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Independents' Day

First 'pharmacy-led' practice set up in bid to counter GP shortage

A surgery in West London is likely to become the first-ever pharmacy-led practice as its partners have been unable to find GPs to run it.

The Argyle Health Group, run by GPs Dr Gouri Dhillon and Dr Arjun Dhillon, currently runs a practice in Ealing but has acquired Isleworth Medical Centre.

The medical centre will be led by five pharmacists and two salaried GPs, having previously been run by locums.

GP leaders said that this is the 'most significant pharmacist involvement' they had seen.

According to a job application for the five pharmacists, which closes at the beginning of October, the surgery will be a ‘pharmacy led, general practice model’, with the pharmacists responsible for ‘leading on out of hospital, QOF, QIPP, PIS and other schemes’.

It says: ‘With the support of pharmacy technicians, pharmacists will take responsibility for repeat management and safe, effective prescribing. 

‘A key role in triage and management of common ailments is anticipated.’

The job description adds that the pharmacists will be expected to manage their own caseload of 'vulnerable housebound patients', patients with 'common/minor/self-limiting ailments' and care home residents.

They will also be expected 'to reconcile medicines following discharge from hospitals, intermediate care and medicines at discharge from into care homes, including identifying and rectifying unexplained changes' and to 'manage these changes without referral to a GP'.

Farid Fouladinejad, chief operating officer of Argyle Health Group, told Pulse that the practice has been looking ‘for some years to diversify its staffing skills mix’ amid a shortage of ‘suitably qualified GPs and practice nurses’.

He said: ‘Managing medications is an important part of primary care. Pharmacists can bring a rich insight and expertise to the primary care setting such as to enhance how medication is used and managed by patients during their care.'

He added: 'Reconciliation of medications after a hospital attendance is an opportunity to enhance patient’s understanding of their management and improve the communication between primary and secondary care.'

Dr Richard Vautrey, chair of the BMA's GP committee, said he has not seen pharmacists involved with the running of a practice 'to this significant extent', adding that 'it's certainly more significant than pharmacy involvement in other practices'.

But he added that many practices are looking to recruit a range of primary care professionals, 'because they're not able to recruit GPs'.

Dr Vautrey said: 'I think the key is how are patients with complex needs and the cases that GPs would routinely see in other practices, how they're going to be dealt with and then if the pharmacists or the workforce as a whole got the expertise to be able to deliver that and thats ultimately the responsibility of the contract holder to ensure that that is the case.'

NHS England launched a £112m scheme to employ more clinical pharmacists in practices, a portion of which NHS Hounslow CCG received.

Readers' comments (40)

  • can you imagine the indemnity bill for having pharmacists do a Dr`s job?

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  • Sounds poor, what is their list size?

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  • Tom Caldwell

    Does this mean that they can send the patient away because theirs a manufacturing problem with the patient?

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  • Healthy Cynic

    This is an interesting development and seems to highlight the gradual erosion of GP's functions over the last 20 years.
    It seems that modern medicine is all about protocols and medicines management, and the expertise to be able to diagnose and treat disease is being gradually sidelined.

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  • Vinci Ho

    I know the feelings of some of us who will react to this type of 'new model' immediately.I would only say survival is one issue and the realistic impact on the patients, hence public , is another. Open minded in experimenting to have some new ways of thinking. Ultimately, time will tell if this is a good way of spending taxpayers' money.
    Personally, would emphasize continuity as a virtue and telos.

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  • Cobblers

    Remind me why I am paying £450 odd quid for the GMC and medical registration? Could I not save this money, lose my registration and go work at this practice?

    I would love to see the GMC chase me for practicing 'medicine' when they patently ignore the proliferating nurses and pharmacists doing the same.

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  • This is clearly and obviously unsafe. It is an uncontrolled management experiment putting patient safety at risk. Where are the commissioners and regulators in this?

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  • Are the pharmacists independent prescribers with their own indemnity or are the two salaried GPs expected to sign off everything they do?

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  • what an easy job for the GP though - just issue every possible medication on unlimited repeat for any and every condition - or if you don't, look for a job elsewhere....

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  • Disgruntled, disillusioned and disappointed

    the only way this will work economically is if corners are cut.

    I.e they're indemnified to do pharmacy work but do clinical work.

    We send out research pharmacists and often when they're involved in research projects they can be based in apractice fro sev months.

    There is mission creep and the pharmacists have to be told to stay within their limits as out indemnity if very clearly defined.

    These projects will fail at the first serious complaint

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