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GPs buried under trusts' workload dump

Pharmacists' vascular screening refers 'up to 70%' back to GPs

By Nigel Praities

Vascular screening by pharmacists is referring large numbers of patients who did not come above risk thresholds back to GPs, in a move critics fear could substantially increase practice workload.

As many as 70% of patients assessed by pharmacists were referred back to a GP practice, even though just a fifth of them were judged as above the cardiovascular risk threshold for treatment with statins.

Vascular screening by pharmacists also failed to attract patients who were not already known to GPs, with only a tiny proportion of those screened not registered at a practice.

The Government has told PCTs to target ‘unregistered groups' as part of the national NHS Health Check programme by carrying out checks in a variety of locations other than GP practices.

But an audit of a ‘showcase' scheme in 251 community pharmacies in Birmingham found of 1,100 patients screened in over nine months, just four were recorded as not having been registered at a GP practice already.

The researchers claimed the scheme had shown ‘some success' in targeting people from more deprived areas and ethnic groups, and suggested the low numbers of unregistered patients picked up might have been because of procedural errors.

The evaluation of the Heart MOT scheme found most patients screened were being referred back to GP practices, largely for elevated blood pressure and cholesterol levels, raising fears that GPs would see unpaid increases in workload.

That was the case even though 18% of patients referred to practices were assessed as being at a 10-year cardiovascular risk of 20% or more.

Study leader Dr Jonathan Horgan, head of medicines management at NHS South Birmingham, defended use of pharmacists for screening.

He insisted: 'Pharmacies may be perceived by the public as a less ‘medical' model with easier access, compared with GP surgeries, for ‘well' people who are interested in finding out more about their health.'

But local GPs said the study – published online by the Journal of Public Health – demonstrated use of pharmacists for vascular screening was a ‘backwards step'.

Dr Vijay Abrol, a GP in Birmingham, said the involvement of pharmacists in the programme was ‘disappointing' as GP practices were more than able to do the work.

‘I don't think any pharmacist in this area has the capacity to do this properly. It is not just about taking one blood pressure reading and then referring them.'

Large numbers of patients who did not come above risk thresholds were referred back to GPs Large numbers of patients who did not come above risk thresholds were referred back to GPs

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