Pharmacy First, ambition last

In Opinion

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The introduction of prescribing into Pharmacy First, and the expansion of the service in England from the autumn, sounds like good news. That’s what we all want, isn’t it? A chance for pharmacy to flex its collective clinical skills to help patients, reduce GP workload, embed pharmacy firmly in the primary care clinical network, and receive appropriate funding.

However, the announcement that hay fever in children, scabies, soft tissue infections, migraine, acne, and ear infections are the new conditions for which pharmacist prescribers will be able to initiate treatment falls somewhat short of this ambition. It all feels rather underwhelming – although we do not yet know the detail, including which additional items prescribers will be able to provide that non-prescribers cannot.

Meanwhile, the Doctors’ Association UK has warned that the expansion of Pharmacy First will require pharmacists without diagnostic skills to provide care that is “beyond their training” and will undermine the role of GPs in diagnosing patients safely.

These kinds of knee-jerk reaction are now so predictable: completely unhelpful, grossly inaccurate and outdated. Those making them would benefit from spending a day in a pharmacy to see what pharmacists actually do. Pharmacists will be very familiar with these added conditions, so they are not remotely a stretch for pharmacist prescribers.

However, until there is a prescriber in most pharmacies – the most recent available figure indicates there is only one for every five – and until all pharmacies sign up for the service, confusion is likely among the public and GP practices about which pharmacies are offering the extended service.

After the CPCF settlement earlier this year, CPE raised a concern that pharmacy prescribing had been set up to fail. That prediction may yet come true.