The Royal College of General Practitioners (RCGP) and the Royal Pharmaceutical Society (RPS) have come up with the plans in a bid to ease current pressures in general practice and address the severe shortage of GPs.
They say that the move will improve patient safety and care and, crucially, reduce waiting times for GP appointments.
GPs and their teams are estimated to make 370m patient consultations this year – 70m more than five years ago – due to an ageing population and more patients being treated for long-term and complex conditions.
But as demand has risen rapidly, the number of GPs in England has remained relatively stagnant.
By contrast there is an over-supply of pharmacists who train as clinicians for five years – one year less than a doctor, one year more than a nurse – and could step in to treat patients directly at the surgery.
Many GP surgeries already work closely with pharmacists. The proposals would see pharmacists working as part of the general practice team, much in the same way as practice nurses.
They would work closely with GPs and other colleagues to resolve day to day medicine issues, particularly for patients with long term conditions and who are taking a number of different medications. They would also liaise with hospitals, community pharmacists and care homes to ensure seamless care for patients.
With many GPs approaching retirement age, and insufficient numbers of medical graduates going into general practice to replace them, practices are struggling to meet patient demand and waiting times to see a GP are getting longer.
According to RCGP research, there will be 67m occasions during 2015 when patients will have to wait a week or more to see a GP or practice nurse.
The RCGP is calling for an increase in the NHS budget for general practice to be increased to 11% by 2017 – it is currently just over 8% – and for 8,000 more GPs in England by the end of the next parliament.
The proposals launched today are the latest in a line of joint initiatives from the RCGP and the RPS to encourage closer working between GPs and pharmacists.
Dr Maureen Baker, Chair of the RCGP, said: “Waiting times for a GP appointment are now a national talking point – and a national cause for concern, not least amongst GPs themselves.
“But, even if we were to get an urgent influx of extra funding and more GPs, we could not turn around the situation overnight due to the length of time it takes to train a GP.
“Yet we already have a ‘hidden army’ of highly-trained pharmacists who could provide a solution.
“Practice -based pharmacists, working as part of the clinical team, would relieve the pressure on GPs and make a huge difference to patient care.
“This isn’t about having a pharmacy premises within a surgery, but about making full use of the pharmacist’s clinical skills to help patients and the over-stretched GP workforce.
“Patients with long term conditions such as asthma or diabetes with complex medicine needs would particularly benefit from having a pharmacist to help them navigate the conflicting and confusing information they sometimes receive about their treatment as they move between hospital and community care.
“Practice teams can also benefit from a pharmacist’s advice to help avoid medicines waste, improve the management of medicines and rationalise costs at this time of a squeeze on NHS finances.
“We are already incredibly grateful for the work community pharmacists do for our patients, and this proposal will take that work to the next level.
“We are extremely grateful to our colleagues at the Royal Pharmaceutical Society for their willingness to work with us in producing such innovative but realistic and workable proposals.
“The health needs of the population are changing and we need to be adaptable and flexible enough to accommodate this without losing the unique strengths of general practice such as continuity of care.
“We hope to see pharmacists working as part of the practice team as soon as possible to improve the care that we can deliver to all our patients in primary care.”
David Branford, Chair of the RPS English Board said: “General practice is the foundation of the NHS but it needs proper resourcing and support. Having a pharmacist as part of the team can make a huge difference to both patients and clinical colleagues.
“Pharmacists can consult with and treat patients directly, relieving GPs of casework and enabling them to focus their skills where they are most needed, for example on diagnosing and treating patients with complex conditions.
“As part of the multidisciplinary team, pharmacists can advise other professionals about medicines, resolve problems with prescriptions and reduce prescribing errors.
“Pharmacists can also work with GPs to resolve day-to-day medicine issues and with practice teams to provide advice on medicines to care homes, as well as visiting patients in their own homes when needed.
“It’s a win-win situation for everyone concerned. The NHS simply can’t afford to wait any longer to create capacity in the system. We must be more strategic and change the services on offer to make best use of the NHS workforce.
“Pharmacists should be working in GP practices all over the country. Patients deserve access to high quality care and services wherever they live and pharmacists are central to providing this.”
