The COVID pandemic has exposed the fragility of our healthcare systems in the UK, says Steve Anderson, Group Managing Director at PHOENIX. GPs are now being urged to postpone or cancel routine check-ups and focus instead on COVID vaccinations. Whilst that may lead to fewer COVID-related hospital admissions, it runs the risk of hospital admissions due to heart attacks, strokes and cancer which might otherwise have been avoided through early screening.
If GPs, understandably, cannot provide such early screening then rather than drop them for at-risk groups, why not look to other professional healthcare providers – such as community pharmacy – to undertake this role? These checks are vital and well within the professional competency of community pharmacy.
It is clear that our “GP-first for every healthcare concern you may have” approach simply cannot cope with the volume, depth and breadth of patient demand. It has been tested to destruction. We have too few GPs per head of population, many existing GPs are reaching retirement age with others leaving due to the stress of incredible and unrelenting workload pressures.
We need to radically rethink how we provide people with the right care at the right time in the right setting with the most appropriate healthcare professional. That means embracing fully the potential of community pharmacy and as the Health Secretary, Sajid Javid, recently said, adopting a “pharmacy first” approach.
Those are welcome words, but they need to be backed up by fair and sustainable funding and an investment in relieving current workforce capacity problems. Community pharmacy wants to provide more patient services and is ideally placed to do so – trusted by the public and accessible in every locality – yet it faces an acute shortage of pharmacists and pharmacy technicians: a situation which will only get worse as PCNs/Health Boards ramp up their efforts to recruit those qualified professionals into paid NHS roles. Robbing Peter to pay Paul is a zero sum game in terms of improving patient care.
In England, the hope is that GP-led Integrated Care Systems will become the means to reinvent local healthcare provision. In some parts of the country the Integration Boards are embracing community pharmacy, but not in others: so, we end up with a continuation of postcode lottery provision with Joe Public confused about when they should see their local pharmacist rather than their GP.
The current pharmacy contract lacks imagination, is no longer relevant to today’s patient needs and is economically illiterate. For example, CPCS referrals are a welcome development, but ill thought through. Pharmacy will be paid for a referral, but not for a walk-in for the same condition. Therefore, if the pharmacy provides an outstanding service and the patient’s condition recurs surely, they will go straight to the pharmacist rather than their GP: if they do that then no fee for the pharmacy. As it stands, the contract does not reward pharmacies for outstanding performance.
COVID should be a game changer for the provision of healthcare. GP telephone and video triage is here to stay, like it or not, and pharmacy also needs to adopt virtual triage, but its USP must be acting as the necessary physical intervention gateway which may then lead to further healthcare support.