Pharmacy First: Pharmacists ‘not a substitute' for doctors, say top GPs

Leading GPs made the comments in response to announcements made about the primary care recovery plan last week (November 16).

The news included details that pharmacists will be able to treat patients for seven common conditions without them first seeing a GP from next year and access patient records currently maintained by GPs.

Chair of the Royal College of GPs (RCGP) Professor Kamila Hawthorne told C+D that while “it is right that [pharmacists] are given the support they need”, pharmacists are not “a substitute” for GPs.

Dr Hawthorne said that pharmacists “do an excellent job for their communities”, adding that they “are providing invaluable support to many GP practice teams against a backdrop of huge workload and workforce pressures”.

“However, pharmacists and GPs are distinct health professionals and neither should be seen as a substitute for the other,” she added.

She said that while the membership body is “keen to see initiatives that will ease the pressure on our struggling family doctor service”, patients will “in many cases, need the expert diagnostic skills and expertise of a GP”.

Beyond “capability and competence”?

And the British Medical Association’s (BMA) top GP also made similar comments, telling C+D yesterday (November 19) that pharmacists should not “work beyond their areas of capability and competence”.

BMA GP committee chair Dr Katie Bramall-Stainer said that the new Pharmacy First service was “welcome news” because of the support that pharmacists and their teams provide to GP practices facing workload and workforce pressures.

She told C+D that the BMA “[recognises] the clinical skills of pharmacists in providing care”, but added that “pharmacists are not a substitute for GPs and should not be expected to work beyond their areas of capability and competence”.

And she said that GPs have “made much progress in recent years to reduce antibiotic prescribing” and it is “important that this progress is not lost and that pharmacists have access to the training, support, diagnostic tools and systems they will need”.

However, the new service “could hinge on whether there are enough staff to implement it” as pharmacy “is also facing a workforce crisis”, Dr Bramall-Stainer added.

“We come back again to the failure to address the workforce crisis and shortfall of staff across primary care, and funding must now target an effective recruitment and retention strategy,” she said.

Tensions in primary care

NHSE last week (November 16) announced the long-awaited details of its primary care recovery plan reforms – including launching the new Pharmacy First service from “early next year” and expanding the pharmacy contraception and blood pressure check services from next month.

Under the new advanced Pharmacy First service, which the negotiator said will launch on January 31 subject to IT systems being ready, patients will be able to get treatment for seven common conditions directly from a pharmacy without the need for a GP appointment or prescription.

Announcements about the new services have been broadly welcomed by the pharmacy sector – although some warned that core pharmacy funding remains a concern.

Meanwhile, the BMA last month said that dispensing GPs should have access to “all funding and services” commissioned to pharmacies.

And earlier this month, president of the National Association of Primary Care (NAPC) Ash Soni suggested that pharmacy, general practice, dentistry and optometry should be united under a “working collaboratively contract”.

His suggestion came after health and social care committee (HSCC) chair Steve Brine proposed that primary care should be brought together “in a physical sense” with pharmacies co-located with other providers at the Pharmacy Show in Birmingham last month.

Lead pharmacists at integrated care systems (ICSs) also warned of a “deep-rooted culture” of excluding pharmacy at the Birmingham conference.

Check the C+D site for the latest coverage on this developing story