The Royal College of GPs (RCGP) and the Royal Pharmaceutical Society (RPS) have announced plans to improve access to GPs at all practices. They are concerned that patient demand is increasing with the complex health needs of a growing and ageing population at a time when the number of GPs is failing to keep pace. They propose that every GP surgery could use pharmacists to ease that mounting pressure.
Since August 2013, pharmacists who undertake specialist training have had the authority to write prescriptions for patients without needing first to refer them to a GP or hospital doctor with prescribing authority. But there seems to have been little improvement in access to GPs for many patients who struggle to make appointments since then.
The RCGP estimates that GP practices will hold 370 million individual consultations this year, 70 million more than just five years ago. In that time, the number of GPs has remained broadly static. This is compounded by concern that many GPs are approaching retirement age and far fewer are training to join the profession.
In contrast, the RCGP and RPS suggest there is an over-supply of pharmacists, whose training as clinicians lasts a year longer than nurses and a year less than doctors. They believe that, with additional training to deliver health advice, pharmacists could treat a wide range of common ailments practising from GP surgeries as part of a wider clinical team. They stress that the proposals would introduce clinical consultations rather than add more pharmacies to GP practices.
The proposals focus in particular on long-term conditions such as asthma or diabetes that have already been diagnosed. Pharmacists could help, for example, with routine patient reviews and in writing repeat prescriptions. They can help patients to understand the medications they were prescribed when they were discharged from hospital and could liaise with hospitals to streamline and refine medication plans.
Andrew Clayton of Penningtons Manches' clinical negligence team welcomes the plans to ease the increasing burden on family doctors but adds a note of caution to ensure patient safety is protected. He explains: "This initiative has the potential to free up time for stretched GPs to improve access for patients. The key will be to deliver effective training to ensure that pharmacists are qualified not only to give health advice in its broadest sense but also to recognise when they need to defer to doctors with greater clinical experience.
“Patient safety depends on the correct diagnosis being made as early as possible and it is imperative that these proposals include stringent safeguards to protect patients from under-qualified and inexperienced clinicians."