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At the heart of general practice since 1960

Pharmacists flavour of month

For the Department of Health, GPs are the unruly schoolchildren of the NHS, with an independence of mind that ministers find unnerving.

For the Department of Health, GPs are the unruly schoolchildren of the NHS, with an independence of mind that ministers find unnerving.

Pharmacists, by contrast, are basking in the warm glow of favoured status, as the recent pharmacy white paper makes plain.

Chronic disease management, public health, immunisations – what was once the domain of general practice could soon be available down at your local branch of Boots.

All of which may be a perfectly good thing, provided of course that each service is piloted, evaluated and its cost-effectiveness confirmed.

GPs have to rigorously demonstrate the benefits of clinical interventions before they are funded through the QOF or a DES, so the same must surely be expected of pharmacists…mustn't it?

Cavalier attitude

Well perhaps not, judging at least by the experience so far of medicines use reviews. During 2007/8, PCTs spent £20m getting pharmacists to check up on GP prescribing – an average of £132,466.

Yet the sizeable expenditures, revealed by Pulse this week, come despite a remarkable and near total lack of evidence for benefit.

Just one trust in four has done any evaluation to see whether medicines use reviews are worthwhile.

PCTs that have checked have often found they are not, which is hardly surprising, since this is exactly what the academics have been saying for several years now.

It all suggests a cavalier attitude to establishing the evidence base for pharmacist interventions – an attitude at complete odds with the fastidious approach to evidence in general practice.

If GPs are to be asked to compete with pharmacists for the provision of services, it is essential that both groups should be judged on the same criteria.

Taxpayers deserve better than an NHS that bases policy on political whim rather than evidence of benefit, and the last thing GPs need is yet another playing field skewed against them.

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