The UK government has announced plans to extend the role of pharmacy in England in dealing with minor illnesses, with more pharmacists being able to prescribe for such conditions.
The White Paper – Building on Strengths, Delivering the Future – sets out how pharmacists will complement the work of general practitioners (GPs) in promoting health, preventing sickness and providing care that is “more personal and responsive to individual needs.”
Health Minister Ben Bradshaw stressed that the proposals are not about pharmacists taking over the work of GPs. “It is about complementing them, taking pressure off GPs and enabling them to spend more time with those patients who really need it,” he said.
In January, the Proprietary Association of Great Britain (PAGB) reported that a survey by IMS had found that treating minor ailments accounts for 18%-20% of GP workload, costing the National Health Service (NHS) around £2 billion a year. 57 million consultations a year are for minor ailments, resulting in over an hour a day for every GP and 52 million prescriptions, it said.
Under the White Paper proposals, pharmacies will:
– become “healthy living” centres promoting health and helping people take better care of themselves;
– be able to prescribe certain common
medicines and be the first port of call for minor ailments;
– provide support for people with long-term conditions, such as high
blood pressure or asthma, 50% of whom may not take their medicines as
intended, especially when starting a new course of treatment;
– screen for vascular disease and certain sexually transmitted
infections, such as chlamydia;
– work much more closely with hospitals to provide safe, seamless care; and
– play a bigger role in vaccination.
“A pharmacy isn’t just a place where you go to pick up a prescription. It’s a service, staffed by health professionals who are capable of dealing with minor ailments, screening for diseases and giving health advice to the local community,” said Mr Bradshaw. “As 99% of the population can get to a pharmacy within 20 minutes, everyone will benefit from more types of treatment available through local pharmacies who can prescribe more, advise more and deal with more,” he added.
The Chief Pharmaceutical Officer, Keith Ridge, called the White Paper “a landmark document” which, when implemented, “should complete the transformation of pharmacy to a clinical profession.” Representatives of the pharmacy profession also welcomed it. Royal Pharmaceutical Society of Great Britain (RPSGB) president Hemant Patel noted that its recognition of the role played by pharmacists in providing access to health care for the most vulnerable was “long overdue, but nevertheless welcome,” and said the Society would be putting forward to the government a set of professional standards to ensure a level of quality for the services.
Colette McCreedy, chief pharmacist at the National Pharmacy Association (NPA) said the White Paper “signals that it’s time to unlock the long-recognised potential of community pharmacy,” but added that much detailed work remains to be done on the contractual mechanisms that underpin NHS-funded services.
Rob Darracott, chief executive of the Company Chemists Association (CCA), said he was particularly pleased with the plan to make better use of skills to support patients with long-term conditions. “There are times in a care pathway for example, when a patient takes a new medicine for a long-term condition – where pharmacists have been shown to have a significant impact on health outcomes by responding to patients’ questions about their medicines and by helping them understand how the medicine will improve their symptoms,” he said.
Caution from GPs
GPs’ representatives were more cautiously welcoming. Professor Steve Field, president of the Royal College of General Practitioners (RCGP) warned that pharmacists “are not doctors, and patients need to understand the difference.” Involving pharmacists in preventative healthcare and screening will actually make GPs busier as they will be identifying more patients who might otherwise slip through the net, he added. Moreover, as pharmacies are businesses generating income, there will be a need to ensure that profit does not “pollute the conversation and that there is no conflict of interest between pharmacists giving advice and their selling particular types of medication,” he cautioned.
Dr Laurence Buckman, chairman of the British Medical Association (BMA) GPs Committee, said the proposals were “helpful.” Primary Care Trusts (PCTs) have been able to commission these and other pharmacist services for several years, but few seem to have done so, he said, adding: “we believe the overall management of patients with long-term conditions is best done within general practice but pharmacists have a role to play in supporting patients in their use of medicines.”
Meantime, the Conservatives claimed the White Paper “promises nothing new.” Three years ago, the government had made the same promises, but it “dithered and it hasn’t happened,” said Shadow Health Secretary Andrew Lansley.
– Mr Bradshaw also said the government would be holding a series of public events around the country, starting May 1, to enable the public, patients, the NHS and the professionals to comment on the proposals. It will then consult on some key proposals later this year, he added.
