Healthcare experts have welcomed news that the NHS will provide financial incentives to GPs who wish to bring pharmacists into practices, as part of a £200m budget to kickstart primary care initiatives to be announced on Friday.
Campaigners say employing more pharmacists in GP surgeries might help to offset the looming shortage of family doctors and ensure patients follow their medication regimes.
“When it is so hard to employ doctors in some parts of the country, [practices] really ought to be looking at this wealth of well-qualified staff,” said Rick Stern, chief executive of NHS Alliance. “There is so much wastage in the system because people don’t use their medicines properly. They haven’t had all their questions answered, or they are not confident or don’t want to talk to their GPs about it.”
The NHS Alliance and the Royal Pharmaceutical Society have both argued that patients would benefit from the extra time that pharmacists can give them, while surgeries could radically cut waste. The shift would also make good use of a glut of pharmacists who spend fewer years in training than doctors, and could also help control the NHS’s enormous medicines bill.
“This potentially has big cost savings in terms of people really complying with, and getting more benefit from, their medicines,” said Stern. “It is not that pharmacists are better. They have different skills. They know more about medicines than GPs and they can explain it probably in better, simpler terms.”
Only a handful of surgeries in the UK currently have on-site pharmacists. A quarter of the population have a long-term health condition such as diabetes, depression, dementia or high blood pressure, and 30-50% of prescribed medication for such conditions is not taken as recommended.
Jeremy Hunt, the health secretary, and officials at the Department of Health have been taking a keen interest in transforming primary care, which is among the priorities of Simon Stevens, chief executive of NHS England, who wants to see more “multi-speciality providers” in GP practices.
This could also lead to mental health and social care specialists becoming part of the teams in doctors’ surgeries. It is understood that NHS England has approved a rise of more than 4% in the overall primary care budget for 2015, to £12.8bn, of which £200m is earmarked for these multi-speciality providers.
Last month Hunt urged the public to seek help from high street pharmacies for minor ailments including flu and colds instead of putting extra pressure on hospital A&Es.
Ash Soni, president of the Royal Pharmaceutical Society, said: “This is a great opportunity to improve patient care and provide support to our GP colleagues. Over a billion prescriptions are issued every year in England but we know around 8% of people end up in hospital because of problems with their medicines.”
Patients attending a south London surgery that has a pharmacist on the team backed the arrangement. Michael Mansfield, 63, who has high blood pressure, said: “The biggest thing is she [the pharmacist] has a little more time. I feel she is an expert in the field and that confidence has built up over time. You are a bit more on a production line with the doctor and [now] it doesn’t worry me not seeing the doctor.”
Christine Jordan, 71, also welcomed the extra time. “You just feel more relaxed. She is never in a rush. I have breathing difficulties and she changed my puffer for me three times until I found one that was suitable. I feel good talking to her. I don’t doubt her one scrap. I am surprised this hasn’t been looked at and talked about more.”
Dipti Gandhi, a pharmacist and managing partner at another south London practice, where there are five GPs and three nurses, said: “It is about fitting in with other healthcare professionals. We help [patients] understand what they are taking. We are all living longer, we want to live better. General practice can’t do it on its own, nurses can’t do it all.”
Dev Malhotra, a GP at the same practice, said: “General practice is getting more and more complex. It is very difficult when you have patients who are on several different medications to keep on top of potential interactions. Ensuring patients are compliant with medications is a very difficult problem. The reality is that in a 10-minute consultation as a GP, you can’t always be certain as to why someone is or isn’t taking their medication.”
