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The waiting game

Pharmacists to prescribe antibiotics to free up '25,000 GP appointments a year'

Pharmacists in Scotland are to start prescribing antibiotics to women with urinary tract infections in a scheme designed to free up thousands of GP appointments.

NHS Grampian said more than 90 community pharmacies have signed up to the scheme, which allows specially trained pharmacists to give the antibiotic trimethoprim to women with uncomplicated UTIs.

The health board said this could free up nearly 25,000 GP appointments a year in the region.

Scottish Health Secretary Shona Robison welcomed the scheme and said it could be rolled out across the whole of Scotland.

Ms Robison said in a statement: ‘Through the National Delivery Plan to Transform Urgent Care, consideration is being given to how a similar model could be rolled out across Scotland benefiting both in and out of hours care.’

The service has been piloted at NHS Forth Valley and is already under consideration at other health boards, the Herald Scotland reported.

A previous trial at NHS Greater Glasgow and Clyde showed the approach could save GP appointments and improve patients’ access to treatment out of hours.

Dr Alasdair Jamieson, GP lead for Aberdeen City with NHS Grampian, said around 1% to 3% of GP consultations a year were for women presenting with UTI and that many ‘are acutely aware when they have a UTI and when it requires treatment’.

He added: ‘That has real potential to reduce GP workload, freeing up appointments and allowing greater focus on more complex, urgent medical conditions. Clearly that will have significant direct and indirect benefits for patients right across general practice.’

Previously, Pulse reported that the Department of Health was forced to drop certain antibiotics - including trimethoprim - from a 'pharmacy access scheme' designed to allow pharmacists to prescribe a wider range of medications.

Readers' comments (10)

  • A future Historian writes:

    'It is believed that the untreatable UTI that killed 4/5ths of mankind originated in the small country of Scotland'.

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  • daft.

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  • Dear All,
    We can't have it both ways, complain of being overloaded then complain when some of the brain dead work is taken away. Do you really need a medical degree to manage initial presentation of repeat uncomplicated UTI?
    In my practice the frontdesk staff and nurses manage ours - working to a protocol under delegation.
    Paul C

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  • My complaint is the cherry picking of things which, as mentioned, can very well be delegated and managed without significant impact on the work of the GPs within the practice.
    Pharmacy is obviously keen to undertake flu vaccine and managing UTI. They will do this work with money which counted in "primary care", but which doesn't really address our workload issues or generate income for GPs to make our job more attractive.
    I do support some GP practices working at scale to "automate" more of our work. How about funding/ support for HCA training to manage suspected UTI under safe protocol within GP? They are already effectively managing INR with minimal supervision in my last practice.

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  • A bit of maths. ...a GP will see face to face a minimum of 6250 patients per year. So this will save the loss of 4 docs.
    The maths just doesn't add up unless the relentless volume of demand reduces significantly.
    I can recall seeing an uncomplicated uti a few years ago. Consultation referral diagnosis and treatment resulted in stage 4 cervical cancer.

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  • I thought there was new guidance recommending that we should be treating uncomplicated UTIs in young women with NSAIDs as first line?

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  • Utter Tosh, Nurses mainly manage UTIs, they dont need antibiotics, and without access to the full record this is worse than dangerous. Its just another stream of access that will be rapidly filled and 10 years down the line we will be getting Holland and Barrett to dish them out because lets face it -- by then Trimethoprim will be as much use as a herbal remedy.

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  • Another half brain idea. Pharmacy will get for This one consultation as much as a GP gets to treat for a whole year. Pay us GP's per consultation and see how much more we can handle

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  • Devil is in the detail I think.

    A GP app costs around £20/app to NHS. Nurse practitioner will be around £8 or so.

    If pharmacists are doing it for free and sticking to the guideline, fine. If they are charging (say) £10/app or not sticking to the guidance, then we'd be better off providing these via NP.

    What's the bt they are getting paid around £20?

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  • @ Anonymous | GP Partner|12 Sep 2016 8:44am

    Pharmacies get £10 per treated person in Devon. Why would they work for free?

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