Pharmacists accuse GPs in England of scuppering Pharmacy First scheme

Denis Campbell Health policy editor
Fri, 3 May 2024 

Pharmacy First is PM’s flagship plan to cut the time it takes to see GPs by sending patients with seven common conditions to pharmacists for treatment.Photograph: Kirsty O’Connor/PA

GPs have been accused of scuppering Rishi Sunak’s flagship plan to cut the time it takes to see them by refusing to refer patients with minor ailments to a pharmacist instead.

Pharmacists claim many GPs in England are not sending patients to them to be treated – and that some are refusing to participate at all in the “groundbreaking” Pharmacy First scheme.

Last May, Sunak made patients being assessed, advised and treated by pharmacists instead of family doctors the centrepiece of his primary care recovery plan.

Related: Pharmacies in England to begin treating patients for seven common conditions

It was intended to ease the pressure on overworked GPs and reduce the delays many patients face when needing care – as well as giving them greater choice of where to seek healthcare and helping free up 15m family doctor appointments in its first two years for people with more pressing illnesses.

The scheme was expanded in January, when the NHS announced patients could seek help from a pharmacist instead of a GP for seven common conditions including earache, sinusitis, a sore throat, infected insect bites and shingles. More than 10,000 community pharmacies were ready to help patients, it added.

But a row has broken out between GPs and pharmacists over the former’s alleged refusal to refer patients onwards.

Three-quarters of pharmacists are not getting regular referrals from GPs, according to a survey of 470 community pharmacies by the National Pharmacy Association (NPA). It represents more than 5,000 independently run pharmacies. Some respondents said GPs in their areas were referring no patients at all.

The NPA is so concerned it has written to the health secretary, Victoria Atkins, asking her to convene an urgent summit.

“We are concerned with reports from many of our members that some GPs are not referring patients via the scheme and in some flatly refusing so to do,” wrote the NPA’s chair, Nick Kaye. Without action the intended expansion of NHS care by pharmacists could “fail”, he warned.

Aisling O’Brien, a pharmacist with the O’Brien’s pharmacy group, which runs nine outlets in north-west England, said patients liked Pharmacy First because of the convenience, access and speed it offered. But she added: “There is one GP surgery who, at the request of the GP partners, are refusing to refer for three out of the seven conditions. They refuse to give a reason.”

Related: ‘I would not be alive’: anger at Sunak plan to strip GPs of sicknote powers

Sunak’s plan last year also said: “By expanding the role of pharmacies, fewer people will need to see their GP in the first place.”

Those extra consultations were central to Sunak’s promise to abolish the widespread “8am rush for GP appointments”.

The British Medical Association, which represents doctors including GPs, did not dispute the NPA’s claims that problems are affecting the rollout of Pharmacy First, but denied family doctors were refusing to take part.

“Community pharmacists and GPs want to work together to ensure patients receive safe and effective care. Rather than a reluctance to engage with Pharmacy First, we are aware of GPs raising concerns that this scheme is being rolled out too quickly, and is relying on inadequate IT infrastructure which is ultimately increasing the burden on our profession. This is putting further pressure on a system already close to breaking point,” said Dr Julius Parker, the deputy chair of the BMA’s GPs committee for England.

“GPs, pharmacists and patients all want the same thing. We want patients to be able to receive quick and easy care, in a practice that is local to them, which is well staffed, resourced and safe. We look forward to engaging with the NPA to better understand their concerns and better maximise the potential of this scheme.”

The Department of Health and Social Care did not respond directly to the NPA’s findings. But it urged family doctors to send patients to be seen by pharmacists if their condition means that is the right course of action.

“The Pharmacy First service will support a shift in patient attitudes towards seeking advice from community pharmacies as a first point of contact for seven common conditions and is expected to free up 10m GP appointments per year, once fully scaled,” a spokesperson said.