Parliamentary group calls for Boots branches to host GPs

APPG vice chair: "Large multiples like Boots could host GPs in their buildings"
The government should look into offering GP services in community pharmacies, particularly those owned by “large multiples”, the all-party pharmacy group (APPG) has suggested.

According to the APPG’s report from its first evidence session on pharmacists in GP surgeries, vice chair Oliver Colvile MP “suggested that community pharmacies, particularly large multiples like Boots, could host GPs in their buildings”.

Mr Colvile argued this would be “cost-effective [and] provide more convenience to the patient”, the APPG said in its notes from the meeting published yesterday (February 1).

Devon local pharmaceutical committee chair David Bearman, who attended the session, “indicated that this idea was being considered in the south west, but was at a very early stage”, the APPG noted.

Mr Colvile's suggestion was included ;as one of the APPG's four recommendations (see below).

How have GP pharmacists impacted services?

The APPG noted that, while there has been no evaluation of the impact of NHS England’s practice pharmacist pilot sites, there is “significant anecdotal evidence about life-changing interventions being made”.

Mr Bearman “said community pharmacies located in clinical pharmacies in GP surgeries are particularly well placed to support patients who suffer from long-term conditions”, according to the APPG's notes.

Peter Magirr, chair of South Yorkshire and Bassetlaw's local professional network for pharmacy, “said the [pilot sites] have added significant, additional capability in GP practices – allowing surgeries to provide more services and work more efficiently”, the APPG said.

What are the challenges to integration?

Mr Magirr “said a great deal of negotiation and organisation is required between the clinical commission group, GPs and pharmacists to establish a rota that ensures practices [in Sheffield] are supported by community pharmacists”, the APPG said.

The group added: “Mr Magirr explained there are indemnity and liability issues related to working across organisations, which need to be addressed, as they are a leading factor in the prevention of further integration.”

“All the witnesses agreed that preconceptions among GPs in regards to the role and capabilities of clinical pharmacists provided a barrier to integration,” the APPG stressed.

“However, they were all optimistic that once an understanding is established, this can quickly lead to a division in roles between diagnostics and medicine optimisation.”

Shortages of staff and money

Mr Bearman said that as the number of pilot sites in the south west increased, “shortages in staffing [have] become apparent”, the APPG noted. “He said that nationally there are enough pharmacists, but regionally this can prove a challenge.”

Mr Magirr highlighted “that securing funding for the initial pilots” was a “challenge”. “However, once the scheme has built momentum, more GPs express[ed] interest in paying into the scheme,” the APPG said.

What did the APPG recommend after the session?
  1. Steps should be taken to encourage the use of shared patient records, to accommodate greater joint working within and between primary and secondary care.
  2. A full evaluation of NHS England sites piloting pharmacists in GP surgeries should be conducted, to determine their impact on patient services.
  3. More community pharmacists should be encouraged to become prescribers.
  4. The government should investigate the feasibility of providing GP services in community pharmacy premises, [in] particular those belonging to large multiples, in order to take advantage of shared facilities.

The full report can be viewed here.

Result

Do you agree with the APPG’s suggestion of placing GPs in community pharmacies?
Yes. It would be cost effective and convenient for patients.
33%
No. It could confuse patients and favour the large multiples.
67%
Total votes: 126
15 Comments
Question: 
What do you make of the APPG's suggestions?

Brian Austen, Senior Management

There is nothing to stop private GP services in Pharmacies; did some work on it in the past and it's not too difficult as long as you can meet CQC standards. With pharmacy funding cuts, unhappy, burnt out GPs paying nearly a quater of their income in pension contributions, and the self-employed  unable to get appointments for 2-4 weeks affecting their ability to work, I can't understand why more independent pharmacies are not looking at this. Private GP services are thriving in the bigger cities around UK.

A Hussain, Senior Management

What are your thoughts on linking up with one of the online GP services as a taster to see if there is interest?

Brian Austen, Senior Management

The online GP services are very successful for example 'Doctor Anywhere' but they are of no financial benefit to pharmacy unless the prescriptions come your way and they probably have an arrangement in place already. In my business model profits are shared between Pharmacy and GP.
 

Brian Austen, Senior Management

The APPG has lost all credibility with this recommendation. As Stephen Eggleston said, it was tried 7-8 years ago. It was not feasible because the 'shops' could not meet premises and confidentiality standards. I doubt very much they would pass inspection by the CQC now! If GPs work in one of the Walgreens Boots Alliance Shops (I never get the impresion I'm in a Pharmacy on the rare occasion I enter one), there are NHS contractual ramifications. I seem to remember a pilot in a new 'flagship' Boots in the SW (Plymouth?), several years ago where there were complaints about GP patients receiving promotional 'goodie bags' from the pharmacy as they left! Some complaints about inducements but nothing came of it.

Valentine Trodd, Community pharmacist

I'd imagine since then, many premises have had private consultation rooms added for those lovely little MUR chats.

Brian Austen, Senior Management

They do not meet CQC standards for GP services.

Peter Smee, Design

Q. Which organisations provide financial support to the All Party Parliamentary Group for Pharmacy?
A. PSNC, Pharmacy Voice, Royal Pharmaceutical Society.

Q. Which of the multiples has board members on all three of the organisations mentioned above?
A. Boots.

Q. Has Oliver Colvile, who suggested that large multiples like Boots could host GPs in their buildings, ever spoken about Boots before?
A. Yes.
https://hansard.parliament.uk/Commons/2016-11-02/debates/1DBDD009-8217-4F80-9519-642E86B72D17/CommunityPharmacies?highlight=community%20pharmacy
(See what he said at 3.25pm)

Stephen Eggleston, Community pharmacist

The idea of "docs in shops" was explored years ago. Not sure what came of it - now we know

Farm Assistant, Community pharmacist

Brown envelopes all around.

Valentine Trodd, Community pharmacist

Might as well stick a solicitor (get your will sorted while you wait - if you're not too busy having an MUR) and a dentist (quick check-up sir?) in there too.

A Hussain, Senior Management

Have you been in a Boots store lately?  Even some of the ones in high-end centres are shabby.  To be given the impression that they are at the forefront of pharmacy is just a joke.

Quantity wins over quality all day long with these guys.

Brian Austen, Senior Management

Walgreens Boots Alliance will be preparing for their eventual split and sell-off from the group at a huge profit. Its been on the cards from the moment they bought it with the large debt including pension deficit offseting tax payments. The sell-off has probably been brought forward by the reduction in revenue from pharmacy activities.

Meera Sharma, Community pharmacist

Is the APPG having a laugh? After all the MUR scandal, they really think it's a great idea to have GP surgeries in Boots? Of course, discussions like these show no bias towards the multiples - beggers belief!

Leroy Jackson, Community pharmacist

There should be open heart surgery in Boots branches too. You get double advantage points for double bypass etc

Pupinder Ghatora, Pharmacy owner/ Proprietor

What a surprise!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Job of the week

Pharmacist Manager
Horsham, West Sussex
Up to 50,000 plus bonus