Now here's a radical idea...

Completely agree. We would definitely save the NHS millions in the process too
Link back to original article

Absolutely agree Gary. Dr. Charles Alessi (the GP clinical leader, GP Lead on the Future Forum and Chair of the NAPC) firmly believes that GPs should be the diagnosticians, initially seeing patients and setting them off on their treatment pathway. However, he also believes that the long term management of patients with LTCs should be left to a team (including pharmacists) in primary care - a view which I completely support.

A very good idea Gary.Another move that I would propose is to rename the psnc to pnc since they have never negotiated anything that has benefited Pharmacists or the profession that I recall.All they ever seem to do is gleefully announce new proposals that are so difficult to incorporate into a normal day with an increasingly smaller and underpaid staff and offer a woeful remuneration for it.

Hi Paul

Thanks for the message - although I do have to disagree with your statement that dispensing by doctors is quicker, more efficient, safer and what patients want.

What I'm trying to get across in my comment is that if we change nothing, the NHS will simply not cope with future demand - and doing things the same way as they've always been done is no reason to continue to doing it the same way!

You say that pharmacists have more to offer practices "but not in the way you might suppose" - can you expand on this please?

I would not expect you or any of your readers to agree with me Gary, Nor would I expect turkeys to vote for Christmas but I do have the evidence of patient preference in the form of vociferous protests when dispensing practices suffer from the predations of "entrepreneurs' cashing in on this very lucrative monopoly provided by a generous taxpayer.

If you are so confident why does your profession need the protection of a monopoly of doubtful legality. Let the NHS give patients a choice and allow market forces to dictate? We would then know who is right.

To take my observations further take a look at what now happens in hospitals? I agree that doctors are no longer adequately trained and most trust employ clinical pharmacists to assist with medicines management. Surely it would make sense to have clinical pharmacists as an integral part of the primary care team on site, directly employed by the practice whose salary would be paid for by dispensing profits - all at no additional cost to the NHS? Makes considerable sense to me.

Yes indeed, to my mind the only thing this " research" (cheap publicity stunt) has managed to do is highlight the inherent weaknesses, inefficiencies and faults from the enforced separation of prescribing and dispensing in time, place and person, as first proposed by Lloyd George in 1909 as it requires a written note with the inherrent risks of transcription error (Remember the Daonil case?).

This separation was only to prevent the abuse by doctors of his proposed free National Insurance scheme for employed men at a cost of something like a penny a week.

Times have changed as has the technology which is used to prevent such abuse so there now exists no valid reason for this very costly and dangerous separation of roles. What a nonsense it would be if chemists could not sell any item OTC unless a doctor agreed! Seems we doctors are not even qualified to sell paracetamol although our local garage can happily poison the whole school!

If safety and protecting patients lives is genuinely the issue I could expect some honesty from government and indeed from the GMC who should acknowledge the excellent safety record of doctor dispensing or at least find out what we offer and just how safe we actually are. This might actually facilitate a fuller clinical role for pharmacists on site with practices, all of which would need to be dispensing in order to pay for it at zero cost to the NHS..

Actually, as Ben suggests, taking this initiative one step further could save the NHS considerable sums as one does not have to be a highly paid retail chemist to check any doctor's prescribing and dispensing on site well before the FP10 even leaves the premises. That is what my dispensers do for me and yours do for you. No need for EPS or any phone calls hours later when the prescriber has gone home!

What a crazy, antiquated, costly and unsafe system we retain for supplying NHS patients with their medicines simply because the wealthy pharmacy corporations have the ear of governments.

Patient safety? What a joke!

I won't hold my breath as, like priests and monks in the time of Henry VIII, doctors are being set up take the blame while big business is set to take the profits. Did you see the coverage given by the Mail? I could understand their take on this if they were a part of Murdock's News International

tut tut!. . .you are quite wrong Michael .

You know nothing about my practice. I do not write notes I issue electronic orders which are received in the dispensary in milliseconds and acted upon without transcription. Before any item leaves the dispensary it is scanned and checked by software called 'Dispense IT" to ensure the item put in the box is the exact item on the electronic order generated with my key pad

Doctors are human and humans make mistakes. Surely it is far better to a clinician to check the prescription before it leaves the surgery? My prescribing patients and the vast majority of NHS patients do not enjoy that protection.

I agree that doctors dispensing fees are excessive but, in my case, they did pay for a second doctor and for a practice nurse here, both recently made redundant.

Paul,

I couldn't agree more with the key part of your argument that doctors and pharmacists should work more closely together under one roof as an integrated primary care team.

But rather than GPs employing pharmacists, I'd argue that it should be pharmacists employing GPs. It would be better for patients (more accessible premises, better trained staff) and better for the NHS (more efficient use of resources and more innovative services).