NEWS Move to bring pharmacists into GP surgeries
A new initiative to bring pharmacists into GP surgeries has been announced by the Department of Health. Health Minister Simon Hamilton said he hoped the multimillion pound scheme would alleviate pressure on doctors and make it easier to get appointments.
Pharmacists will be able to carry out routine medication reviews and advise patients on medication, working as part of a team with GPs and practice nurses. Some £2.55 million will be rolled out during the 2016/17 financial year, rising to £14 million a year in 2020/21. Doctors delivered 875,000 more consultations with patients in 2013/14 than in 2010/11.
In 2016, 46 Pharmacists will be recruited immediately to work full time in GP practices, then after six months that figure will be expanded to include up to 90 Pharmacists. After another six months, an additional 50 Pharmacists will be recruited leading to an estimated 140 Pharmacists working full time among GP practices in NI at the end of the first year.
After five years, it is hoped that the number of Pharmacists working in GP practices will be a little over 300, thereby providing a new type of primary care service.
Gerard Greene, CPNI Chief Executive told Pharmacy in Focus, “We are pleased to see that the Minister recognises the medicines expertise of Pharmacists and the role they can play to better support patients. We also appreciate the workforce issue facing our GP colleagues at this time and understand their drive to help combat this by utilising Pharmacists’ skills to relieve practice workload.
“The HSC system and primary care are undoubtedly under pressure and while of course we sympathise with GP pressures, we can see that the limitations of this approach which offers only a short-term solution. In order to properly transform the HSC system we firmly believe that patient care should be supported outside the practice setting, where appropriate, closer to patients at home. GP practices are bottle-necks in terms of patient demand and expectation, the real objective for the health service should be to how best to divert patients away from clogged areas in the system by facilitating care provision in alternative settings such as the community Pharmacy. This would allow GP practice staff to concentrate on managing acute care and higher risk patients.”
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He added, “Community Pharmacy teams are the most accessible in the HSC service and community Pharmacists are usually the healthcare professionals that patients see most regularly. A wealth of national and international evidence supports enabling community Pharmacists to play a greater role in patient care not only by supporting prescribing, adherence and review of medicines but also through maximising early intervention and preventative strategies, with the Pharmacy acting as the community interface between patients and the HSC service.
“In order to support long-term transformational change, we would support investing in both community Pharmacy and GP settings. A co- investment in the Pharmacists and services that are provided in community Pharmacies aligned to an investment in GP practice based Pharmacists alongside integrated IT with access to the Electronic Care Record, offers the best long term solution to the HSC service. Such an approach would quickly realise some of the recommendations in both Transforming Your Care and the Donaldson Review.
“So while we welcome this initial investment, we encourage commissioners and politicians to look beyond the GP practice to look at new and innovative solutions in community Pharmacy which will yield much greater long term rewards for patients and the HSC service.”
The announcement has been welcomed by the British Medical Association (BMA).
Dr Tom Black, Chair of the BMA's GP committee, said doctors were dealing with "unprecedented pressures".
"The five year investment from the Department and HSCB will go some way to alleviating the crisis faced by GPs in Northern Ireland whereby they are dealing with increased bureaucracy, rising patient lists and a shortfall in the number of training places available for GPs in Northern Ireland."
NPA Representation Manager in Northern Ireland, Anne McAlister, said, “We are supportive of a multidisciplinary approach, utilising Pharmacy skills alongside other disciplines to ensure that services are delivered as close to patients/service users homes as possible, empower patients and promote health and prevent illness to provide the best possible patient outcomes.
“We are however keen to highlight the role that community Pharmacists have to play in reducing demand on GP practices and optimising medicines use. For example, research undertaken by Pharmacy Research UK in 2014 showed that approximately 18 000 000 GP visits for minor ailments could be treated by community pharmacy. Yet the current minor ailments service in Northern Ireland is limited to ten specific conditions.
“In order for community pharmacists to play a greater role within health and social care it is imperative that there is appropriate read and write access the patient health records and the NPA stress the need for this to occur sooner rather than later,” she added.
UCA President Cliff McElhinney cautiously welcomed the news that DHSSPS is investing in primary care pharmacy services.
“Transforming your Care highlighted greater utilisation of Pharmacists’ skills and a multi-disciplinary approach to ensure that the right healthcare can be provided to people where they need it – closer to home,” he says.
“Pharmacy, through its community network, is best placed to deliver a range of health services in conjunction with other primary and secondary care colleagues; services which can optimise patients’ use of their medication, prescribed or over-the-
counter, reduce wastage and prevent unscheduled hospital admissions. The strength is the community Pharmacy network. The UCA welcomes the addition of Pharmacists to GP surgeries, where they liaise with the local Pharmacy network to enhance the primary care offering.
“However, GP surgery Pharmacists cannot alleviate the pressure on the surgery alone. It would be a mistake to think that that is the case. The community Pharmacy network is the strength of Pharmacy. Primary care Pharmacists are not new – we have been on the High Street for over 100 years.”
He goes on to add that this opportunity presents an excellent platform to promote collaborative working to improve outcomes for patients.
“Community Pharmacy already provides a Minor Ailment Service, Managing Your Medicines and Medicine Utilisation Reviews, not to mention excellent services such as smoking cessation. But the addition of services such as flu vaccinations or services to support patients on new medicines or following discharge from hospital, will make a real difference to patients and alleviate pressure on the GP or secondary through unscheduled admissions.
“Real commitment to and investment in programmes such as Health + Pharmacies, access to patient records and integrated care is necessary to realise not only Transforming your Care but also Making It Better, originally published back in 2003. The UCA is calling on the Minister and Chief Pharmaceutical Officer to redouble their efforts to implement this strategy, resolve the contract negotiations with CPNI and invest in community Pharmacy services to deliver better patient care.”
“While we welcome this initial investment, we encourage commissioners and politicians to look beyond the GP practice to look at new and innovative solutions in community Pharmacy which will yield much greater long term rewards for patients and the HSC service”
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