Patients in Scotland could be deprived of valuable pharmacy services if new pharmacy applicants are forced to prove they do not adversely affect a dispensing doctors' practice, the Royal Pharmaceutical Society (RPS) has warned.

The ‘prejudice test', proposed by the Scottish government as part of its plans for control of entry and dispensing GP practices in remote areas, would "shift public policy away" from pharmacy and preventative health, the RPS's Scottish Pharmacy Board has said.

The RPS supported the need for dispensing doctors in very remote and rural areas where there was no possibility of providing full NHS pharmaceutical services, director for Scotland Alex MacKinnon said in response to the two-month consultation on the control of entry tests, which ended last week (Feb 20).

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	The government consultation proposed that certain remote areas be labelled as "controlled remote, rural and island localities" as there was "increasing concerns" by dispensing GP practices and rural communities that pharmacy applications could destabilise local NHS services by making some of their staff and services redundant.

But the test suggested that a dispensing service would be "adequate" for all Scottish citizens rather than the provision of "comprehensive patient care", Mr Mackinnon said.

Pharmacists not only offered dispensing services but provided public health services and supported self-care and long-term conditions through the minor ailment service and chronic medication service, he argued.

"Communities benefit in many ways by having another highly-skilled health professional nearby who is an expert in medicine," Mr MacKinnon said. "Patient safety and preventative health care are at the core of a pharmacist's role and contribute to shifting the balance of care in the community, freeing up GP and hospital time."

Mr MacKinnon argued that there were "many good examples" of pharmacists and GPs working together for patients benefit and he called for further discussions with dispensing doctors to find "agreeable solutions" to providing pharmaceutical care for Scotland's rural populations.

The professional body also raised concerns that GPs were being given payments for dispensing in addition to their usual funding. Dispensing services should not be used as an incentive to recruit GPs and to "subsequently deprive local residents of a full pharmacy service", it said.

But the Dispensing Doctors' Association (DDA) said the Scottish government must recognise its members could provide equivalent services to a pharmacy and the "very presence" of a dispensing doctor should not be used as proof there was an unmet need for a pharmacy in an area.

The DDA supported the concept of pharmacists working alongside dispensing doctors but raised concerns that funding to support pharmacists in rural areas could "eliminate GP practice income from dispensing", it said in its consultation response.

Community Pharmacy Scotland (CPS) called for money to be made available to help dispensing practices move away from a "perceived reliance" on dispensing income.

"It is important to recognise that a dispensing service provided by a GP is not comparable to the pharmaceutical care provided by a community pharmacy. To partially address this gap, standards of dispensing and the payment arrangements, including drug cost reimbursement, should be the same for pharmacies and dispensing doctors," CPS said in its response.

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