Allowing pharmacists to refer patients to hospital could drive up activity, GP warns

Proposals to overhaul prescribing training for pharmacists and allow them to refer patients direct to hospital would need 'vigorous' monitoring and could lead to unnecessary hospital visits, a senior GP has warned.

GPC prescribing subcommittee chair Dr Andrew Green (Photo: JH Lancy)

The Royal Pharmaceutical Society (RPS) report said that pharmacists should be able to prescribe routinely for patients with long-term conditions and refer them direct to other healthcare professionals - including hospital consultants - rather than always via a GP.

The report argued that all pharmacists providing direct patient care should be given the chance to train as prescribers and to refer patients to other clinicians to help reduce 'unnecessary' GP appointments. It called for a relaxation of the current requirement for pharmacists training as prescribers to be mentored by doctors, to allow senior nurses and pharmacists to oversee their training.

The RPS argues that doctors' availability to mentor pharmacist prescribers is too limited to allow the workforce to grow fast enough.

GPC prescribing subcommittee chairman Dr Andrew Green said that the BMA backed much of the report, and that GP leaders had been 'consistent advocates for a wider role for pharmacists'. He reiterated the GPC stance that pharmacists with extended roles were 'most effective when fully integrated with practice-based teams'.

GP prescribing

Dr Green added: 'It is true that the requirement for all non-medical providers to have a doctor mentor during training is a difficulty, but any change to this requirement would require very vigorous measures to ensure that quality is maintained.

'In many areas patients can self-refer to allied professions such as physiotherapists and for pharmacists to be able to do so would be welcomed, but I have concerns about referral to consultants as many practices have GPs with clinical interests and by-passing the practice may result in unnecessary activity.

'Opticians do have direct referral arrangements in many areas for acute eye problems and cataracts, but these conditions are very specific and I struggle to map these over to a community pharmacy situation.'

Launching the report this week RPS England chair Sandra Gidley said the time had come for a 'radical reform of how care is provided' for patients with long-term conditions.

'We can’t continue with the current model which doesn’t serve patients well and puts GPs under intolerable pressure,' she said.

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