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General practice hasn’t vanished, but I wish community pharmacy would


fruit and veg prescription


Hard to judge, wasn’t it, when the managing director of a large chain of pharmacists recently suggested that the rest of primary care had disappeared during lockdown? Was this pharmacists deliberately putting the Boots into general practice? Or was it merely an unfortunate case of Boots in mouth?

After all, it is so easy to mis-speak. I could say, for example, that, from my perspective, the main function of community pharmacy is to flog placebos, leave me with surplus flu vaccines and tell patients to see their GP for antibiotics when they don’t really need them. But that might not be what I actually mean.

On the other hand, this incident, together with Pulse’s current ‘re-think primary care’ project, has got me wondering what, exactly, community pharmacy is for. And, to be honest, I’m struggling. The more I think about it, the more pharmacies seem to be an anomaly, providing a service that is incongruous or redundant.

So they dispense and deliver medication – OK, you could do that with a cupboard, a car and a grade C in maths. They manage minor illness – but most trivial ailments are self-limiting, don’t require any professional input at all and get better despite ‘remedies’ (cough mixtures, anyone?). They advise on over-the-counter medication – yet they’re not diagnosticians, so how can they rationally guide treatment? They provide advice and follow-up for long-term medication – as if GPs don’t have training in pharmacology and don’t do this already.

And so on and so forth. All this, of course, within that uncomfortable tension of pitching for scientific credibility while running a shop. No wonder they’re forever trying to redefine and elevate their role, which perhaps explains the increasing numbers working within general practice, where they can do something worthwhile.

And for the avoidance of doubt, yes, that’s in general practices that are open, and always have been. And for the avoidance of further doubt, yes – I am saying that, if you dreamed up primary care from scratch, certain facets really would disappear, and it wouldn’t be GPs.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

PLEASE NOTE: WE HAVE IDENTIFIED A GLITCH IN THE SYSTEM THAT IS REMOVING COMMENTS AUTOMATICALLY. WE ARE WORKING ON FIXING THIS. APOLOGIES FOR THIS

READERS' COMMENTS [12]

Patrufini Duffy 7 July, 2021 3:13 pm

Still I am confused – why pharmacists can sell dubious Nexium, limitless non-evidence based syrups and linctuses and flog £20 eczema creams to new mums beside an NHS contract. While you, can’t sell zero. Not even a private letter, without an argument. Let’s not start on dentists, and their electric toothbrushes and toothpaste. Modern slavery and utter contempt for your profession.

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The Prime Minister 7 July, 2021 4:03 pm

THE ONLY THING “DISAPPEARING” IS THE TAX PAYERS MONEY INTO BOOTS GREEDY HANDS……THEY RECIEVED £136 MILLION IN TAX PAYER “ADVANCED” FUNDING IN 2020 AND HAVE ONLY PAID BACK £25 MILLION…WHERE IS THE REMAINING GREEDY £111 MILLION????

TALKING OF DISAPPEARING…..AS ONE FAMOUS MAGICIAN ONCE SAID “NOW THAT’S MAGIC”…..

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John Graham Munro 7 July, 2021 4:12 pm

When my Practice disappears for so-called half day training, the local pharmacist cannot cope with the multitude of patients turning up——there’re not doctors see——–no matter how highly qualified we’re told they are

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John Graham Munro 8 July, 2021 8:30 am

My surgery shut shop for the so called half day training again last week——–the local pharmacy could not cope with the deluge of patients——-pharmacists are not doctors , no matter how highly qualified we’re told they are

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Sachin Patel 8 July, 2021 4:55 pm

What a bigoted article. Without pharmacy, you would be in tears.

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Scottish GP 8 July, 2021 6:18 pm

Tears, I think not, dispensing and in clover more like. Sticking labels on boxes looks a little easier than ftf GP!

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Mark Davis 9 July, 2021 1:35 pm

If Pharmacists weren’t there, think of the trivia that would be queuing up to see us.

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Neil Wellappili 9 July, 2021 2:41 pm

Bit of an unfair target this week perhaps.

Keith M Laycock 10 July, 2021 12:39 am

Copperfield is absolutely correct and I would add ‘What about the conflict of interest component’?
Selling unproven quasi-medical products, well displayed for the gullible public.

James Cuthbertson 10 July, 2021 8:36 am

Getting my prescriptions switched to a large online provider has been a godsend- no more queuing up to be told xyz isn’t available and can I come back in 48 hours.
I guess we’re sick of more and more people being involved in the patient advice business who don’t retain any responsibility for the patient. GP is rapidly moving from being the first point of contact in ill health to the dustbin where patients are sent when everyone else has given up with them.

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Finola ONeill 12 July, 2021 1:44 pm

“I guess we’re sick of more and more people being involved in the patient advice business who don’t retain any responsibility for the patient.”
That is totally, totally it.
Clinical psychologist: I think patient has ASD, can you refer them to specialist ASD service. I inform there is a pathway for them to refer. No we can’t we don’t have x info, etc, etc. Nor do I, have never spoken to said patient.
A&E SHO, can you please f/u with cardiac monitor/cardiology ref, whatever. No, it’s not clinically indicated.
“Nurse specialist”, during Pandemic, asking for advice re rheum meds, advises me to visit patient at home. Er no, I wanted advice on rheum meds.
And the long list of patients advised by the pharmacist to come to me usually for symptoms that don’t need any treatment.
Actually the PCN physios are excellent, and physios generally don’t tend to increase our workload, they are very useful.
PCN pharmacists can be useful but then I guess we are already filtering out what we want them to do rather than being on the receiving end of their turfs.
Re Mr Boots. Boots are trying to muscle in on private primary care services so that was all very deliberate as is the Tory press criticism of GPs. Hoping to push the private sector through asap.

Subhash Chandra Bhatt 13 July, 2021 7:02 pm

Well said fiona
Too many helper just complicates a simple task.
It has not will never reduce work load for go’s.
Too many cooks—————-