Avoiding 57 million GP appointments

We commonly hear that GPs are under pressure. Well they are – working their cotton socks off! This is not good as many of them complain of stress and dissatisfaction, just at the time when we need them to change the tanker that is the NHS around.

What if I said that I could take 57 million GP consultations out of the system? Would you be interested? Would that at least create a breather to allow GPs to regroup and come out fighting?

Well approximately 57 million GP appointments are for minor conditions every year. Some CCGs have made progress in developing minor ailment schemes such as ‘Pharmacy First’, but often it is half-hearted, poorly supported, poorly run and poorly publicised. For example, in one area I can only find the scheme mentioned on two of the GP websites.

So let’s do it – it makes sense!

This is all you have to do:

Include a common conditions service specification within the national pharmacy contract. Not as an add on – as a core service. Perhaps give all pharmacies 6 months to comply, but if they are unable to deliver then they no longer have a contract with the NHS. Fund it properly and reward pharmacies who choose to reorganise their premises to deliver a new model of care based on ‘Pharmacy First’.

Include the majority of common conditions that are included at the moment, but scale up – please don’t dumb down! And create a development program where some areas can add new common condition pilot areas – so it is always getting bigger.

Sort out the process:

  • advise – produce national leaflets based on NICE CKS or other reputable source
  • treat – introduce national PGDs or change the legal framework to create community pharmacy prescriber status – make selling or supplying appropriate medicines easy
  • refer – build local referral pathways and preferable pharmacist booked appointment slots within general practice

Advertise – a national campaign please with a little creativity. Standard internet pages that can be slotted into GP websites and all local communications. I don’t really have to say this, but the NHS does employ communication experts!

Consolidate – just ensure that it is used to the full. Ask receptionists to refer patients with common conditions to the pharmacy. Get GPs to say ‘if this happens again – go and see the pharmacist’. Put up signs in A&E and Walk in centres ‘if you think you might have one of these conditions – check with the pharmacist first’

And even if you reduce the number of GP appointments by just half, you know that you have supported General Practice to free up some time to deliver even better outcomes.


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