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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)

  • End of gatekeeper role
    End of general practice and all its efficiencies

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  • A&E will be even busier . Our local pharmacist had a patient faint while doing a flu jab.
    999 ambulance called.
    Pharmacists have inadequate training in diagnosis and in particular where examination is needed. Absolute nonesense.

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  • Considering there is a real time wait for secondary care of about 40-50 weeks - not sure how pharmacists , even if referring appropriately, will suddenly "help access care." Let's be arrogant for a minute - GPs are by far the best people at gatekeeping and referring appropriately. Consider how many patients with a bit of dry skin are seen in other clinics and a Dermatology referral is recommended with no consideration that we successfully manage most things without involving anyone else. Let pharmacists refer, waiting times will simply be measured in years and decades not weeks and months.

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  • excellent why not. will their referrals be audited also?

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  • As 10.25 says- end of gatekeeping role will lead to the opening of the floodgates. Just how much uncertainty can you tolerate Mr/Mrs Pharmacist?

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  • I agree with the suggestion particularly referrals to dietician etc would be really helpful. As mentioned there they will be audited. Same for opticians to refer directly. I am drowning with workload and I dont mind some of it taken from me.

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  • Fantastic news. On one hand CCG are on GPS back to cut down referral rates. SO it won't be our problem anymore. Lets see how CCG will monitor referral rates and most importantly see how hospital will cope with sudden increase in demand.

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  • Locally our referrals are triaged and "inappropriate" referrals returned to the GP even if the GP did not make the initial referral. Looks like more work for GPs.

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  • This plan completely misunderstands the skill of being a GP.
    Referring patients to hospital is the really easy part of the job - in fact I would say anyone could do it. It is the 'not' referring that is the clever skillful part of the job.
    if Pharmacists are allowed to refer Secondary care will soon be completely overwhelmed.

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