Noel Wicks comments on the proposal for employing pharmacists in general practice

It’s been interesting reading the views on the recent joint RPS and RCGP announcement regarding pharmacists in GP surgeries. I don’t think anyone would deny that pharmacists could add value, but does the suggestion have the four ‘rights’? By this, I mean ‘the right role, in the right place, at the right time, and at the right dose’.

I may be stretching it as an idea, but stay with me on this. First, is this the right role for the pharmacists? I’m not convinced GPs are that willing to shed aspects of the longer-term management of their patients. In fact, of the GPs I know, most consider their daily practice to be one of ‘trivialism’ instead of ‘generalism’: dealing with the huge number of patients presenting with trivial conditions, who are simply looking for reassurance or free NHS treatment is clogging up their surgeries.

This is one area that the national minor ailments service in Scotland has proved extremely effective in alleviating GP burden. These same GPs can now claim blissful ignorance of the local head lice guidelines. This is because people invariably go to the pharmacy, because it’s the most convenient solution both in terms of time and location. The same applies for many other minor conditions.

Which brings me on to pharmacists working in GP surgeries. I don’t deny there is a growing workload burden for all within the NHS, but does this need to be managed in the GP surgery? I’m not convinced and to be honest, if our only argument for being based in surgeries is so that we can read medical notes or hold a conversation with the GP, then we also need to consider that these may become historical barriers sooner rather than later. I would hope that within a few years, these could and should fall away with the advancement of NHS IT.

So, is it the right time? The timing of this joint proposal is interesting. It’s laudable for the RPS to be looking at solutions for the growing oversupply of pharmacists. However, we need to be careful not to create a short-term fix that forgoes a long-term solution. At a time when community pharmacists are finding their feet in delivering pharmaceutical care, it seems somewhat self-defeating to pull the rug from under them prematurely. Perhaps now isn’t actually the right time?

This brings us nicely to the fourth, and possibly most important, ‘right’ of all: the dose.

I’m not sure that we actually have a ready ‘army’ of pharmacists (unless it’s the Saint Kitts and Nevis army, with 150 active military personnel). In reality will the number of pharmacists available to be employed in general practice be so low as to be sub-therapeutic?

Ultimately, it seems as though it will be up to the GPs themselves to decide if employing a pharmacist will be a value proposition for their practice. We can only sit back and hope that whatever happens to pharmacy as a result will be all right on the night.

Noel Wicks is an independent pharmacist.


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