I found a lot to be excited about in the new GP contract, which was published in January. Although the full detail is still to be revealed, the huge level of commitment to sustainable, long-term funding of pharmacists in general practice has to be seen as a positive endorsement of the role. It now establishes GP pharmacy as the fastest growing sector in our profession.
I shall ignore the insistence by NHS England on using the term “clinical pharmacist”, as I have already made my opinion clear on that. What resonated with me was that one of the most-anticipated pharmacist roles within these new primary care networks is to lead on integrating general practice with other healthcare teams – including community pharmacy.
The aim of better collaboration is to improve patient safety and reduce harm. This is a premise I cannot fault, and something I have always worked closely on with local community pharmacists. Just this week I was contacted by a community pharmacist, who was concerned about a mutual patient who has weekly prescriptions but had not collected their medication. The early warning alert was very welcome.
There are other recent examples that spring to mind. One patient with epilepsy, who spent time in care as a child, now sofa-surfs and leads a very chaotic lifestyle, as well as struggling to cope with ordering medication in a timely manner. Another is an elderly gentleman with severe mental health issues, who refuses telephone contact and rarely attends the surgery. For both patients, I have regular, and reassuring, contact with their community pharmacist.
Community pharmacy is integral to supporting so many patients in a multitude of ways. Their accessibility and proximity to patients is crucial to patient safety. As I now work solely in general practice, there have been many occasions when I have felt myself that little bit further removed from the social challenges that many patients face. In a recent consultation with an unemployed man with diabetes, he revealed to me that he was living in emergency accommodation, and didn’t have access to a fridge to safely store his insulin. His local pharmacy had been “owing” him insulin so he only had to take what he needed.
I just hope the enthusiasm for GP pharmacists is not to the detriment of other sectors. The current negotiations on the new pharmacy funding contract must produce an equal level of endorsement of this vital sector, and demonstrate the need for sustainable, long-term funding and development. Otherwise, there will be a negative impact on patient safety, as the unique support is gradually eroded away.
Unfortunately, the future looks a bit bleak against a backdrop of established pharmacy chains selling numerous branches, and redundancies at Boots head office. Let’s not forget that six ‘clinical’ pharmacists per 50,000 patients equates to over 10% of currently registered pharmacists. Where will they all come from? And how will that impact on other sectors? Unsustainable funding cuts coupled with a potential mass exodus of pharmacists from the community sector could be the final straw for many pharmacies.
The new GP contract may well be remembered as the final nail in the coffin for community pharmacy.
The GP Pharmacist is a former community pharmacist working in a general practice