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Pharmacists set to work in GP surgeries

The aim of the RCGP and RPS plans is to take pressure off GPs and improve access for patients

Ingrid Torjesen

Tuesday, 17 March 2015

The Royal College of General Practitioners (RCGP) and the Royal Pharmaceutical Society (RPS) have come up with plans for pharmacists to work in GP surgeries in a bid to ease pressures.

GP practices are estimated to have 370m patient consultations this year – 70m more than five years ago – due to an ageing population and more patients being treated for long-term and complex conditions. But as demand has risen rapidly, the number of GPs in England has remained relatively stagnant.

In contrast there is an over-supply of pharmacists who train as clinicians for five years - one year less than a doctor, one year more than a nurse – and could step in to treat patients directly at the surgery.

The proposals would see pharmacists working as part of the general practice team, much in the same way as practice nurses to improve patient safety and care and, crucially, reduce waiting times for GP appointments.

Pharmacists would work closely with GPs and other colleagues to resolve day to day medicine issues, particularly for patients with long-term conditions and who are taking a number of different medications. They would also liaise with hospitals, community pharmacists and care homes to ensure seamless care for patients.

According to RCGP research, there will be 67m occasions during 2015 when patients will have to wait a week or more to see a GP or practice nurse. The RCGP is calling for the NHS budget for general practice to be increased to 11% by 2017 – it is currently just over 8% - and for 8,000 more GPs in England by the end of the next parliament.

Dr Maureen Baker, chair of the RCGP, said: “Waiting times for a GP appointment are now a national talking point – and a national cause for concern, not least amongst GPs themselves.

“But, even if we were to get an urgent influx of extra funding and more GPs, we could not turn around the situation overnight due to the length of time it takes to train a GP.

“Yet we already have a ‘hidden army’ of highly-trained pharmacists who could provide a solution.” She added: “This isn’t about having a pharmacy premises within a surgery, but about making full use of the pharmacist’s clinical skills to help patients and the over-stretched GP workforce.

“Patients with long-term conditions such as asthma or diabetes with complex medicine needs would particularly benefit from having a pharmacist to help them navigate the conflicting and confusing information they sometimes receive about their treatment as they move between hospital and community care.

“Practice teams can also benefit from a pharmacist’s advice to help avoid medicines waste, improve the management of medicines and rationalise costs at this time of a squeeze on NHS finances.” 

David Branford, chair of the RPS English Board said: “Pharmacists can consult with and treat patients directly, relieving GPs of casework and enabling them to focus their skills where they are most needed, for example on diagnosing and treating patients with complex conditions.  

“As part of the multidisciplinary team, pharmacists can advise other professionals about medicines, resolve problems with prescriptions and reduce prescribing errors.”

Dr Chaand Nagpaul, BMA GP committee chair, said that placing more pharmacists into GP practice teams is a move that the BMA has been advocating for some time.

“This proposal has the potential to improve the skills mix in local GP services and raise the number of healthcare professionals on hand to provide help to patients. This will be a welcome step forward given that GP practices are currently under unprecedented strain from rising patient demand and falling resources.”

However, he warned for the plans to work properly there will need to be additional resources to enable enough pharmacists to be placed in GP surgeries. “A further limiting factor at present is that many GP practices are struggling because their buildings are inadequate or don't have space to expand staffing,” he said. “If we are to realise the potential behind this announcement, there will need to be a well thought out, adequately resourced plan to ensure it is delivered effectively.”

Katherine Murphy, chief executive of the Patients Association said patients were experiencing increasing difficulties obtaining a GP appointment and the plan for GPs and pharmacists to work together is “an innovate step in the right direction”. “Of course, there must always be concerns that the pharmacists who undertake this work have the relevant skills and qualifications to treat patients, and with care,” she said.  

“The Patients Association are confident that assuring safety has been uppermost in the minds of The Royal College of General Practitioners and the Royal Pharmaceutical Society, who have come up with the plans.”

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