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Pharmacy push in long-term care

MPs and peers call for greater role for pharmacists in chronic illness - and criticise GPs for not valuing their skills

GPs have been urged to shake off their 'territorial resistance' to community pharmacists by handing over responsibility for treating patients with stable long-term conditions and minor ailments, plus aspects of out-of-hours care.

The recommendations come in a critical report by MPs and peers in the All-Party Pharmacy Group, following a year-long investigation into how pharmaceutical care could be improved.

GPs reacted angrily to the report, which accused them of having 'poor or non-existent' relationships with pharmacists and a lack of awareness of pharmacists' capabilities.The group called for points in the quality and outcomes framework for collaborations between GPs and pharmacists to encourage closer working.

This would address GPs' perceptions that they were currently competing with pharmacists for PCT funds, the report said. And the group said it wanted the Department of Health to produce a 'pharmacy out-of-hours action plan' on opening hours to help tackle current gaps in GP care.

GP and Labour MP Dr Howard Stoate, who sits on the group, denied the report was overly critical of GPs. 'It's more that we are frustrated by the poor relationship between GPs and pharmacists, which has not developed in the way we had hoped,' he added. 'GPs and pharmacists are simply not talking enough and not exchanging enough ideas.'

The report also says pharmacists are 'ideally placed to take on more services which have traditionally been undertaken by GPs'.The Royal Pharmaceutical Society of Great Britain said in evidence to the investigation that each GP's workload could be reduced by up to 16 consultations a day if self-medication were encouraged for certain minor ailments.

But Dr Laurence Buckman, deputy chair of the GPC, told Pulse he strongly disagreed with the conclusions. 'Pharmacists should not be taking care of people with long-term conditions. This requires clinical knowledge that they do not have.'

Dr Buckman disputed the report's claims that the Medicines Use Review system had created resentment from GPs over extra workload.

He argued that most GPs did not have a problem with the system.The pharmacy group also said many GPs were reluctant to mentor trainee pharmacists, but that the department could encourage such a practice by offering financial incentives. Many GPs think of pharmacists merely as 'shopkeepers', said Justin Ash, chief executive of the UK's largest community pharmacy chain, Lloydspharmacy.

A spokesperson for Bolton Local Pharmaceutical Committee said: 'GPs feel pharmacy is taking their money. They do not know enough about our role and see us as a threat.'

Alex Gourlay, Boots's healthcare director, told Pulse last week that pharmacists could undertake two-thirds of GP consultations.

Report pushes for greater pharmacy role
Jobs pharmacists could take on:
• Monitoring and management of stable long-term conditions
• Medication management
• Medication reviews
• Emergency supplies of medication
• Immunisation programmes for conditions such as flu and pneumonia

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