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Nice: Perception of pharmacists as dispensers is barrier to potential

Nice: Healthcare practitioners should promote services offered by local pharmacies
Nice: Healthcare practitioners should promote services offered by local pharmacies

The perception of community pharmacists as “mainly responsible for dispensing” is a barrier to the profession expanding its role, Nice has warned.

Community pharmacists could “play a greater role in health promotion, prevention and recognition of ill health”, the National Institute for health and Care Excellence (Nice) said in a draft quality standard on the sector published last week (January 17).

However, the “lack of awareness of their skills” among the public and healthcare professionals, combined with the “long-held view” that they are “responsible mainly for dispensing medicines”, presents a barrier to them “fulfilling their full potential”, the organisation said in a one of four ‘quality statements’ contained in the standard.

Nice’s comments unintentionally echoed criticism of pharmacists’ perceived abilities on a controversial segment of ITV’s This Morning programme last week – itself triggered by a suggestion in the Nice standard that pharmacists offer healthy lifestyle advice to customers (see below).

Changing perceptions

Service providers, including community pharmacies, GP practices and primary care networks, could change perceptions locally of the role of pharmacists, through “campaigns and activities that promote the wider role of community pharmacies”, Nice said.

Healthcare practitioners could also promote the services offered by their local community pharmacies and “raise awareness of the skills and knowledge of community pharmacy teams”, it explained.

These initiatives will need to be “tailored to the local populations”, it added, as pharmacists’ roles could be “perceived differently by people from different cultural backgrounds”.

In another recommendation, Nice said community pharmacists should be facilitated to make referrals to other NHS services, “without the need for the GP to be involved unless appropriate”.

Healthier lifestyle advice

Nice also suggested community pharmacists engage with people who regularly visit their pharmacies, using these opportunities to “start a more general conversation about health and wellbeing”.

“Community pharmacy teams can offer support with adopting a healthier lifestyle, including stopping smoking, reducing alcohol consumption and managing weight,” it said.

Commenting on the draft guidance, Royal Pharmaceutical Society English board chair Professor Claire Anderson said: “Community pharmacists are one of the most trusted and accessible health professionals for the public.

“There is strong evidence for their role in helping people to stop smoking and they are well-equipped to advise about alcohol use and weight management.”

The draft quality standard is open for consultation until February 14, with the final version expected to be published in June.

What do you make of the Nice draft quality standard?

Gerry Diamond, Primary care pharmacist

Young pharmacists dont want to work in community these days as there are better offerings in GP and other sectors. Community pharmacy is a hard graft and undervalued role, which even after working as a teacher pratitioner many years agon seems to have gotten worse, atleast in the 90s and up to 2010, there was funding for extra services EHC, head lice, smoking cessation , minor ailments, UTis , needle exchange, supervised methadone. This has all gone by the way side due to cuts........of dear

Kevin Western, Community pharmacist

Here goes... 

Generalisations are always dangerous but,there is still a perception among many Pharmacists that they have to do a final check on scripts. The best person to do this is a competent ACT. All the Pharmacist HAS to do is a clinical check if you have one. Having one frees up immense Pharmacist time to do other stuff - if another staff member can do any job, THEY should be doing it, Not the Pharmacist.

The days of waving through counter medicine sales with a nod are also gone, we should be out there showing an interest and giving advice.  Insisting on full 2wham questions from staff and look out for potential triggers for other illnesses - it wont be long before missing one might land you in hot water. You will get some resistance from patients but they cant have it both ways.

If you havent got an ACT then now is the time to start training one up. Anything you can do to reduce your dispensary time is going to pay dividends down the line.

I realise that I'm going to get loads of flack from hard working people who havent got the staff balance or are in huge dispensing practices where this is all very difficult to achieve but its time to start working towards it.

Equally there are many already doing this or versions of it.

All this raises your profile with the patients and makes you less of a pill boxer and more of a medicines expert. 


Leon The Apothecary, Student

I quite agree with your statements here Kevin. If you have a good Technician team in place, if we take out clinical checking for a second, there isn't a lot that a Pharmacist needs to do in a dispensary - and that's a good thing.

The effect this can have to the day-to-day management of a pharmacy is like night and day. We could also argue that automation can do a lot of the accuracy checking substantially quicker and with perfect accuracy. There is so much potential to be unlocked.

Not to say that those who work hard are by any means doing things wrong; there are plenty of factors in consideration to just simply make the change. However, I strongly believe that it is past time that we look at not just work hard; many Pharmacists, Technicians and Assistants already do the professional proud through their work ethic; now it is time to work smarter.

Benie I, Locum pharmacist

Raises your profile, and who knows possibly your wages....

Jay Anwar, Community pharmacist

May be thorny issue but are Responsible Pharmacist regulations a barrier to our growth? RP regulations amended and suddenly Pharmacist will not be perceived as a dispenser but some one who can work along with the GP's . Does that make sense ?

Leon The Apothecary, Student

It's an interesting point because one could look at the Remote Supervision proposals a while back and say that was an attempt (that was met with a lot of controversy), to remove that particular barrier.

Caroline Jones, Community pharmacist

The Fact the NHS is perceived as being ‘free’ does not help. If patients had to purchase ‘real’ medicines from a pharmacy via the self care route......I suspect there’d be a change in opinion.

As it stands patients go to walk in centres/GP’s with their problems, get a Ox then the Pharmacist ‘just’ gives it to them.

Obviously there are some products that can be purchased, but not enough - plus they are so expensive!

How is it £6 to buy 15g of Eumovate in the UK and €3 to buy 30g of Dermovate in Spain?

Leon The Apothecary, Student

I've always been of the opinion we should be notifying the patient how much their medicines cost the NHS. Like a receipt.

Might go a ways to giving people a perspective into what their medicines cost.

Adam Spencer, Community pharmacist

A postman delivers letters,he is a postman. A teacher teaches they are a teacher.a pharmacist dispenses drugs he is a dispenser. I don't know why everyone is offended by the comments made on good morning. This perception is valid and accurately made by the public accorinding to what they see. It is purely the professions fault for not evolving,adapting and growing out of the dispensing side of things.  I absolutely think it is a joke to go to university to get a pharmacy degree just so we can final check dispensed pharmacists have no real skill that's why they are so poorly valued.WAKE UP.




Uma Patel, Community pharmacist

I would add, if you have a shop you are shopkeeper, which a large section of the public treat us as. Until we get rid of all non health related products from the shop it is going to be difficult to change the image

Bob Dunkley, Locum pharmacist

Very true Adam, something I have been aware of in the nearly 50 years I have been practicing. WE all know the wonderful things we do, but the public don't. Apart from some wonderful points of light from some pharmacies, the rest of the profession do not promote themselves and hence the public see them as counters of tablets and stickers on of labels. It is noticeable that the Twitter storm following the Good Morning programme was mainly regarding the Markle malarkey and not pharmacy. 

Leon The Apothecary, Student

I would love to see a commissioned infographic showing patients the journey of a prescription. I would love the shatter the perception of It Just Comes.

Benie I, Locum pharmacist

I'm sure you cound fit a little more into your day. Cancer services would be useful.

A.S. Singh, Community pharmacist

Community pharmacists could “play a greater role in health promotion, prevention and recognition of ill health”.

After all the dispensing, dealing with supply issues, maintenance of staff, overpriced hardware and software, training, payroll, PCN, simultaneous screening services including Diabetes, Lithium, Valproate, NSAIDS, all the PQS criteria, advanced and locally commissioned services, dosettes, discharge patients and free advice to patients-I didn't know I could do more. What more NICE or DoH?

Can you guys open your eyes and remove the fingers from your ears. Visit your local independent pharmacy and find out more. More is borderline slavery and am I not doing this already? 

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