The tension was inevitable. When pharmacy was commissioned to provide a national flu vaccination service in July, PSNC warned that GPs would not be happy – and the prediction has not taken long to come true. Just one month into the service, and GPs have already complained about the way pharmacists are marketing their services, while pharmacists feel similarly wronged.
There is one thing both sides will probably agree on, at least in theory, though: the flu service should be about patient care, not fierce competition. And the only way to put a stop to this competitive atmosphere is by taking steps to nip it in the bud. So if you’re keen to make the first move, how should you approach your local surgery? Dean Eggitt, GP and secretary of Doncaster local medical committee (LMC), gives his advice based on disputes in his area.
Set up a face-to-face meeting
Pharmacists haven’t had much time to communicate with GPs about the flu service, which was announced just two months before it began in September. But Dr Eggitt stresses that it’s not too late to talk to your GP about how you want the service to progress.
He says communication is “always key” to resolving conflict – and he recommends an old-fashioned face-to-face meeting, rather than a phone call or an email. Talking to each other in person should reduce antagonism on both sides, he believes. “It’s very easy to criticise an organisation but difficult to criticise an organisation that you’re speaking to,” he points out.
Acknowledge the elephant in the room
There’s no denying it: pharmacists and GPs are in competition for flu vaccinations. It’s best to acknowledge this truth at the start of the meeting rather than tiptoeing around it, suggests Dr Eggitt. “I think what needs to be discussed is that we’ve been pitted against each other,” he says. “We’ve been put into a competitive situation at a time when we need to be working collaboratively.”
Dr Eggitt says GPs are keen to establish “a growing relationship” with pharmacists and it is “counterintuitive” to find themselves fighting over flu jabs. “Acknowledge this elephant and get it out of the way,” he advises. “There is competition – let’s discuss the rules and how to play fairly.”
Establish the ground rules
So what is fair play when it comes to the flu service? Both sides may have different opinions, so it is important to establish a code of conduct from the outset, says Dr Eggitt. Avoiding advertising that slurs the competition – as has taken place in some GP practices – may be a good starting point.
GPs are likely to have demands of their own. Dr Eggitt says GPs in his area have complained about pharmacies advising patients to cancel their appointments with the surgery and have their vaccinations there instead. The surgeries are likely to feel aggrieved by what they see as “poaching”, Dr Eggitt explains. All in all, he says it comes down to respecting each other: “You need to communicate and keep the relationship.”
Avoid going on the offensive
So what happens if the GP has already jeopardised the relationship by dissuading patients from using your pharmacy? It can be all too easy to react in anger when you see advertising promoting the surgery’s service as superior to your own. But Dr Eggitt warns against jumping to conclusions. “Advertising is new to general practice so it’s likely to be clumsy. It’s about understanding that it may come across as offensive when no harm is meant,” he says.
In these cases, a non-confrontational conversation may be all that is necessary. Where there are less honourable intentions at play, Dr Eggitt still advises against becoming aggressive. Instead, he recommends talking the problem through with the surgery to understand what “pushed them to that point”. If all else fails, he suggests contacting your local pharmaceutical committee (LPC) to raise the issue with the LMC.
Communication, communication, communication
Failing to communicate about the flu service is the easiest way to alienate your local GP surgery. Not only could GPs be left unaware of how many at-risk patients have been vaccinated, thereby missing out on the incentive for hitting their targets, but some patients are reluctant to “question the doctor” and will receive the flu jab twice.
Keeping your GP informed is therefore vital to collaborating on the flu service, Dr Eggitt stresses.
Do you have evidence that a GP practice is discouraging patients from using the pharmacy flu service?
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