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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

pharmacistJanuary 20 2016

UCL School of Pharmacy is proposing that community pharmacists could extend their clinical roles and help free up GP time equivalent to 5,000 extra GPs.

Its new discussion paper looking at primary care in the 21st Century says there is a need for health and social care to improve its capacity to offer “convenient access to preventive and ‘common need’ diagnostic and treatment services to people of all ages.” It also says that health care in future will move towards more professionally facilitated preventative and primary care support self-care in the community.

Evidence already shows the role community pharmacy can play in delivering accessible health care alongside optimising medicines usage, and that increasing the number of clinical pharmacists in general practice is a valuable step. However, “it cannot substitute for a clear vision for the future of community pharmacies as ‘first contact’ health care providers,” says the paper.

“If community pharmacists successfully extend their clinical care roles this would free general practice and linked community capacity to work towards reducing inappropriate hospital admissions and unduly long inpatient stays. Without well planned, pro-active, interventions pharmacy skills will be under-used and the established community pharmacy network lost.

“If each community pharmacy in England were able to take on just 10% of the average general practice’s existing workload over the next five years, this will release approaching 5,000 GPs and similar volumes of practice staff for additional service provision.”

The paper is intended to address issues around rapid service access and the need for well-coordinated person-centre health and social care at every stage of life. It points out that nine out of ten people live within a 20 minute walk of a pharmacy, but warns against planners who want to see savings made via concentrating dispensing in warehouse-like facilities and increasing the use of medicines home delivery services.

“At a system-wide level, a potentially more desirable way forward could be to extend pharmacist prescribing and improve shared health record systems,” suggests the paper. “This would combine convenient local medicines supply with more accessible forms of ‘pharmacist first’ care in areas ranging from managing blood pressure to providing better chronic obstructive pulmonary disease (COPD) and type 2 diabetes prevention and care.”

The paper argues that “well-coordinated and clinically empowered” community pharmacy services could, contribute more to the appropriate management of long term conditions. This would be done in partnership with, or as an integral part of, bodies such as GP federations or organisations such as multispecialty community providers (MCPs)

“To be cost effective, this will almost certainly require them to become an alternative direct source of some types of care currently offered in general practice, rather than merely a provider of services aimed at augmenting work that continues to be done by GPs and their immediate colleagues,” it says.

“There is good reason to believe that as IT based links and diagnostic and other support instruments become increasingly available in pharmacy settings and in places like residential and nursing homes, pharmacists will – subject to regulatory restraints – be able to offer a progressively widening range of direct access illness and preventive services.”

Link:

UCL School of Pharmacy ‘Primary Care in the Twenty-first Century’. January 2016

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