GPs have raised concerns around unintended workload consequences from having to check record updates that have been made under the Pharmacy First scheme.
Under the scheme launching 31 January, pharmacists can consult with patients on conditions including sore throats and ear aches.
Community pharmacy IT systems will automatically send details of patient consultations to general practice clinical IT systems via GP Connect. NHS England said that the details will then be ‘ready for a GP to check and update the patient’s record’ and that this ‘will remove the current need for staff to transcribe information from emails’.
But GPs have told Pulse that having to check record updates coming from a pharmacy will add to their workload, rather than save time.
Tower Hamlets GP Dr Selvaseelan Selvarajah said that ‘there isn’t the capacity to check all community pharmacies consults’ and that this wouldn’t be efficient use of GP time.
He told Pulse: ‘The whole point of this scheme was to actually see how community pharmacists can take some of the GP workload away from us, not add to our workload.
‘Community pharmacists are also very supportive of trying to contain the patients within the community pharmacy and only passing the relevant information to the GPs.
‘The GP having to review the details defeats the purpose and devalues the service that they’re offering.
‘I think it’s a welcome initiative but we just need to make sure that the tech works in the right way to support GPs, pharmacists and patients and that everything is done safely and efficiently.’
Dr Emma Nash, a GP partner in in Portchester, said this would negate ‘the benefit to GPs if it has to be us checking their work’.
She told Pulse: ‘In fact, it’s additional work. If we see and prescribe ourselves then it’s recognised as an appointment.
‘This set-up means that we’ll end up doing work on top and there’s so much unseen already. It’s not clear what will happen if we disagree with the management and what if there is a dangerous or potentially untoward interaction?’
Other GPs posted their concerns about the new functionality on X, including dispensing GP Dr Ankit Kant, who said: ‘There are several of us who are GP partners and also have pharmacies – we would have loved to have contributed to the framework behind Pharmacy First and wider clinical services.
‘This implementation is concerning as both a pharmacy owner and a GP partner.’
Leigh GP Dr James Weems said: ‘There should be absolutely no checking on the part of the GP. These are independent pharmacists operating within their competence. Otherwise it isn’t really freeing up GP time, is it?’
But Dr Neil Bhatia, a GP and records access lead at his practice in Hampshire, told Pulse that many practices have ‘workflow teams’, admin staff with training who sift through documents and only make the GP aware of them if the GP needs to read it.
He said: ‘So I’d like to think that these – seemingly uncomplicated – consultations wouldn’t even end up in my inbox.
‘It does add to the volume of documents we receive from all sorts. But that’s the price we pay for being the “single source of truth” for medical records.
‘GP records are the most comprehensive precisely because we receive, and store, correspondence from all providers.
‘This is no different to receiving a letter from out of hours, or NHS 111, or a hospital clinic. At least we can see, action, “hide” (if needs be, from patient access), and be aware of, what has happened at the pharmacy for our patient.’
Pulse has approached NHS England for comment regarding the concerns.
The seven conditions covered by Pharmacy First
- sinusitis
- sore throat
- acute otitis media
- infected insect bite
- impetigo
- shingles
- uncomplicated urinary tract infections in women
So the pharmacist first practitioner takes the money and I get to check their homework, take on the legal liability, and file documents for a living. Great!
I worry about pharmacists not having much of a future.
They are too well trained to put boxes of tablets in paper bags and sell whistling lollipops but undertrained to see medical conditions independently. They are often too scared of the drugs they handle/sell that it paralyses them.
Going forward, I just don’t see where they fit in. Deregulation and allowing sale of goodwill is what’s needed – to allow practices to take over pharmacies and vice versa.
Surely now that we have decided to abolish continuity and store records outside GP Practices’ control, ‘in the cloud’, then each Practitioner takes on full responsibility for their own interaction, and until the next patient-Practitioner consultation.
Is it not up to the Pharmacy Practitioner to ensure they have fully accessed all previous relevant health records for the patient, and made a suitable ‘handover’-qualifying entry in the records, and be fully responsible for all matters relating to the patient’s health until a different (possibly medically-qualified, possibly not) Practitioner is next consulted by the patient?
Im sorry they are independent practitioner with their own training and indemnity, the responsibility lies with them.
However, as far as we are concerned the local chemist just sends them all back to us anyway, so we will just continue to see patients as usual.
Our local family run pharmacy has just been sold to a chain who seem to be gearing up to take on Pharmacy First. Income generation for the Pharmacy, workload generation for GPs
Any initiative that allows non medically qualified clinicians to autonomously and safely take some of the workload away from general practice is to be welcomed but we cannot be expected to monitor this. If the work cannot be guaranteed clinically safe then it should not be undertaken in the first place, harm could have been done by the time we get to check it and although we cannot be held responsible we will have to deal with the consequences. And don’t forget that if outside agencies enter inappropriate coded information this can at best mess up the clinical record and at worst affect our QOF records in a way that we cannot change ourselves without requesting mark in error and following up.
Pharmacists do an excellent job at giving advice but even if overqualified for some of their tasks they are under-qualified for clinical work involving maintaining a shared clinical record.
Just shows you. When The System designs any such initiative, GP time is valued at £0 and GP capacity to undertake any work generated by other providers is assumed to be infinite. It’s a fundamental problem.