The chemist and druggist, 18/25. December 2010 (issue 6778)
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Are doctors in dispensaries a friend or foe to the pharmacist? Sainsbury's is offering doctors use of its pharmacy consultation rooms, but is bringing GPs into dispensaries a good idea for pharmacists? Miriam Reissner and Zoe Smeaton report Putting doctors in pharmacy consultation rooms should enable CPs and pharmacists to work more closely together, as well as making use of spare capacity in the facilities, Sainsbury's claims. But the plans announced last week (C+D, December 11, plO) have hardly been met with friendly faces Royal College of General Practitioners' chair Clare Gerada condemned the move, saying: "Supermarkets should stick to selling fruit and vegetables." General practitioners would be sanctioned for selling tobacco products, alcohol and high calorie foods within their surgeries, she pointed out, concluding: "We would urge any GPs. .. to take a step back and consider how they are able to provide excellent generalist care in such environments." And there was little mention from GPs joining the debate about how working more closely with pharmacists could be a benefit. But while many have sung Dr Gerada's praises, some in the community pharmacy sector have been less willing to dismiss the plans, saying bringing the two professions together could be a good idea. Working under the same roof makes communication easier, says Shamsul Islam, pharmacy manager at Britannia Pharmacy, located in the Loxford Polyclinic in London: "Any face-to-face meeting always has its own value. There is only so much you can do over the phone or by letter." Boots agrees having health professionals all on one site "works really well" and now has GPs linked to stores in 19 locations. Ian Brown, Could CPs in pharmacies help improve interprofessional relationships? healthcare development manager at the multiple, says it allows easy communication between the two professions about preferred medicines and availability of medicines. "I think it's also advantageous as an opportunity for the pharmacist to get involved in MURs - that works really well having a resident GP. In some of our stores the GP has invited the pharmacist into the consultation with the patient," he says. And John D'Arcy, managing director at Numark, says bringing the two together can help build strong relationships and give doctors a better idea of what pharmacy does. As Mr Islam concludes: "Working together can lead to professionalism and emphasise what the NHS is trying to do - bring excellence to life." There is no doubt, then, that getting the professions working together is a good thing, but is letting doctors work from dispensaries the right way to achieve that? Sainsbury's says the move means it can make the most of consultation rooms, which are not always in use. But others have reservations. Mr Brown says the Boots model, which provides GPs with purpose-built facilities rather than using consultation rooms is "much superior". And as Mr D'Arcy points out: "If the consultation room is not available for use by the pharmacy, this would mean that patients will be denied access to MURs, EHC, weight management and other services when it is occupied by theGP." Furthermore, although Mr D'Arcy says having a medical surgery in the dispensary could have a halo effect, with some customers seeing it as making the pharmacy in some way superior, he adds: "I do not believe that simply putting a GP in the pharmacy will of itself make the pharmacy 'more professional'. "The professionalism of the pharmacy is something that flows from the design and layout and the attitude and approach of the staff working in it." And although using the consultation room during 'down time' could indeed be making best use of resources, Jonathan Mason, the DH community pharmacy tsar, says he would rather see pharmacists working with local health and social care providers to offer ancillary services such as podiatry from their consultation rooms. "I worry that [the Sainsbury's model] would be seen as pharmacy trying to encroach into GPs' territory," he says. "Pharmacy should focus on delivering high-quality pharmaceutical services rather than part-time GP services." It seems, then, that it might be better for pharmacists to look for other ways to forge links with GPs. Jeremy Main, managing director at Alliance Healthcare, suggests pharmacists find out what local doctors need. "There might not be something for every pharmacy or GP, but there may be opportunities that can be developed following an open conversation," he says. Sainsbury's clearly believes the consulting room surgery model will be the answer, but as Fin McCaul, chair of the independent pharmacy federation, concludes, it's pretty hard to tell yet whether it will be positive or negative for community pharmacy. Whatever the answer on that specific model, though, it's clear that thinking about innovative ways to start working with doctors is going to be vital as NHS reforms take shape - and now might not be a bad time to start. /'/•■:' 7011 Have you guided your pharmacy to success with your incredible management skills, attitude and motivation? You could win the C+D Award for Manager of the Year. Enter now at: Jto^ www.chemistanddruggist.co.uk/awards