2021. Available at:



Image 1: Dragana Gordic/

Image 2: WavebreakmediaMicro/

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Image 4: Chinnapong/