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Pharmacists could help plug the gap in the GP workforce

Pharmacists could start treating patients in GP surgeries under “radical” new proposals from medical professionals to help bring down waiting times and ease the burden on general practice.

The Royal College of General Practitioners (RCGP) and the Royal Pharmaceutical Society (RPS) say pharmacists could treat those patients whose main reason for visiting their GP is medicines-related.

This could include large numbers of patients who have already been diagnosed with a long-term condition, such as asthma, high blood pressure, diabetes or chronic obstructive pulmonary disease (COPD).

Pharmacists could also take control of a GP practice’s medicine stocks and liaise with local hospitals and care homes about prescriptions.

The RCGP and RPS say the move would improve patient safety and care, and reduce waiting times for GP appointments.

NHS England officials said the idea complemented plans to increase staffing in GP surgeries, but it is not yet clear whether they will push the proposals forward.

GPs and their teams have seen a massive rise in demand, with an estimated 70 million more consultations this year than five years ago.

However as demand has risen general practice has struggled to lure new doctors into the profession, causing a shortage in GPs. To combat this NHS England announced a £10m investment to kick-start a new plan to expand the general practice workforce in January this year.

But according to Dr Maureen Baker, chair of the RCGP, even if general practice was to get an urgent influx of extra funding and more young GP trainees, it would still take some time for this to help the situation due to the length of time it takes to train a GP.

By contrast there is already an over-supply of pharmacists, many of whom are qualified to prescribe medicines, and it is thought they could step in to treat patients directly at the surgery.

“We already have a ‘hidden army’ of highly-trained pharmacists who could provide a solution,” Dr Baker said.

“Practice-based pharmacists, working as part of the clinical team, would relieve the pressure on GPs and make a huge difference to patient care.

“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.”

Many GP surgeries already work closely with pharmacists. The proposals would see pharmacists working as part of the general practice team, much in the same way as practice nurses.

These types of partnership already exist in a handful of practices but experts hope the plan will eventually be rolled out across the UK.

David Branford, chair of the RPS English Board said:  “General practice is the foundation of the NHS but it needs proper resourcing and support. Having a pharmacist as part of the team can make a huge difference to both patients and clinical colleagues.

“It’s a win-win situation for everyone concerned.  The NHS simply can’t afford to wait any longer to create capacity in the system.  We must be more strategic and change the services on offer to make best use of the NHS workforce.

“Pharmacists should be working in GP practices all over the country. Patients deserve access to high quality care and services wherever they live and pharmacists are central to providing this.”

The move has been welcomed by charities and patient groups, but they warn that the focus must remain on patient safety.

Katherine Murphy, of the Patients Association said: "Any action that can, at the very least, ease the problem is to be welcomed and this plan for doctors and pharmacists to work together is an innovative 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."

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