Pharmacists and GPs need to work collaboratively to make a success of Pharmacy First, attendees at The Pharmacist's recent roundtable have said.
And one suggested that cross-sector working was often 'missing' from primary care.
The discussion, held in August this year, brought together community pharmacy and general practice representatives to discuss the successes, challenges and future of Pharmacy First, six months after the service began in England.
Attendees from both sectors highlighted funding and workload pressures, while one GP present raised concerns from GPs about the cost-effectiveness of the service.
The group agreed that Pharmacy First was not a solution to GP access issues nor to the community pharmacy funding crisis.
Shilpa Shah, chief executive of Community Pharmacy North East London, warned against an ‘us and them’ feeling between the two sectors.
‘I would just like to see integrated working,’ she said.
‘Our narrative needs to be the same to the patient: “come and see whichever healthcare professional you find it most easy to see for your specific condition, your lifestyle, your working career, etc, and we will help you. And if we’re not the right people, we will signpost you or get you help from the person that you’re meant to see”.
‘Because ultimately, we just want the public to have faith in primary care services. With that, everything else will just come together, won’t it? The funding and the accolades that the public will give us,’ she added.
Ms Shah also suggested that training placements for both pharmacists and GPs could take place across settings, helping to improve collaboration and mitigate concerns raised by GPs about reduced opportunities for trainees to see minor ailments in general practice if patients were attending Pharmacy First instead.
‘I do think that that is what is missing in primary care – that we don’t have enough cross sector working. We don’t have enough understanding of how things work in each other’s particular sectors,’ she said.
‘The way people access healthcare is changing, and it’s changing quicker than it’s ever changed before, so we need to start getting used to that and thinking, “what do we need to do differently to make sure it’s safe and efficient for the patient and the NHS?”’
Meanwhile, Sukhy Somal, head of community pharmacy clinical services at the Black Country Integrated Care System (ICS), suggested a perceived competition within the sectors for the funding allocated to Pharmacy First.
Instead, she said she would ‘much rather’ the service were ‘a collective GP-pharmacist joint venture’.
And Dr Selvaseelan Selvarajah, a GP partner in East London, also advised caution against ‘artificial competition’ being created between the sectors.
‘There’s one pot of money for primary care. We divide that into general practice, pharmacy and other sectors, and we’re being kind of forced to compete with each other, and we’re all struggling,' he said.
And he added that each sector should be mindful of the ‘intense pressures’ both were facing, he added.
‘If general practice collapses, community pharmacy will struggle, likewise, the other way as well. So, I think it’s important we support each other,’ he said.
Dr Selvarajan also highlighted that pharmacists having greater access to patient records would be ‘really helpful’ for integrated working.
And he suggested that the advent of pharmacist prescribing on a more widespread scale was an opportunity for both sectors to consider how they work together. ‘Things are changing, we need to look at how we work,’ he said.
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