Pharmacy First ‘will fail’ if patients ‘keep having to return to their GPs’, a group of influential MPs has warned.
A new report by the House of Commons health and social care committee said that patients’ concerns about ‘being referred back to the GP’ if they go to community pharmacies to receive care ‘should ring alarm bells for the Government’.
Under Pharmacy First, GP practices refer patients to community pharmacies for seven common conditions – including sore throats and ear infections – but some GPs have said that the scheme was not working as intended, with some pharmacies directing patients back to general practice for a variety for reasons.
The health and social care committee report acknowledged that medicines shortages are one of the reasons patients are redirected to their GP, and recommended that regulations ‘must be updated within three months’ to allow community pharmacists to make dose and formulation substitutions for out-of-stock items and ‘dispense what they have available’.
The report said that it is ‘especially worrying’ that shortages are resulting in patients being directed back into general practice, and that there is a ‘serious risk’ that any capacity that general practice gains through Pharmacy First ‘will be negated by the time spent re-issuing prescriptions as a result of shortages, thus undermining this initiative’.
The committee added that to ‘avoid patients continuing to use GPs for support’ that could be offered by community pharmacists due to concerns about ‘affordability’, over-the-counter medication should be free for people on low incomes as part of Pharmacy First.
The report said: ‘Pharmacy First, the Government’s flagship policy to free up GPs’ time and capacity, will fail if people keep having to return to their GP.
‘Regulations must be updated within three months to allow community pharmacists to make dose and formulation substitutions for out-of-stock items and dispense what they have available, with generic substitution to follow after consultation on implementation to avoid unintended consequences.’
Data sharing
The ongoing evaluation of Pharmacy First should also include an assessment of the extent to which pharmacy and general practice digital systems are enabling the necessary data sharing ‘to protect patient safety and ensure continuity of care’.
As part of the service, community pharmacy IT systems will automatically send details of patient consultations to general practice clinical IT systems via GP Connect.
The GP Connect functionality which will enable pharmacists to add to GP records with ‘one click’ was originally due to be live in time for the Pharmacy First launch on 31 January 2024 but is still currently being rolled out, with only one IT provider, Cegedim Rx, currently live with the functionality.
The report added: ‘We ask that the Government sets out what progress has been made on rolling out the full digital product for the documentation of Pharmacy First consultations, including the percentage of community pharmacies that have fully functioning and interoperable read/write access to patient records.’
Workforce
The report also recommended that greater planning and forward thinking be done on the pharmacy workforce, with support given to ICBs to build ‘one pharmacy workforce’ that can be deployed across pharmacy services within health and social care.
In its recommendations, it said: ‘We reiterate that an integrated and funded workforce plan for pharmacy must be developed and laid before Parliament within 12 months.’
It added: ‘We further recommend that any workforce planning, be it at a national or ICB level, should ensure the appropriate and safe and mix of skills in all settings, including hospital wards.
‘This should include consideration of the need for more than one pharmacist per community pharmacy in relation to the delivery of initiatives such as Pharmacy First.’
It comes as ICBs are to receive funding for a community pharmacy PCN engagement role to help deliver the access recovery plan.
A version of this story was first published on our sister title Pulse.
