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Pharmacists to hand out emergency medication supplies without GP approval



NHS 111 will be referring fewer patients to GP out-of-hours services and A&E, under new plans announced by the Department of Health.

The DH said GPs were currently spending ‘nearly 40% of their time advising patients on minor ailments’ but, starting from December, NHS 111 will send patients requiring urgent repeat prescriptions, or suffer minor issues like ear aches, sore throats or bites, straight to community pharmacy instead.

Under the plans, pharmacies will be given direct powers to hand out medicines to patients who have run out, without the approval of a doctor, as long as their surgery has put the prescription on repeat. The DH said NHS 111 currently receives 200,000 calls each year from patients needing urgent prescriptions.

Asked how GPs would be kept informed about their patients’ medication, the DH said it would be done via a direct communication from the pharmacy, for example secure email or other confidential communication.

The Summary Care Record, which is in the process of being rolled out to community pharmacies nationally, ‘will be available as an additional safety net to check the patient’s usual repeat medication and any medicine related allergies’, the DH added.

At the time of writing, it had not clarified whether pharmacies would be giving patients their full supply of medication or just a stop-gap.

NHS England will evaluate the success of the Pharmacy Urgent Care pilot by April 2018, but the DH said it has already been trialled in the North East, where it was ‘positively received by patients and supported the resilience of the local urgent and emergency care system’.

Community health and care minister David Mowat, who announced the launch of the programme at a pharmacy awards ceremony last night, said it was part of a DH ‘drive to meet increasing demand for services’, would be ‘bringing clear benefits to patients and the public’, and also was ‘making the best use of taxpayers’ money’.

He said: ‘Community pharmacists already contribute a huge amount to the NHS, but we are modernising the sector to give patients the best possible quality and care.

‘This new scheme will make more use of pharmacists’ expertise, as well as freeing up vital time for GPs and reducing visits to A&E for urgent repeat medicines.’

Professor Keith Willett, medical director for acute care at NHS England, said: ‘Directing patients to go to a community pharmacy instead of a GP or A&E for urgent repeat medicines and less serious conditions, could certainly reduce the current pressure on the NHS, and become an important part of pharmacy services in the future.

‘This pilot will explore a sustainable approach to integrate this into NHS urgent care.’

The GPC said the scheme was ‘sensible’ and could be an ‘important part of  workload management’.

Prescribing lead Dr Andrew Green said: ‘GPs working out of hours do find a large number of calls coming to them are from patients who have forgotten to order repeat medications. There are mechanisms in place for pharmacists to provide short supplies in such situations but these are not often used.

‘Using the NHS 111 service to direct patients there, where appropriate, may well relieve pressure on the OOH service.’

It comes as out-of-hours services are struggling with a lack of available GPs to fill shifts, with out-of-hours leads have warned that the number of out-of-hours GPs needs to grow by 30% to meet demand.

Can pharmacists relieve GP workload?

This is the latest in a number of NHS schemes to reduce pressure on GP practices with the help of pharmacists, including last year’s pilot placing pharmacists in GP practices to see patients.

Following this, the GP Forward View went as far as to promise that every practice in England will get access to a clinical pharmacist.

But it comes as, at the same time, there are warnings GPs will pick up the slack when community pharmacy suffers a 6% budget cut next year.

There has been warnings that up to 3,000 pharmacies could close as a result of the funding cuts, with critics pointing out this could mean patients turning to their GP instead with minor illnesses.