Pharmacists have said outrage over health secretary Thérèse Coffey’s comments about sharing antibiotics should not overshadow the conversation about the value of pharmacist prescribing.
The Times reported this weekend that Ms Coffey had admitted to sharing leftover antibiotics with others and that she was considering allowing pharmacists to prescribe antibiotics without the advice of a doctor, both of which triggered concern from some healthcare professionals on Twitter.
Overuse of antibiotics can contribute to antimicrobial resistance, but pharmacists have argued on Twitter and to The Pharmacist that the profession has long championed antibiotic stewardship.
Community pharmacist and independent prescriber Mike Hewitson told The Pharmacist that ‘we are all horrified’ over the comments about sharing antibiotics, but stressed that ‘there is absolutely an appropriate place for community pharmacists to be involved in the supply of appropriate anti-microbial therapy’.
He said that it was ‘grossly insulting’ to imply that community pharmacy was incapable of safely prescribing antibiotics, as some have suggested over Twitter, and added that many independent prescribers can and do prescribe antibiotics within their area of specialism.
Mr Hewitson continued: ‘Appropriate access is about making sure that wherever possible, supply or prescribing is accompanied with appropriate diagnostic confirmation.
‘I feel incensed by the comments raised from fellow healthcare professionals who seem to be thinking that pharmacists will be operating like a sweetie shop where people come in and get whatever they want whenever they want.
‘Any pharmacist that was operating that way, I’m sure would quickly find themselves subject to regulatory or disciplinary action,’ he said.
Pharmacist Ade Williams said that the fact the health secretary’s comments about sharing antibiotics were quoted alongside her plans for pharmacists taking on more clinical work ‘did not set us up well for our own relationships with other health care professionals’, as it conflated pharmacists being able to prescribe antibiotics with antibiotics being more freely available.
He added that independent prescribers within community pharmacy would only prescribe antibiotics after a consultation with the patient and the exploration of other treatment routes.
Pharmacy student Rafaella Woolmer said that the lack of information around the plans for pharmacists to prescribe antibiotics 'doesn't really help with public confidence in the profession'.
'The role of the pharmacist isn't as fully appreciated or understood to the extent that I think it should be, so following it with something that's already going to make people uncomfortable by saying about sharing her prescriptions, following it with that really doesn't help I think,' she said, adding that she wished that there was more public understanding of the profession.
Many pharmacists trained as independent prescribers are already able to prescribe antibiotics for some conditions – whether privately in England, as part of pilot projects, or within the devolved nations of Scotland and Wales.
The Times also reported that the plans were drawn up to reduce the need for GP appointments.
In response to the reported plans, Thorrun Govind, English pharmacy board chair of the Royal Pharmaceutical Society, argued that allowing pharmacists to prescribe antibiotics could not only take pressure off GPs, but improve patient access to care.
‘A growing number of pharmacists are prescribers and many are recognised as global leaders in antimicrobials,’ she explained.
‘We will see a whole new generation of pharmacist independent prescribers in a few years’ time and it is positive to see the health secretary talking about how we can use their skills. This is not just about taking pressure off GPs, but enhancing patient access to care and making best use of the whole of the health and care workforce.’
She said that it was ‘unfortunate’ that this message was lost, adding: ‘It was disappointing to see comments about sharing antibiotics, which people should never do. I hope the minister will be listening to the experts on the importance of antimicrobial stewardship.’
Ms Govind also said that pharmacists ‘play a key role’ in supporting the appropriate use of antibiotics across primary and secondary care.
A spokesperson for Ms Coffey said she had explored a range of policy options to relieve pressure on GPs, ‘including whether it is possible to allow greater prescribing by pharmacists’.
They continued: ‘These wide-ranging discussions included reflections on the importance of anti-microbial resistance and societal behaviours around antibiotics.
‘The outcomes of these discussions were contained in the secretary of state’s ABCD Plan for Patients, which set out policies to expand the range of services available from community pharmacies.’
The Department of Health and Social Care estimated that pharmacists prescribing antibiotics for UTIs alone could save 400,000 GP appointments and £8.4m each year, based on data from Scotland. It also said that prescribing would likely be part of specific clinical services or patient pathways, such as hypertension, high cholesterol, contraception or minor illnesses.
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