The merits of handing pharmacists new prescription powers are being hotly debated after the government announced bold new plans that it hopes will free up 15 million slots at doctors’ surgeries over the next two years.
In a bid to ease pressure on overstretched GP services, pharmacists in England will, for the first time, be allowed to prescribe medication for seven common conditions – earache, sore throat, urinary tract infections, sinusitis, infected insect bite, impetigo and shingles – without a doctor’s input.
Additionally, half-a-million women will no longer need to speak to a nurse or GP to get oral contraception and the number of patients accessing blood pressure checks in pharmacies will more than double to 2.5 million a year.
The primary care access recovery plan, backed by £645m of spending over two years, is likely to kick in by next winter. It will also include investment in better phone technology for GP teams.
Rishi Sunak says the decision to expand the role of pharmacists is a personal one. After working as a boy in his mother’s pharmacy in Southampton, he witnessed first hand the “powerful connection” she formed with patients in the family shop – and saw just how much people trust their local pharmacist.
The PM also says he hopes the reforms will eliminate the 8am rush for appointments, meaning no patient will have to wait on hold only to be told to call back another day.
The plan represents one of the biggest shake-ups in the way prescriptions are managed in England since the NHS was created 75 years ago. But how much difference will it actually make?
The broad consensus seems to be that allowing pharmacists to play a much more central role in managing the nation’s health is, in itself, a sensible idea. The National Pharmacy Association described the move – which is already implemented in Scotland – as “a long overdue step”.
Richard Sloggett, programme director at the Future Health Research Centre, approves. “There is lots to welcome in today’s plan,” he told Reaction.
Yet Sloggett also pointed out that freeing up 15 million appointment slots represents less than 4% of the total number of appointments over the last year. Since the pandemic, there have been roughly 24 million more GP appointments annually, compared to the year from April 2019 to March 2020. Meanwhile, the number of fully-qualified, full-time GPs has declined: as of March this year, there were 2,000 fewer practicing than in September 2015.
So, while a step in the right direction, Sloggett warns: “The claim that these measures will end the 8am scramble feels decidedly premature.”
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What’s more, the growing number of local chemists going out of business risks complicating the plan. Thanks to staff shortages, the ever-increasing prices of medicines and the higher general costs of doing business, over 800 pharmacies have closed permanently since 2015. There are now just over 11,000 community chemists, according to NHS data – the lowest figure in eight years.
“There is a shortfall of £1.1bn in pharmacy funding every year and rising,” warns the Association of Independent Multiple Pharmacies. So the plan must be sufficiently funded to ensure it doesn’t simply ease pressure on GPs by shifting it onto pharmacies.
Another thing to consider is the training pharmacists will require to take on these new responsibilities. From 2026, all newly qualified pharmacy graduates will have a prescribing qualification, but this will take some time to feed through.
The proposals come at a time of growing concern about the over-prescription of antibiotics – and resulting antimicrobial resistance. Ear infections, for instance, which feature on the list of seven common conditions soon to be treated by pharmacists, clear up on their own in many instances, and are often treated unnecessarily with antibiotics.
This means the plan will need to be rolled out carefully, with some very good guidelines for pharmacists.
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