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‘GPs on the cheap’? Pharmacists must not be seen as GP substitutes, says RCGP

The Royal College of General Practitioners (RCGP) has said that pharmacists are not a substitute for GPs and “must not be seen as GPs on the cheap” because of the services they provide.

RCGP chair Professor Kamila Hawthorne made the comments in response to a new report published by the all-party parliamentary group on pharmacy (APPG) last week (January 23).

In a statement published the same day, Professor Hawthorne said that “pharmacists are not a substitute for GPs and the services they provide must not be seen as ‘GPs on the cheap’”.

“While we are keen to see initiatives that will ease the pressure on our struggling family doctor service, pharmacists should not be expected to work beyond their areas of competency,” she added.

Read more: Primary care recovery plan: Barclay wants pharmacists to do 'even more'

And she said that the government “will find that [pharmacists’] role is not a solution to the chronic shortage of GPs as many patients come to see us with more than one problem and these can be complex”.

"Patients should be able to get high quality, safe, and appropriate care when they need it – and in many cases, they will need the expert diagnostic skills and expertise of a GP,” she added. 


“Right” to give pharmacists support to stay viable


However, Professor Hawthorne also said that it “is right that [pharmacists] are given the support they need to stay viable and available for people with minor illnesses and ailments”.

“Our high street and online pharmacist colleagues do an excellent job for their communities and are providing invaluable support to many GP practice teams against a backdrop of huge workload and workforce pressures,” she added.

The APPG report warned that the government must take “urgent action” to relieve funding pressure on community pharmacies.

It set out the group’s “manifesto” for the “future of pharmacy” and called for more funding and reform to the current funding model as well as funded independent prescribing training and a properly funded pharmacy walk-in service.

Read more: PSNC kicks off ‘proper discussions’ on Pharmacy First with DH


A “better use” of pharmacies can relieve pressure from GPs and other parts of the NHS but pharmacies “can only do so if given the right support and investment”, it said.

Laura Wilson, director for Scotland at the Royal Pharmaceutical Society, said: “The role of a pharmacist is not the same as that of a doctor. Pharmacists have a unique role around medicines and patient safety and play an integral part of multidisciplinary healthcare teams who work together to benefit patient care.”



Pharmacists are “highly trained professionals”


Pharmacists’ Defence Association (PDA) director Paul Day stressed that a pharmacist is a “highly trained health professional”.

“Each heath profession has distinct skills and competencies, which can combine to provide the very best of patient care,” he told C+D.

Read more: Patient groups set out vision for ‘future role’ of community pharmacy

The government must “think and act holistically so that this is achieved”, he added.

And the PDA “certainly agrees” that GP practices employing pharmacists “should ensure that none of their employees are being expected to work beyond their areas of competency”, Mr Day said.

The union also agrees with the RCGP that “patients should be able to get high quality, safe, and appropriate care when they need it”, he added.  


“I don't want to be seen as GPs on the cheap”


Manor Pharmacy Group pharmacist and managing director Graham Phillips told C+D that he “broadly agrees” with the RCGP.


“I don't want to be seen as GPs on the cheap, I want to be seen as a maxi-pharmacist doing good stuff – to at least the same standard as our GP colleagues, not less,” he said.


“I do think we fall into this trap of saying we can do everything more cheaply – I'm not sure that's true and I'm not sure that's the right positioning for a quality service anyway,” he added.


Read more: Medway pharmacies to offer NHS health checks in year-long pilot


Mr Philips told C+D that pharmacists “can definitely take pressure off GPs” by taking on minor ailments, prescribing and managing long-term conditions so that GPs can be freed up “to do clinically complex work for which we don't have the skills and never will”.


“Pharmacists can't do everything a GP can do, but the fact is they can do quite a lot of it,” he said.


“That doesn't make us GPs on the cheap,” he added. “That makes us equivalent health professionals working in a team, in a collaboration with the patient at the centre of everything we do and it's about capacity and capability and quality – not cheapness”.


Read more: 'High' patient confidence in independent prescribers, study shows


Contractor Amish Patel, who owns Hodgson Pharmacy in Kent, said there was "some truth" in Professor Hawthorne's comments.


"I think there is some truth in it, in a sense that we have our own specialities and we can't deny that," he told C+D. "As pharmacists, we are specialists in medicine but we do take on prescribing roles now and our roles are becoming advanced."


He continued: "That's not to say that I would claim to be necessarily as knowledgable as much as a clinical expert as a GP for example. So, yes, we should not be seen as cheap GPs.

"We should be appropriately remunerated for the services that we offer, and at the same time we should be utilised for our skillset, which would support relieving pressure on GP colleagues."


Meanwhile, Nahim Khan, a portfolio pharmacist based in Warrington, said Professor Hawthorne's statement "confused" him.


He commented: "A few years ago, there was a lot of joint working between the profession and the RCGP and pharmacists working in general practise, so they should be aware what our general skillset is.


"There's still a great role for dispensing but if they're saying they're overworked and they need support, why not give community pharmacy some of that work?"


But he said he was "not offended" by the comments.


"There's always a scrap over flu [jabs] and who's doing what so I'm not surprised. But I think it's just disappointing."

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