Incentives for GPs and pharmacists to work together will improve patient care

‘World class commissioning’ should extend community pharmacy care to
achieve greater service integration and better health outcomes.

“There is an urgent need to develop new payment and information systems to facilitate better joint working between GPs and community pharmacists,” concludes a new report*, published today by the School of Pharmacy, University of London, in partnership with Alliance Boots. Commissioning for Choice, Quality and Outcomes argues that greater collaboration between GPs and community pharmacists, coupled with more choice for people using health services, will be essential for delivering the Government’s vision of better overall health outcomes and well integrated care for people with long-term conditions.

Incentivising GPs and community pharmacists to work together more productively would:

• promote more effective identification of health risks and early stage illnesses;

• enhance access to treatment for minor and common conditions; and

• support better medicines taking and self care.

One way of achieving better collaboration would be to adapt the Quality and Outcomes Framework (QOF) in the GP contract to provide payments shared with pharmacists. The alternative will be to create a separate pharmacy based health care budget. The new report also stresses the importance of developing existing provisions in the community, rather than becoming preoccupied with new buildings. It acknowledges the need to invest in new health centres or ‘polyclinics’ in some deprived areas, where care is poor. But elsewhere spending on costly new buildings or establishing large ‘integrated care organisations’ could restrict local choices without providing more convenient or effective services.

The School of Pharmacy report’s recommendations include:

• extending pharmacy access to NHS electronic care records. NHS ‘customers’ should be able to give permission for pharmacists to see relevant information and amend their records when necessary;

• providing NHS LifeCheck services and vascular disease checks in community
pharmacies. These are needed to help identify health risks and illnesses earlier,
and open the way to treatments that will reduce disability rates in later life; and

• enhancing Medicines Use Reviews by pharmacists. A targeted ‘MUR Plus’ approach could lead to better medicines use amongst people most in need of more effective treatment and so improve health outcomes. Doctors should when
appropriate refer patients to pharmacists for MURs and health checks.

Commissioning for Choice, Quality and Outcomes calls for informed local dialogues between NHS service users, providers and commissioners. ‘There is a need to resist top down interventions that risk de-personalising patient care and de-motivating health professionals’ commented author Professor David Taylor today. The report says that future primary care developments should be aimed at supporting self-care and extending patient choices, partly through allowing better use of existing resources like the UK’s easily accessible community pharmacy network. The report argues that an acceptance of the need to protect patients’ freedom to access their GPs should not undermine awareness of the growing ability of community pharmacists to provide convenient and cost effective health care in local settings. Better primary care is a vital key to overall health improvement.

For further information please contact David Taylor  - david.taylor@pharmacy.ac.uk

Note: This is the fifth of a series of School of Pharmacy/Alliance Boots joint
publications on health policy and allied issues. David Taylor is Professor of
Pharmaceutical and Public Health Policy at the School of Pharmacy,
University of London

*Commissioning for Choice, Quality and Outcomes by Dr Jennifer Newbould and Professor David Taylor. Available here