Prime Minister Rishi Sunak has set out an ambitious plan – in a commitment to tackle the 8am phone-line queues for NHS GP appointments, he is attempting to widen access to primary care by enabling pharmacies to prescribe antibiotics.
NHS England set out the plan yesterday in a promise to reduce waiting times by shifting some of the pressure placed on GPs onto other parts of the health service.
The NHS in crisis
The Government’s plan comes amid mounting concern about the NHS, along with the Conservative’s poor performance in the local elections last week. Rishi Sunak proclaimed “I am getting on with delivering on my five priorities and transforming primary care is the next part of this Government’s promise to cut NHS waiting lists”. He continued “I know how frustrating it is to be stuck on hold to your GP practice when you or a family member desperately need an appointment for a common illness”.
The latest GP patient survey shows 13% of people rate the service as poor or very poor overall, with nearly half complaining they did not find it easy to get through on the phone and nearly a quarter saying they were not happy with the appointment they were offered. In the hope of ending the “all-too stressful wait” for GP appointments, expanding the services provided by pharmacies will supposedly free-up 15 million GP slots over the next two years.
Moreover, the Government’s target to recruit an extra 6,000 GPs by 2024 seems unreachable. When the promise was made at the end of 2019, there were just over 28,000 full-time equivalent GPs. At the end of March, that number had actually fallen to less than 27,500.
What does the plan outline?
Based on the proposal that more people will be able to access health services without needing to see a GP, pharmacies could soon take on the prescribing of drugs for earache, sore throat, sinusitis, impetigo, shingles infected insect bites and uncomplicated urinary tract infections in women.
Moreover, women will be able to get oral contraceptive pills in the hope that almost half-a-million would no longer need to speak to a nurse or GP to receive them.
People will also be able to self-refer for physiotherapy, hearing tests, and podiatry. And, backed by £645 million of spending, the number of people with access to blood pressure checks in pharmacies would be more than doubled to 2.5 million a year.
Thorrun Govind, the chairwoman of the Royal Pharmaceutical Society in England, said the plans are a ‘real game-changer’ for patients. Additionally, Sir Stephen Powis, the national medical director for NHS England contended “We know this works. We’ve seen it work in local schemes, and similar schemes are operating in Scotland and Wales. We also know pharmacy wants to do it.”
Criticism
Despite the Government’s optimism, much criticism has been made about the plan. Many have argued that the root cause of the problem is that there are not enough GPs. For example, The Royal College of Practitioners welcomed “some encouraging initiatives” in the NHS England plan but warned that “change is not going to happen overnight” and said thousands more GPs had to be trained and retained.
Regional inequalities have also been pointed out as in some areas, there are 2,000 patients for every GP.
Shadow Health Secretary Wes Streeting said “the reason people can’t get a GP appointment is the Conservatives have cut 2,000 GPs”. He went on to label Rishi Sunak as “completely out of touch with the problems facing patients and the NHS”, explaining how Labour supports “fundamental reform of the NHS” while Sunak has “no plan to address the shortage of GPs, or to reverse the cut in the number of doctors trained every year”.
Lib Dem Health spokeswoman Daisy Cooper also stated that “accessing faster care is critical for patients but ministers just don’t seem to grasp the scale of the problem”.
Moreover, some are concerned about how pharmacies will cope with extra demand. Data shows there are now fewer local chemists than at any time since 2015. Rising operational costs, staff shortages and reduced government financial support have been blamed. Industry groups have warned more pharmacies will close unless ministers provide more funding to the ‘struggling’ sector.
The King’s Fund health think tank warned some pharmacies will not be able to offer the services because they may not have access to diagnostic tools, or sufficient staff and consultation rooms.
Senior fellow Beccy Baird said that ‘not all pharmacies will be able to offer these services and it will be really frustrating for patients to be bumped from pillar to post, only to end up back at the GP. Whilst any improvements to make it easier for people to access their local practices are welcome, to make the kinds of system changes needed to reform general practice, it is essential that, over the long-term, primary care is as much of a priority as reducing the hospital backlog”.
Final thought
While the plan may sound positive, the NHS lacks resources, funding, and staff across numerous areas. Placing more pressure on pharmacies without adequate support is not a sustainable answer to the crisis our health service is facing. Freeing up appointments is vital, but it seems the Government is attempting to cover up its failure to recruit enough GPs.