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Letter: Copperfield, the NHS needs pharmacists

The Royal Pharmaceutical Society responds to a blog

From Neal Patel, pharmacist, The Royal Pharmaceutical Society

Perhaps we shouldn’t rise to the bait, but we feel it’s only right to stand up for those who felt offended by the thoughtless and deliberately provocative remarks in Dr Copperfield ‘s blog.

Despite the original intention, which we can only hope was to be controversial for the sake of attention, it is in the context of change, challenge and austerity that the NHS faces, that this blog has been published.

We agree that we all have a responsibility to look at how best finite NHS resources can be used more effectively to improve patient care, however we believe that it is through harnessing the skills and commitment of doctors, health visitors and pharmacists we will improve patient outcomes and  save the NHS money.

Pharmacists have a vital role in helping the NHS make the shift from siloed to integrated care and are fulfilling the pressing need to do more for less. Like Doctors we’re working incredibly hard with less time and resources.  

In fact pharmacists all over the country are already working more closely with patients and healthcare colleagues including doctors, in hospitals, outreach teams, patient’s homes, residential care, hospices, and general practice as well as in community pharmacies.

As highly-skilled professionals they do have a thing or two to advise GPs on, such as safe and effective prescribing of medicines, utilising evidence based practice, and medicines use by patients, to name just a few! Perhaps Dr Copperfield doesn’t know that his bacon has been saved many times by a pharmacist…

 And yes, we can do more and do it really well. Local pilots show that collaboration and sharing clinical information with pharmacists have huge benefits in terms of safer, better patient care. But for this to be successful everywhere it needs a shift in thinking. We suggest Copperfield read the recently-published Pulse article, How we reduced workload by working with pharmacists.  

Perhaps it is time to drop the sarcasm and focus on the positive. In between blogging and caring for patients, maybe  Dr Copperfield could take some time out  to harness the relationship with his local pharmacists which will improve the care provided for patients. We would be delighted to help.

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Readers' comments (16)

  • Copperfield is quite right. For example, 'Boots' is n't vaguely like a 'pharmacy'. One has to fight down yards of aisles, through 'poor' women buying smelly junk to get to a tiny counter where the pill-counters are in chaos. They decant scrips from large containers into smaller ones.This ridiculous 'health-care professionals' nonsense is plain silly.

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  • The Boots analogy is only one end of the scale. At the other end we have the local pharmacy who know their customers, understand them and have the time that no GP seems to have. They also have the common sense to ask about over the counter medication being taken when they dispense the prescriptions, how often do GPs do that?

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  • It seems to me that there is a great opportunity for GP's to work more closely with pharmacists, especially the more independent pharmacists rather than the high street chains, that will be to the benefit, not just to their collective patients, but also for the GP's and pharmacists alike. For example, why not give the pharmacists the opportunity to focus on the NHS vascular health checks for the 40-74 year olds in the first instance, and any patients detected with undiagnosed and asymptomatic high BP, high cholesterol levels, diabetes, etc., to be counselled in lifestyle changes where appropriate and in more serious cases be referred to the relevant GP practice for further investigation and treatment. This allows the GP's to focus on the "sick" rather than having to routinely test everyone according to NHS England policy / guidelines. Surely such co-operation will lighten the workloads of GP's allowing them to focus on the sick, with pharmacists "screening" the population. This funnel approach is more cost effective and will certainly achieve the uptake targets required by NHS England for their health checks programme. I believe that in Germany and Italy, pharmacists are routinely performing health checks in the first instance with onward referral to medical professionals when a problem is detected that requires further investigation. This approach also seems to strongly engage patients to be more responsible for their own health rather than being reliant on a particular free at the point of care health system.

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  • Any Pharmacist who sells 'cough medicines' should be debarred from offering any form of health advice as an NHS paid service.

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  • Anonymous 7:51

    I would love someone else to do the health checks to free us up to see the sick. Unfortunately the Government does not value the core work that we do.

    It does not pay the true cost of a consultation so we are forced to scrabble around for extra funding to pay for our running costs.

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  • The tenor of these comments seems to be that pharmacists can do these "simple" things more efficiently than GPs. I have three problems with this: 1. Pharmacists are not clinicians. GPs are. 2. They are businesses and make a profit from selling medications (unlike GPs) 3. GP in the UK is extremely cost effective, as we all know. Why should a private pharmacist be able to do health checks more cheaply that us?

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  • It was only a humorous rant. Okay so maybe many a true word is spoken in jest. I am a DN, he had a swipe at us too, I was amused but it was also the most useful bit of "realtime feedback" that I have seen in these feedback obsessed times.

    Surely we all need to keep a seems of humour. This is a sight for GP's, if we don't want to know what they think we don't have to read it. I find him a brilliant antidote to the NHS madness that we put up with on a daily basis.

    Now where are those swabs...

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  • As a GP who works with pharmacists for a significant proportion of the week, I am dismayed at the lack of basic knowledge that GPs are displaying here. GP trainers listen up, your registrars need educating!

    We need to realise and support the fact that our patients visit the pharmacy 14 times a year on average, and that the pharmacists don't have a workforce crisis like we do. Google "healthy living pharmacy" to learn some of the possibilities.

    50% of our prescribing is wasted as patients don't take the meds properly, but the pharmacists can assist with adherence and IMPROVE the patient outcome.

    Finally, only a small proportion of their income is from selling things, the same as general practice. Their income is from dispensing and providing enhanced services. Our income is from core services & enhanced services.

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  • Pharmacists don't have a workforce crisis only because the UK is being flooded by E. European pharmacists who are undercutting established UK pharmacists.

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  • very true regarding the workforce but also numbers of home grown pharmacists have been ramped up in numbers over several years meaning lower and lower pay. PJ used to have many job ads but now individual people take adverts out to advertise their services!
    As for local independent pharmacies that know their patient population well - they are a dying breed. A private business owner cannot compete with large chains for several reasons. Sounds a bit familar to the dying breed of local single/dual handed GP practices?

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