During this time of intense pressure on general practices and local hospitals, could practitioner assistants (equivalent to F1 doctor qualification) and/or practice nurses be employed to contribute to the pharmacy environment with personal, social and therapeutic health management, including being qualified to prescribe some medications and thus be able to support pharmacists and to relieve some of the footfall in General Practices and Emergency Departments of their heavy workload?
The main hurdle to overcome would involve providing financial support to the chemist shops to enable this kind of employment. Also to consider would be the change in culture within the medical professions would be a paradigm shift in the inter professional roles that professionals play in the healthcare environment.
Dr Annwyne Houldsworth
Interesting question. Before I retired, I was a nurse practitioner (actually, advanced practitioner, but that was not a title that informed people very much about what I did) for bladder and bowel health.: (https://www.nhsemployers.org/articles/advanced-practice-and-enhanced-practice)
I used to carry out assessment and treatment, often after general practitioner (GP) referral, and would be involved in assessment and treatments that GPs felt that I would be more able to carry out than they (as generalists) could.
At the moment - probably owing to the legacy of COVID-19 - the local practices where I live seem to be very busy and use locums (qualified doctors who are not part of the GP team) quite a lot.
So, I feel that to increase the clinical care available from pharmacies would be a very positive step. At the moment, practice nurses and pharmacists within the GP practices take on a lot more responsibility than they used to be given, including prescribing. And in the chemist shops, pharmacists now carry out vaccination.
I am not sure about the monetary perspective; would the NHS be able to employ these practitioners? I really don't know how this would work out or be allowed. There would also be the aspect of who were the nurses - for example - be managed. There would be the need for clinical supervision and support in the way that we had a (marvellous) manager, who was at one grade higher than we were, who we looked up to (in more ways than one). And she, likewise, had a manager and so it went up.
Hi Annwyne, I'm an Italian GP and a "former" Emergency doctor, GPs in Italy spend a lot of time through things that could be carried out by other figures like pharmacists or administrative teams for instance regarding the application of patient benefits connected with chronic diseases or avoiding unuseful repetitions in regularly prescription to the chemist shop( in Italy prescription is only valid for 2-month time therapy ), the examples would have been more and more.
Thanks for your time
Best regards
You and yours on Radio 4 this afternoon discussed Pharmacy First Service-Community Pharmacy England. James Davie, part of the national team that evaluated the New Medicines Service in community pharmacy promoted the concept and described the 7 conditions that could be overseen by pharmacists. There was some criticism from the Royal College of General Practitioners, who expressed concerns about continuity of care with existing patients but this was rebutted by the spokesperson from New medicine Services in Community Pharmacy.
In my opinion, it would be useful to imagine a real scenario where patients come into the pharmacy complaining of symptoms giving the patient the best opportunity of care. Many times patients need only advice, in any case, the pharmacist can activate the emergency if a life-threatening condition occurs.
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