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At the heart of general practice since 1960

GPs warn of 'enormous influx' from Boots diabetes risk assessments

Boots pharmacies have begun offering free diabetes risk assessments in all stores, in a scheme GPs warn could see an ‘enormous influx’ of patients into practices.

The scheme involves pharmacists using a recognised diabetes risk score to assess the risk of patients developing type 2 diabetes, with those deemed high risk advised to see their GP.

The scheme has been rolled out in conjunction with charity Diabetes UK, and will see pharmacists offering advice on lifestyle changes and how to prevent the onset of diabetes.

GPs have welcomed the scheme, but say that it could lead to duplication of tests and should be carried out in practices.

Participants will answer seven questions related to age, gender, waist circumference, BMI, ethnic background, blood pressure and family history- in a Diabetes Risk Assessment tool developed by the University of Leicester and University Hospitals of Leicester NHS Trust in collaboration with Diabetes UK.

One of the researchers who developed the tool, Professor Kamlesh Khunti, professor of primary care diabetes and vascular medicine at the University of Leicester, said the scheme was a good idea ‘overall’, but that he was worried it was not integrated with other schemes.

He said: ‘I’d be concerned about a lot of duplication of tests. People might have had the test in NHS Health Checks, at their GP and now at the pharmacy too. It might lead to unnecessary checks and a lot of people chasing for resources.’

Dr Simon Griffin, assistant director of the MRC Epidemiology Unit at the University of Cambridge and a GP in Cambridge, voiced concerns over the impact the risk assessments could have on general practice.

He said: ‘Rather than having everyone in general practice being screened with blood tests, stratifying the population with some kind of screening is probably sensible.

‘My concerns would be that it might produce an enormous influx of patients into general practice and general practice isn’t prepared for that. Is general practice sufficiently resourced to give advice? I don’t think we have enough dieticians or exercise physiologists for referrals.’

Dr Alan Begg, a GP in Montrose, Scotland, said: ‘The idea is a good idea. It’s fine for it to be done in pharmacies but I would say ideally it should be done in general practice and should be properly funded. This really should be done under QOF.’

Last year, GPs were urged to screen all patients aged over 40 years and offer annual checks to those at high risk of diabetes in a major drive to reduce the numbers of patients developing the disease launched by NICE.

Peter Bainbridge, director of pharmacy at Boots UK, said: ‘Our customers come to our healthcare teams for information and advice on how they can make positive changes to their health.

‘This service meets these needs by raising awareness of the risk factors of Type 2 diabetes and helping not only to identify people who may develop it in the future but, importantly, give them the right support and advice to manage any potential risk.’

Barbara Young, chief executive of Diabetes UK, said: ‘Having risk assessments available for free in the heart of people’s communities will make it easier for people to access them and so increase the number of people who are aware of whether they are at risk. This is why we are delighted to be working with Boots UK to make risk assessments available in-store.’

Readers' comments (7)

  • No offense to the pharmacist but I often find them inflexible and lacking in depth of knowledge to be able to give consistent advice.

    Today alone I had an elderly lady with DM who was told to stop using topical NSAIDs. Another who questions out of license use of cetirizine TDS (recommended by dermatologist for urticaria) every single time the script is done. Or their advice to see GP for any cough longer than a week, even if they are well. Or their recommendation to every single patient to see their GP after the MUR (i might as well have done it myself). Not to mention the monthly GTN spray dispence or their willingness to suggest weekly med scrip for blister pack.

    Diabetes UK is not there to pick up the disturbance caused by such inexperienced and unsupported "clinicians" - it will be the primary care that'll end up picking up the pieces. And yes, for free.

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  • The one thing you can be sure of when you tell someone they've screened positive is that you've damaged them, broken their sense of wellbeing, created an expanding circle of concern among relatives, friends, employers, insurers. This is justified only if there is evidence that, as a result, one can more than compensate with a therapeutic intervention. In the case of systematic population screening for diabetes, that evidence is scanty or non-existent. A further question. Has the Boots project been piloted and its outcomes evaluated? Primum non nocere applies just as much to populations as to people - maybe more.

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  • Just had my first recommedation for assessment - reassuringly I'd already checked his blood sugar less than 2 months ago!
    A distinct lack of jointed up care again, which is going to increase workload unnecessarily.

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  • what a ,load of codswallop . Some of you gps need to wake up and smell the coffee . All you care about is making money , you will never do anything for free , at least boots puts its money where its mouth is.MR annonymous im a specialist pharmacist and i would wipe the floor with you and half the gps in the country in the management of diabetes and cardiovascular disease .so put up or shut up if you did your job right in the first place there woulld be no need for these schemes.

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  • Sounds to me like our specialist pharmacist has sour grapes about cutting the mustard and getting into medicine.Most dispensing is done by dispensers and generally i feel patients get a poor deal from pharmacists. I have patients who get different brands of the same medicine with every script and on some occasions two different brands of the same medicine on the same script. Any fool can stick a label on a box of pills. A little knowledge can be a dangerous thing. Parallel imports should be banned. Do not try and pretend that boots do not have an agenda here the keyword is profit. Our local pharmacists get £1000 per annum for dispensing methadone to each patient.

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  • @aptaim Unknown

    I just wanted to add a bit of balance to these comments as a pharmacist employed by GPs: I think Mr Specialist Pharmacist is talking rubbish, and should reflect on his professionalism after posting that, but that some the Dr comments here are also tosh. We all have negative anecdotes about each other’s practice, but this doesn’t mean all pharmacists or Drs are the same. I think that fundamentally our professions – in general – don’t spend enough time talking to each other about patients and pathways, and this is why we have ad hoc efforts and duplication of activity. Whether or not you’re a fan of the ‘new’ NHS starting in April, now’s the time to start discussing these issues locally either via H&WBs or by inviting pharmacy reps to your CCG meetings.

    Anyhow, specifically with this screening service: of course Boots are looking for profit, but given the forthcoming contract changes, PMS changes, MPIG loss etc, show me a GP who isn’t reviewing their finances & profitability. Money aside, this service will usefully pick up some patients who would otherwise not be on the GP’s radar (access and reach is an undeniable pharmacy strength), but it is also going to be mostly a waste of time and increase GP workload. However, I’d suggest that patients coming to the practice from the pharmacy don’t need to be seen by the GP, but instead by a good practice nurse. Either way pharmacists working for large chains have little choice but to offer what they’re told by HQ, so practices should start to consider how they can make this work to their advantage.

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  • My wife is a pharmacist for a big company. yes orders come from above and usually without any evaluation or discussion. 20 years of medical hard graft or 1 or 2 emodules? hmmmm........................

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