I thought he was joking, but it was some poker face. You are joking – right?
“No seriously, we now have an increased relationship with two of our local community pharmacies and it is just like having branch surgeries. They have CCG funded minor ailment schemes and we work closely with them to develop this to the maximum”.
So how did this all start?
“The CCG let us know that they had commissioned this service and we invited the two closest pharmacists around for coffee after surgery and they had closed to understand what this actually means”.
“So the community pharmacists delivered a short lunchtime session to all practice staff on what they felt competent to manage. The receptionists have a list and a leaflet and they actively divert patients to the local pharmacies.”
How does this work for the GPs?
“When patients visit the surgery with listed conditions we try to ask them if they have been to the pharmacy. This was a little tricky at first, but it is now fairly routine. Patients now ask us if they could have seen the pharmacist”
Have you had any issues?
“Not really, but we do have a monthly catch up session. The pharmacists come over at lunch time. They talk about some cases that they treated or referred and we explained what we would have done.”
Has this led to any improvement?
“Well the pharmacists now seem more confident – they have developed some additional diagnostic skills and will deal with more conditions”.
And the patient viewpoint?
“At first some were surprised, but it is much quicker to get to see the pharmacist than the GP and they get similar advice. Of course some prefer to come to us, but a lot are happy to see the Pharmacist”
Have there been any other additional advantages?
“We are more aware of the other commissioned services that the pharmacies deliver and we actively refer to their services. We better understand MUR and NMS and try to make these services work for both of us. We now refer all of our patients to them for smoking cessation as it is uneconomical for us to do it. The improved communication has allowed us to sort out prescribing issues quickly and we take advantage of the emergency supply service.”
And what are the plans going forward?
“The pharmacies both support inhaler technique monitoring in all patients with asthma and COPD. We have been working together to identify high risk or poorly controlled patients, using a small amount of money from an innovation fund. This has been going particularly well and we have reduced unplanned admissions and improved quality of life for our patients. The Pharmacists have a ‘hotline’ to us when they feel that a patient has problems that need urgent attention. And we have even used skype and facetime to hold a consultation with our patients in the pharmacy. We would like to expand this to other clinical areas such as dyspepsia and IBS, before dealing with hypertension and even diabetes.”
Why don’t other GPs share your view?
“We are very busy, but we felt that we had to look for other ways of dealing with our workload. We invest one hour a month for a chat over tea and sandwiches and it frees up at least 5 times this number of appointments in our practice. We have developed great relationships with our local pharmacists and it works. I am sure that there are many that do understand the benefits of working with the local pharmacists, but it needs a little bit of effort.”
In summary, working closely with your local community pharmacists has led to benefits for both sides.