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Features
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7/5/2011
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Community pharmacy - why work with GPs?
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Ask pharmacy owners what support they get from their PCTs and almost all will say that service provision is patchy, there is a poor understanding of pharmacy within the trust and a general lack of engagement, says Hiten Patel, managing director of PharmaPlus...
Prior to the changes announced in the Health and Social Care bill, many community pharmacists would have been glad to see the back of their PCTs. As the old saying goes, “be careful of what you wish for, you may actually get it!” In this instance, we actually did!
Even with all the changes going on at the moment, two things are clear. Firstly, commissioning powers are going to be given to a group of healthcare professionals led by GPs and additionally, to local authorities. Secondly, PCTs are going to disappear in their current form.
Few community pharmacists would agree that their PCT was brilliant at delivering services from community pharmacies. There have been a handful of PCTs that have significantly benefited from a strong pharmacist representation but the majority are - to say the very least - very poor at using our services to the advantage of the local population.
The question to ask is whether this is likely to change with the new clinical commissioning arrangements. Commissioners are business people. They aim to purchase healthcare services at a decent price to provide to the patients that they care for. There is nothing wrong with this - in actual fact, it makes perfect business sense; and we all do it. With the economy in the way it is, it is very unlikely that a service which can not prove itself to be cost effective will survive.
Now let us go back a few steps. Think about the enhanced services that you provide in your community pharmacy. If you were a commissioner, would you commission the services that you provide at your pharmacy? For example, take your minor ailments scheme that you have been providing over the past few years:
Can you produce the hard evidence that it has actually reduced GP or A&E attendance? Can you prove that it has actually saved the health economy money. Can you prove that people aren't just turning up to get free medicine which is actually costing more from the prescribing budget? If you were a commissioner, would you commission your minor ailments scheme in its current form with the current administrative procedures and bureaucracy that has plagued your PCT?
GP commissioners will not be interested in hearsay and they have no commitment to enhancing the role of the pharmacist. This is our job as pharmacists to promote. They will want the facts before committing any money to a service - be it from a pharmacist, nurse or other provider. It is therefore imperative that you speak the same language as a commissioner. For example:
- Do you know the contents of the local GP incentive scheme
- Can you provide any practice based services at the surgery itself to help with their medicines management function
- Can you perform an analysis of the prescribing data
- Can you conduct higher level medication reviews on patients (not MURs)
- What is your current level of clinical knowledge like?
- Is the only contact you have with the GP the times when you are querying a prescription, the occasional phone call or collecting a repeat prescription? If so, why?
- Can you use the GP computer systems?
- Can you produce a comprehensive business plan?
Answering some of these questions will get you noticed. The problem is that it means that we need to change the way community pharmacy is both reimbursed and structured - and this will take time.
Community pharmacy also needs to be given the data sitting in PCT land for the enhanced services we have now been providing for a number of years. We know how sophisticated the data is that is provided to GPs for their incentive payments. We too should be afforded the same so we can better argue our case when it's proposed a service be decommissioned.
Hiten Patel MRPharmS is managing director of PharmaPlus Ltd, an organisation dedicated to helping community pharmacists get the most out of their businesses. PharmaPlus can help pharmacists work with GPs - it provides training packs, webinars, meetings, videos and hands-on, one-to-one support. Visit www.pharmaplusltd.co.uk or call 020 8863 3335 for more information.
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