Some times I wonder much the people at NHS England understand about the pressures in the NHS and how sensible they are with their solutions. It often doesn’t seem very sensible to me and it includes just putting increasing pressure on the few. It is more about good news and less about reality.
So we watch the announcements that GPs are going to be located in A&E and urgent care hubs. That’s nice. I didn’t appreciate that there were so many GPs around kicking their heels. Most of the GPs I talk to are rushed off their feet, working long hours and inundated with paperwork.
I noticed the new guidance around influenza immunisation. It is great that we are expanding the immunisation of children right up to the age of 8. It is very important that we enhance community immunity and make real efforts to hit the Public Health England targets.
So, bearing in mind the importance of community immunity – what do you think they have suggested? That’s right – increase GP workload – that should make them happy. And then employ some more school nurses to administer vaccine in schools and let GPs pick up all the ones that miss their scheduled time slots. I didn’t know that there was a glut of school nurses? I assume that every CCG in England will have to employ a couple more. That is, perhaps another 500 nurses, but where will they come from? Yep that’s right from the overworked GP practices or the permanently under pressure hospital system.
Now sitting out there are loads of community pharmacists. With the national program there are thousands who have been trained and will go through training again this year. They were forcibly excluded from immunising children this year by NHS England denying them access to the nationally purchased stock. And now left out again.
I don’t believe it!
There are plenty of community pharmacists out there. Not necessarily a ‘glut’, but there are enough so you could commission a community pharmacy to look after every school in the country.
Now here’s the maths. There are 16,000 state funded primary schools, perhaps 2,000 independent and a 1,000 special schools and there are 11,000 community pharmacies. So that’s simple – two each. Visits to immunise by class and allowing parents to bring their children to the pharmacy if they missed it the first time.
It is pretty simple. If the average primary schools size is 280 pupils then perhaps there are 300 immunisations to do which will hardly be difficult for a pharmacy to achieve.
All it takes is a little understanding, utilise spare capacity and reduce demand on the most pressured services.
But what will happen? I suspect that it will be more pressure on general practice, by giving them more to do and then taking their nurses away.