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GPs go forth

Pharmacists want to bypass GP and refer patients directly to hospital

Pharmacists should have the power to refer directly to specialists and social care teams to ease the burden on GPs, a report has recommended.

The Royal Pharmaceutical Society of Scotland said such a move would help patients get access to care and reduce the number of unnecessary appointments for people with long-term conditions.

There is work underway to increase the number of pharmacists in general practice in Scotland, with RCGP Scotland recommending that every GP practice has a clinical pharmacist.

In 2015 £16.2 million was announced for recruiting up to 140 pharmacists with advanced clinical skills training over three years to support GPs in managing patients with long term conditions in Scotland.

Meanwhile, NHS England has pledged that every practice in England will gain access to a clinical pharmacist, in a £112m expansion of its current pilot.

The RPS policy document says the current referral process can cause delays in access to treatment for the patient and contributes to unnecessary workload for the GP.

The report said: ‘When people present at a pharmacy with problems or symptoms that require referral to, for example, a dietician or physiotherapist, the pharmacist has few options other than to default to the traditional route of referring individuals to their GP.

‘The pharmacist may have already recognised that the patient would benefit from quick access to another health or social care professional and should be able to do so as an integrated member of the multidisciplinary team.’

RPS Scotland also call for pharmacists to carry out more simple screening tests for long-term conditions such as blood sugar testing and blood pressure measurements.

Around two million people in Scotland are living with a long-term condition, which take up around 80% of GP appointments, according to the report which outlines the ‘key role’ the pharmacist can have in the ‘on-going monitoring, support and treatment’ of patients with long-term conditions.

‘The funding for pharmacists working in GP practice should become permanent to enable continuity of care and build a wider primary care team.’ RPS Scotland concludes.

John McAnaw, chair of the Scottish Pharmacy Board said: ‘I want to see these recommendations being taken forward in Scotland, so that people with long term conditions benefit further from the knowledge and expertise their pharmacist can offer as part of the wider care team.’

Dr Alan McDevitt, GPC Scotland chair, said: ‘There is definitely scope for pharmacists to be more involved in patient care and we are keen to explore ways in which this can be done that will give GPs more time with their patients.’

It comes as the NHS 111 care helpline in England has begun sending patients with minor ailments directly to pharmacy instead of GP out of hours, including for emergency prescriptions.

Readers' comments (36)

  • It will only make the matter worse as regards the referral rate-I know it well. Only GP should filter the referral. Patients are likely to demand even more than what are the are doing now-I have extensive experience in the secondary care services.

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  • I am married to a pharmacist. They would be the first to admit that they are not trained in clinical examination. Having taken a thorough history, done a thorough examination, a doctor may arrive at a clinical diagnosis, perhaps supported by some investigations. Since when were pharmacist so trained?
    Our hospital colleagues are already burdened with the referrals of 'want to be doctors' within secondary care, this would idea would only add to the waiting list for an OPD appointment, further keeping those with proper illness waiting for specialist care.

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  • And the cost? Whose budget it will erode? Who will get the hospital report and who will shoulder the responsibility to follow ups and continuity of care?

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  • What ? When I get sent sore throats, cut fingers & all children under 2 years because it is deemed a doctor should see them.
    Unfortunately this equates to 'an emergency' by the patient & they are often added on as extras on a friday afternoon.
    I would worry about the quality of secondary referral

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  • 140 pharmacists nationally will have NO impact, but will divert funding from General Practice

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  • I agree with previous comment, if referring was all we do and If we had fast and easy access to secondary care, there wouldn't be any need to reduce our workload, everyone would be seen and treated the same day in the hospital by a specialist!

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