A debate motion put forward by GP leaders from local medical committees (LMC) has demanded that pharmacy blood pressure checks “be terminated with immediate effect and the money put into pharmacy dispensing fees” instead.
The motion, among other issues, will be proposed by Devon LMC and voted on at the British Medical Association (BMA) annual conference of England LMC representatives later this month (November 22) – with motions voted in becoming official BMA policy.
Read more: BMA’s top GP warns budget will ‘break’ pharmacies – but less than GPs
It said that pharmacy blood pressure checks generate “more work” for GP practices.
The motion also called for the Pharmacy First service to “follow guidelines on prescribing and ensure appropriate antibiotic stewardship”.
Read more: Pharmacies losing £115m a year over ‘informal’ GP referrals
And it demanded an end to “the increasing tendency of NHS England (NHSE) to pit general practice and community pharmacy against each other in zero-sum games for scant funding”.
It said that NHSE must fund pharmacies’ “core work of dispensing appropriately” and ensure that “their survival [is not] made contingent upon doing work traditionally and contractually the remit of general practice”.
Remove “antibiotic prescribing rights”
The conference will have a debate dedicated to “community pharmacy” and other LMCs have also submitted motions to the BMA for consideration – but there is no guarantee these issues will be discussed.
Gateshead and South Tyneside LMC demanded that “antibiotic prescribing rights be removed from community pharmacy and the money put into pharmacy dispensing fees”.
Read more: GPs need to ‘feel confident’ about Pharmacy First referrals, says BMA
It said that this is because “six of the seven conditions for which pharmacists are paid to provide antibiotics can be ‘diagnosed’ without actually seeing and examining the patient under their contract”.
While Pharmacy First allows pharmacists to supply medicine to patients under patient group directions (PGDs), it does not allow them to prescribe.
Workload worries
Meanwhile, Cambridgeshire LMC said it was concerned that the Pharmacy First service is “failing to both ‘save up to 10 million general practice appointments a year’ and help patients ‘access quicker and more convenient care’” – as initially promised by NHSE.
It called for the BMA’s General Practitioners Committee for England (GPCE) to work with Community Pharmacy England (CPE) to “investigate the scheme’s outcomes”.
Read more: BMA: GPs not ‘reluctant’ to engage but Pharmacy First rolled out ‘too quickly’
This should include “prescribing rates, antibiotic stewardship, clinical outcomes, dispensing waits, the proportion of patients immediately redirected to general practice and re-presentation to GP for the same issue”, it said.
Devon LMC also asked the GPCE to “assess the workload that Pharmacy First shifts both away from, and back to general practice”.
And Hull and East Yorkshire LMC demanded that “the requirement for patient referrals to come from general practice” be removed – although patients do not need a referral from a GP to access Pharmacy First services.
Let GPs deliver Pharmacy First
But while other LMCs raised concerns about the Pharmacy First scheme causing additional workload for GP practices, one called for GPs to be able to take part in the scheme themselves.
Oxfordshire LMC recommended the “future possibility” of allowing “non-dispensing” GP practices to take part in Pharmacy First services if “allowed to supply the relevant medicines directly”.
Read more: Pharmacy First: GP referral tech to reduce ‘informal signposting’ launched
It also said that participation in the service should be offered to dispensing practices on an equal basis to pharmacies “as soon as possible”.
It comes as BMA GPCE chair Dr Katie Bramall-Stainer this month stressed that the budget will have a “devastating impact” on the health sector, “but none more so than NHS GP services”.
And a new audit by the pharmacy negotiator has revealed that the pharmacy network has lost more than £115-million-worth of potential Pharmacy First funding this year due to “informal referrals” by GPs and NHS 111.