NHS restructuring has "weakened" relationships between GPs and community health services, including pharmacy, the Royal College of General Practitioners (RCGP) has said.

The professional body criticised the "fragmentation" of primary care budgets between different commissioners and called for pharmacists to be given a greater role in the commissioning process, in its inquiry into patient-centred care published on Saturday (November 22).

The RCGP welcomed NHS England's interest in re-combining budgets by co-commissioning services from pharmacists and GPs. Encouraging more effective collaboration between the two professions could increase support for patients to self-care and improve the medicines management of those with multiple conditions, it said.

It would be possible to protect healthcare budgets from the "undue influence" of GPs with vested interests in specific businesses by instilling "good governance and transparency" in the commissioning process, the RCGP claimed.

The professional body also called for clinical commissioning groups (CCGs) to invest in an "enhanced range of options to support self-care", which needed to be integrated with both pharmacy and general practice. 

GPs' capacity to create personalised care plans for patients was "constrained" and required the support of other primary care professionals with the "time, resources and skills" to deliver them, the RCGP said.

Patients with "very complex" needs could be supported by pharmacists "working in tandem" with a GP, it suggested. The RCGP also believed that primary care providers would increasingly need to build partnerships with commercial organisations such as high street pharmacy chains, it said, as patients were turning to health and wellbeing services offered by the commercial sector, such as home test kits and health tracking technology.

The RCGP stressed the importance of bringing together services such as general practice, pharmacy, mental health and social care to "ensure a smoother continuum" of care for patients. It suggested the use of multispeciality community providers - expanded versions of GP practices outlined in NHS England's Five Year Forward Vision document last month - as one way to do this.

	What services would you like to see co-commissioned with GPs?