Did I hear that correctly?


Did I hear that correctly?

News of change is coming from all directions within healthcare at the moment, but it may not always be for the better, says community pharmacist Noel Wicks

Occasionally in this line of work you hear things and your first reaction is “that can’t possibly be true”. And I’m not talking about Brexit. Perhaps you are not quite sure if something you just heard is an exaggeration or if it’s an urban myth. Whichever it is, you think that someone, somewhere, has muddled their facts.

I had this experience only a few weeks ago, when someone told me that a CCG in England – in an attempt to cut costs – had informed GP practices not to prescribe things that could be bought over the counter. I laughed at first, but it quickly became apparent that the person imparting these “facts” was being deadly serious. I explained how ridiculous that would be, citing a long list of reasons why no one in their right mind would issue that sort of guidance. First and foremost it would represent a major policy change from the NHS’s mantra of free at the point of access. I wouldn’t imagine this going down well with the local population or their representatives in Westminster.

Second, it would put your average GP in an enormously difficult position in refusing to treat a patient. I’m not sure how their regulatory body would view this, but I would imagine that refusing to treat someone might be considered worse than treating them wrongly.

There were quite a few other reasons that came instantly to mind, but these seemed the most obvious as to why this couldn’t possibly be true. I thought it was likely just some advice aimed at patients who weren’t exempt from prescription charges, being told to buy items at the pharmacy rather than pay a prescription charge. My colleague from “down south” was adamant they had heard correctly, but we left it at that and went our own ways.

Imagine my surprise then, when a few weeks later I spot an article on a GP website that not only confirmed my colleague’s facts, but also went on to discuss the danger to GPs in Bristol of following this CCG guidance. I couldn’t believe it: every single word had been true and I was going to have to eat a very large slice of humble pie.

The advice from Bristol CCG gave a list of items that all patients should be told to buy, which included creams, laxatives, indigestion remedies, hayfever and conjunctivitis treatments among other things. They also sent out a poster for the GPs to put up in their practice to explain that they (the GPs) would not be prescribing these sorts of items unless in “extreme circumstances”. I can imagine the GPs weren’t thrilled at having the responsibility for this put on them and suspect that many posters went in the bin.

Undoubtedly, Bristol isn’t the first to try and encourage patients to use more self care. Although this is a good principle, I don’t know of anywhere else that has been so aggressive in its approach to try to implement this. So as I tuck into my humble pie, I am left to consider that the next time I hear the “impossible” I should probably keep quiet, because it seems these days that, actually, anything is possible.

Record my learning outcomes