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Pharmacy First ‘will fail’ if people ‘keep having to return to their GP’, MPs warn

Pharmacy First ‘will fail’ if people ‘keep having to return to their GP’, MPs warn

Pharmacy First ‘will fail’ if patients ‘keep having to return to their GPs’, a group of influential MPs has warned.

A new report by the House of Commons health and social care committee said that patients’ concerns about ‘being referred back to the GP’ if they go to community pharmacies to receive care ‘should ring alarm bells for the Government’.

Under Pharmacy First, GP practices refer patients to community pharmacies for seven common conditions – including sore throats and ear infections – but some GPs told Pulse that the scheme was not working as intended, with some pharmacies directing patients back to general practice for a variety for reasons.

The health and social care committee report acknowledged that medicines shortages are one of the reasons patients are redirected to their GP, and recommended that regulations ‘must be updated within three months’ to allow community pharmacists to make dose and formulation substitutions for out-of-stock items and ‘dispense what they have available’.  

The report said that it is ‘especially worrying’ that shortages are resulting in patients being directed back into general practice, and that there is a ‘serious risk’ that any capacity that general practice gains through Pharmacy First ‘will be negated by the time spent re-issuing prescriptions as a result of shortages, thus undermining this initiative’.

The committee also added that to ‘avoid patients continuing to use GPs for support’ that could be offered by community pharmacists due to concerns about ‘affordability’, over-the-counter medication should be free for people on low incomes as part of Pharmacy First.

The report said: ‘Pharmacy First, the Government’s flagship policy to free up GPs’ time and capacity, will fail if people keep having to return to their GP.

‘Regulations must be updated within three months to allow community pharmacists to make dose and formulation substitutions for out-of-stock items and dispense what they have available, with generic substitution to follow after consultation on implementation to avoid unintended consequences.’

It recommended the introduction of generic substitution, which should follow a government consultation focusing on ‘how best this policy could be implemented to ensure patient safety’.

‘We believe that allowing generic substitution would be an important way of reducing the need for patients to return to their GP for out-of-stock medication,’ the report added.

The ongoing evaluation of Pharmacy First should also include an assessment of the extent to which pharmacy and general practice digital systems are enabling the necessary data sharing ‘to protect patient safety and ensure continuity of care’.

As part of the service, community pharmacy IT systems will automatically send details of patient consultations to general practice clinical IT systems via GP Connect.

The GP Connect functionality which will enable pharmacists to add to GP records with ‘one click’ was originally due to be live in time for the Pharmacy First launch on 31 January 2024 but is still currently being rolled out, with only one IT provider, Cegedim Rx, currently live with the functionality.  

The report added: ‘We ask that the Government sets out what progress has been made on rolling out the full digital product for the documentation of Pharmacy First consultations, including the percentage of community pharmacies that have fully functioning and interoperable read/write access to patient records.’

Earlier this month, trade leaders said that pharmacists are supplying antibiotics ‘only when absolutely necessary’ as part of Pharmacy First, so concerns that the scheme would drive antibiotic resistance are so far ‘unfounded’.

NHS England has said it will closely monitor the scheme’s impact on antimicrobial resistance.


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Please note, only GPs are permitted to add comments to articles

Simmering Frog 29 May, 2024 11:39 am

Dead scheme.

What needs to happen is to change the rules so GPs can take over pharmacies and pharmacies can take over GPs – allow us to sell goodwill. The whole sector would innovate and integrate very quickly indeed.

Not on your Nelly 29 May, 2024 1:00 pm

How well is this being monitored? how do they know how many patients are being told to see their GP on the day for slightly high blood pressures, not being able to deal with sore throat or ear aches? how many? where is the evidence? Why can’t this same money be redirected so GPs can actually do this in one go?

Mo Anon 29 May, 2024 1:52 pm

The pharmacist gets paid more to consult the patient than the GP. This is designed to damage and break primary care. money should be re-directed to primary care in its entity.

Truth Finder 29 May, 2024 2:13 pm

It has already failed. The usual see GP is still happening.

Dr No 29 May, 2024 2:17 pm

Nelly and Anon, you know the answer of course already. There IS new money it’s just forbidden for it to find its way to GPs. Any crazy scheme, any unevidenced “innovation” or pseudo-medic can have some dosh, but NOT GPs. It’s because the Tories want rid of us. We are overtrained and expensive. We are being phased out.

Marilyn Monroe 29 May, 2024 7:59 pm

A confused and slippery slope wide open to a whole bunch of unintended and undesirable consequences. There is too much government in medicine

Peter Frost 29 May, 2024 10:44 pm

Simmering Frog raises a serious issue.
It makes no sense to have pharmacy and primary running separately…. on so many levels.
The role of a conventional high street pharmacist is a redundant concept, and the sooner this is grasped the better.
Dispensing Drs are being slowly strangled by red tape, so the playing field is not even.
The training for Pharmacy first is laughable – how to use an otoscope… 5 minutes….I know the “training” that has happened in my area. We have seen cases where antibiotics have been issued but the patient has still be told to see a GP?
Pharmacists should be working in GP surgeries, and the money from drug sales/dispensing ploughed back into primary care, rather than going into the pockets of the hedge fund managers that own Boots et al.
Pharmacy first is being pushed for ideological reasons, but no mention is made of the profit made by pharmacy pushing non evidence based treatments on patients – millions wasted on cough mixtures and branded OTC drugs that can be bought for pence rather than pounds eg Feminax and the multitude of branded NSAID, antihistamines etc etc Patients are being ripped off rather than helped by the majority of pharmacy’s and it’s not their fault – they have to sell otc meds to survive.
Pharmacists can, and do have a huge role to play in primary care (they do in my Practice – one of my partners is a pharmacist) and they could achieve so much more when in embedded in primary care where they can get the clinical training they need and also use the vast amount of knowledge they undoubtedly have.
Government should be looking at big pharma and pharmacy itself – the whole system needs radical reform.

Yes Man 30 May, 2024 7:29 am

When will they understand that no one can manage risk like GPs can?! Maybe we should stop making it look so easy?