By Alexander Humphries*

General practice may not have literally shut its doors during the pandemic but access for patients was – and remains – a massive problem. Why the attempt to rewrite history?

For the first nine months of the Covid crisis I wasn’t even sure if my local surgeries were open. I exaggerate to make a point, but not much. Patients were breaking down the door of my pharmacy claiming that they couldn’t see a GP, or that their GP had sent them to us instead with all kinds of problems. I know this because I was there.

So I’m finding this current retrospective reality adjustment (aka rewriting history) from GPs rather disingenuous. Yes, I know that appointments may have been available online or over the phone during the crisis. I also appreciate that Covid merely accelerated the use of remote consultations and telephone triage by practice teams that was happening even before the pandemic.

However, for whatever reason, that isn’t what patients wanted or understood. Now I feel like I’m almost being gaslighted when GPs say they never shut their doors to patients. The end result was the same. 

I understand why general practice is touchy about this subject as it doesn’t exactly present it in the best light. However, no one can deny that GP access became a significant problem during the pandemic – not that it was exactly easy before. And pharmacy bore the brunt.

Of course, alternative ways of communicating were tried during the pandemic, some of them very successfully (I am not going to another parents’ evening again). And there should definitely be the option for patients to choose a remote consultation if they find this useful and convenient for them.

But the same should apply for face-to-face appointments, which is all that NHSE&I is saying. People should have the choice. Now I am hearing general practice screaming about the “tsunami” of patients they are having to deal with. Well, where do you think these patients have been for the last 15 months? Banging down my door, that’s where!

GPs have the clout to help

I read the PSNC audit on consultations carried out in community pharmacy with interest. It turns out that we deliver about 58 million (unfunded) consultations each year. The way I feel right now, the NHS can have all of these patients back. I actually think that general practice has enough political clout to prevent NHS England from kicking community pharmacy if it chooses to.

But for that to happen it needs to be made clear to GPs that it is in their interests that we work together to stabilise community services. One way of doing this would be to incorporate CPCS GP referrals into local care pathways in a widespread and systematic manner.

This service has failed to take off, mainly because GPs don’t seem to know about it, but the benefits are clear. Something for our GP practice pharmacist colleagues to ponder maybe...

Time to charge patients?

I am also seriously considering charging patients for a consultation. I’ve already stopped answering questions from people who are not my patients. I do it politely and on the grounds of safety – “I don’t have access to your records” or “sorry, I can’t advise you on supplements you bought at Boots”.

That might upset some pharmacists who believe we have a professional duty to help every person who walks through the door – and a few years ago I would have said the same. But that was before we found ourselves tied to a no-frills stripped- back Ryanair-type pharmacy contract and I can only put in so many hours a day.

Whatever we are doing at the moment isn’t working. The Government has been taking the mickey for the last 12 months over our Covid costs and nobody seems to have even recognised the human cost across our sector from teams working flat out for nearly 18 months.

So am I being mercenary? Maybe. But we’ve all got to make a living.

*Alexander Humphries is the pen name of a practising community pharmacist. The views in this article are not necessarily those of Pharmacy Magazine. Would you ever consider charging patients for consultations? Email pm@1530.com