Pharmacists want power to send patients to specialists
PHARMACISTS in Scotland want the power to refer customers to a hospital specialist directly – bypassing their GPs – in an attempt to fast-track treatment and ease the burden on primary care.
The Royal Pharmaceutical Society (RPS) Scotland is today calling for a “transformational change” in the role of community pharmacists to help the NHS cope with the spiralling burden of longterm conditions.
The policy document, Improving Care For People With Long-Term Conditions, argues the existing system creates barriers that slow patients’ access to the correct treatment and pile unnecessary pressure on overstretched GPs.
It states: “When people present at a pharmacy with problems or symptoms that require referral to, for example, a dietician or physiotherapist, the pharmacist has few options other than to default to the traditional route of referring individuals to their GP. To ease the pressure on GPs, direct referral arrangements to other healthcare professionals must be routinely available, enabling GPs to focus on diagnosing new conditions and providing more complex care to those who need it.”
A pilot study in London has allowed pharmacists in deprived areas to make urgent referrals to a hospital respiratory consultant for patients with suspected lung cancer, targeting those aged over 40 who were smokers or ex-smokers with symptoms such as a persistent cough, chest pain or breathlessness.
However, Alan MacKinnon, director of RPS Scotland, said that for now direct referrals should be limited to simpler conditions.
He said: “It is about getting quicker access – making the whole journey a lot more seamless. With a lot of sports injuries, for example, people often go to their GP, but imagine if they could just go to their local pharmacist for a direct referral?
“Pharmacists are very good at responding to sets of symptoms, but with more complicated diseases direct referral becomes more tricky to do. If it looks like something more serious, then I think it’s
right to refer it on to the appropriate practitioner - and that’s usually the GP.”
Long-term conditions such as diabetes, arthritis and dementia are the greatest challenge facing the NHS as the population ages and the effects of obesity hit hard. Already, two million people in Scotland have at least one long-term condition. These account for 80 per cent of GP appointments.
The proportion of over-75s is also due to grow by 60 per cent over the next 20 years, signalling a looming crisis unless frontline care is overhauled.
Mr MacKinnon described this dilemma as a “frightener”. He said: “If we don’t get the appropriate health professional at the appropriate place in this health and social care integration, we are just not going to be able to cope with it. It is almost like a medicines tsunami is coming our way because of this ageing population and we need to be there to sort it.”
RPS Scotland also wants pharmacists to be more involved in early detection and prevention of long-term conditions, and cut the need for “significant medical interventions and hospital admissions in the longer term”.
Dr Alan McDevitt, chairman of the BMA’s Scottish GP Committee, said: “There is definitely scope for pharmacists to be more involved in patient care and we are keen to explore ways in which this can be done.”