Pharmacists strike deal to take lead in vascular checks
By Nigel Praities
The Department of Health has approved an agreement with pharmacists that could see them increasingly commissioned as the front-line providers of vascular screening, Pulse has learned.
Pharmacy negotiators and the department have agreed the terms of a template service contract for PCTs that could bypass GPs for all but those at highest risk, a move described as ‘madness' by GP leaders.
The template says patients found to be at moderate or high risk will be offered appropriate interventions – including medication, either by referral or from those pharmacists trained as independent or supplementary prescribers.
Patients should also be referred back to their GPs or ‘a professional with suitable patient information and prescribing responsibilities' if they have hypertension or high fasting glucose or HbA1c results for further investigations.
The vascular screening roll-out began in April, and all PCTs have to 'show some evidence of participation' with the programme by the end of the year.
A Pulse investigation published earlier this year revealed pharmacists were involved in screening in a third of PCTs and were being paid three times as much as GPs for each patient.
GPC negotiator Dr Peter Holden said the Pharmaceutical Services Negotiating Committee's template agreement threatened patient care and contained a ‘huge conflict of interest'.
‘This is madness. I believe many of our graduate nurses are qualified to do this sort of thing, especially as there is a doctor around on tap, but I don't believe pharmacists are. They have totally different training,' he said.
‘I am sick and tired of us trying to make friends, this is a turf war and it is about proper service for patients, not some veneer of a service'
Mr Alastair Buxton, head of NHS services at the PSNC said the guidance would act as a ‘prompt' for PCTs to consider how community pharmacies can deliver vascular screening programmes.
‘Pharmacies have demonstrated they can provide the service in an efficient and effective manner in a location that is convenient for all sections of the population, including hard-to-access groups,' he saidWhen pharmacists should refer patients to GPs
1. Blood pressure is 140/90 mmHg or more
2. High fasting blood glucose or HbA1c result is found
3. All people found to be at high risk
4. Where pre-existing disease is suspected or identified
Pharmacists have struck a deal to take the lead in vascular screening
Source: PSNC NHS Health Check template enhanced service specification, June 2009