Time to collaborate, not compete
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Community pharmacists want to work in collaboration with GPs, not compete with them to deliver flu jabs, writes pharmacist Graham Phillips.
The launch of a nationally commissioned flu jab service via community pharmacy was as much of a surprise to pharmacists as it was to GPs. Now I could easily make the case that the predictably negative reaction from GPs is simply a territorial response from a profession whose default stance is: €The answer is no... now what was the question?€
The truth, of course, is that pharmacists, like GPs, are committed professionals who do a very safe job. Quite simply, patients often find community pharmacists' services more convenient. However things are a little more complicated than that and I understand entirely why GPs perceive this as unwelcome competition, especially at a time when they are already under extreme pressure and morale, not to mention recruitment, are both at rock bottom.
The shame of it is that pharmacists were anticipating the announcement of a different service entirely €“ one that GPs would have supported. It would have been antibiotic-sparing, saved over £1bn of precious NHS cash and freed-up 57m GP appointments a year as well as thousands of out-of-hours, urgent and A&E appointments. I am talking, of course, about a national, pharmacy-led, common ailments service.
Natural allies
I have argued for years that local community pharmacists and GPs are natural allies, caring for the same primary care populations. Our complementary skills should be aligned in such a way as to best benefit those whom we all serve. The enforced competition between GPs and pharmacists, just like the competition between primary and secondary care, is anathematic to the culture of health professionals and to the person-centred values of the NHS.
It drives silo behaviours and exacerbates the tribalism that so frustrates the obvious benefits of working together. The arguments in favour of aligning the GP contract with that of community pharmacy have never been stronger. I'm acutely aware of the pressure GP colleagues are under and the desperate shortage of GPs.
Surely it makes sense for community pharmacists, who are currently in superabundant supply, to take some of the pressure away so that, working together, we might fulfil the ambition expressed by the Royal College of General Practitioners of 15-minute appointments. There are many community pharmacists, and I certainly count myself among them, who have little confidence in our negotiators.
On the one hand PSNC is always entreating us to work more closely with GP colleagues. Yet on the other it has gone on record as saying there is no need for GPs to support the pharmacy-led flu service. PSNC can't have it both ways.
However we cannot lay the blame for this obsession with competition and lack of a joined-up vision solely at the door of PSNC. What on earth was NHS England thinking? Is it a classic divide and rule strategy?
The last thing community pharmacists want is to be forced to compete against our GP colleagues, especially when they dominate CCGs and (of course) NHS commissioning decisions. Perhaps inevitably we are already seeing notices in GP surgeries extolling the virtues of the GP-led flu service (fair enough) and inappropriately knocking the community pharmacy-led alternative (unprofessional and unacceptable).
So please let us not exacerbate the differences between the two professions in a polarised debate. Instead let us seize the opportunity to come together and create a joint vision of how we can best work together for the future.
Despite PSNC's scare-mongering tactics, I believe that the joint paper recently published by the Royal Pharmaceutical Society and the National Association of Primary Care, nattily titled 'Improving patient care through general practice and community pharmacy integration', which makes the case for joint working and the alignment of our contracts, is a good place to start the debate.
Surely we should all be working together for the benefit of our patients and to save the NHS?
Is it a classic divide and rule strategy?