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At the heart of general practice since 1960

Government advisers doubt value of GP exercise plans

Pharmacists in England could be allowed to prescribe from the full BNF for any condition without consulting a doctor, under options included in a new Government consultation.

The GPC and RCGP pledged to resist such a radical move.

Health Secretary John Reid put forward seven different options to bolster pharmacists' prescribing powers, as part of the Government's drive to increase the skill mix in primary care.

The options range from keeping the status quo, to prescribing from a limited formulary for certain conditions, to access to the whole BNF.

The National Pharmaceutical Association made clear it favoured the more radical approach. John D'Arcy, the association's chief executive, said its 'starting position' would probably be a call for access to the whole BNF.

'What if a pharmacist wants to prescribe something a patient needs but can't, even though they have the competence, because it is not in their formulary?' he asked.

The Department of Health also issued a consultation on extending nurses' prescribing powers. But GP representative bodies will submit evidence to the Government cautioning that some areas of prescribing should remain off limits. They are concerned blurring of the division between prescribing and dispensing could introduce 'the profit motive'.

Dr Hamish Meldrum, GPC chair, said: 'Were nurses or pharmacists to be allowed to prescribe for any medical condition from a full formulary these health professionals would need the same level and length of training as doctors.'

Dr Jim Kennedy, RCGP prescribing spokesperson, cited cardiovascular drugs and some antibiotics as therapies where 'more expert opinion should be involved'.

David Pruce, director of practice and quality improvement at the Royal Pharmaceutical Society, said it might opt for the 'hybrid approach', allowing a pharmacist to prescribe any drug after a doctor's diagnosis, but only to prescribe from a limited formulary if treating symptoms.

But some GPs condemn the whole idea of pharmacists being allowed to prescribe.

Dr David Roberts, a GP in Kettering, Northamptonshire, said: 'I don't think pharmacists could possibly have enough training.'


prescribing options

for pharmacists

·No change

·Prescribing for certain conditions from a limited formulary

·Prescribing for any condition from a limited formulary

·Prescribing for specific conditions from a full formulary

·Prescribing for any condition from a full formulary

·A different approach for the different clinical settings

·A hybrid approach

By Cato Pedder

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