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Pharmacists should be ‘beating a path’ to GPs, NHS leaders say

Practice Take the initiative with GPs and don’t wait for local professional networks to act as a “bridge” to commissioners, pharmacists were advised at the Pharmacy Show

Pharmacists should be "beating a path" to GPs' doors rather than waiting for local professional networks (LPNs) to help establish a relationship with commissioners, NHS leaders have said.  

Without an LPN to act as a "bridge" for pharmacists to get services commissioned from clinical commissioning groups (GGCs), pharmacists were in an "ideal position" to engage with local GPs themselves, Horsham and Mid-Sussex CCG clinical chair Minesh Patel said at the Pharmacy Show in Birmingham yesterday (September 30).  

LPNs are being trialled by pharmacy, dentistry and optometry as a way for the professions to have a voice in the commissioning system. Pharmacy LPNs are designed to provide leadership and feed back to commissioners, but it was "pretty evident" that not all LPNs were fully established yet, Mr Patel said.

"Some of you will have worked alongside your GP colleagues for 30 years and never gone into the surgery. That kind of model can't go on" Clare Howard, deputy chief pharmaceutical officer, NHS England

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There was still a "clunky relationship" between pharmacists, CCGs and NHS England's area teams, which made it difficult to commission services, he said during a debate on whether pharmacy was fit for purpose.

"A lot of the solutions will need to come from professionals talking to each other, not the commissioners dreaming [up] an interesting innovation to a pathway problem," he told C+D.  

NHS England's deputy chief pharmaceutical officer Clare Howard said pharmacists had to "engage properly" with GPs.  

"Some of you will have worked alongside your GP colleagues for 30 years and yet have never gone into the surgery. That kind of model can't go on," Ms Howard said during the debate.  

As a pharmacist, Ms Howard had organised meetings with her local GP twice a year, she said. But this attitude seemed to be "the exception and not the rule", she added.  

"I've never experienced the stereotypical scenario that people describe of community pharmacy and GPs at loggerheads in the locality. But as a community pharmacist I think I did my bit to make sure that wasn't what happened," she said.  

In response to freedom of information requests, less than a quarter of CCGs said they had met with LPCs to discuss commissioning services through community pharmacies, a C+D investigation revealed in July.

Do you visit your local GP in their surgery?

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Amal England, Public Relations

Clare, pharmacy is powerless and meaningless in this new but backward NHS, until pharmacy is backed by a powerful lobby group. You say "Some of you will have worked alongside your GP colleagues for 30 years and yet have never gone into the surgery. That kind of model can't go on,".... We are taking about the NHS here, it's a national service, and thus the key to cost effectiveness is lost when the doctor in your example has failed to pop into the pharmacy for 30 years. Pharmacy is disintegrating because leaders, organisations and the governing body in this profession have failed to uphold professionalism. In fact the governing body looks down to pharmacy and pharmacists as workers in a fast food resturant- this is the model that cannot go on. Doctors work well with pharmacists in hospitals up and down the country because those doctors are made to do so. In the retail world the doctors have no obligation to bring pharmacists on board, the reason is money.

G K, Superintendent Pharmacist

It does feel as if our organisations are washing their hands of THIER responsibility to speak for us. Individual pharmacists will find it very difficult to get services commissioned without some Pharmacy organisation and significant numbers in the profession behind them. This is with any organisation. To expect us individually to get services commissioned is a ludicrous idea. LPCs and the PSNC are paid to drive forward ideas both at a local and national level and that is where the attention needs to be focused in my opinion. We need unity and a clear focus to go forward.

Mike Hewitson, Superintendent Pharmacist

LPNs are a sop to clinical leadership. Poorly resourced, unaccountable, unrepresentative of the views of frontline pharmacists and contractors.

No leavers to pull, no funding. How can they change anything? Once again, we're relying on the goodwill of an increasingly stretched profession and our teams.

Serious about clinical leadership, surely the NHS or DH could afford to find more than £3m to fund pharmacy clinical leadership? NHS medicines spend in primary care = £8.8bn. £750m of preventable medicines related harm. Total NHS budget north of £100bn. I'll bet the NHS biscuit bill is more than the pharmacy clinical leadership bill!

Relying on Contractors to fund clinical leadership through LPCs and in turn LPNs is a nonsense. Contractors need a fair return, for services such as public health those margins are slim to none after overheads are taken into account, asking for full participation in the work of an LPN, let alone CCGs (at the expense of Contractors) is both cheeky and naive.

Kevin Western, Community pharmacist

Which planet do they live on? Which part of "the GPs dont want to listen " do they not understand? The GPs know the NHS will chuck money at them until they relent and do what is needed , why put any in the Pharmacy begging bowl? Pharmacists have no control over wether CCGs collaborate (or anything else either), all we can do is say yessir! when they feel like calling on us.

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