Pharmacies could offer 'health MoTs', the government says
The government wants chemists to play a greater role in providing care for those with minor ailments, potentially freeing up GPs for more serious ills.
It believes pharmacists are a vastly under-used resource who could easily provide diagnosis for some conditions as well as dispensing treatments.
Primary care trusts - responsible for local health services - already have the power to ask more of chemists.
But the extent to which they do so varies greatly across England.
This is what the government wants to address in a new White Paper, which is designed to encourage PCTs to commission more services from pharmacies by outlining exactly how they could assist.
It is estimated the proposals could save 57 million GP consultations a year.
Health Minister Ben Bradshaw said pharmacists were health professionals capable of dealing with minor ailments, screening for diseases and giving health advice.
"As 99% of the population can get to a pharmacy within 20 minutes, everyone will benefit from more types of treatment available through local pharmacies who can prescribe more, advise more and deal with more."
Smoking and pregnancy
The kind of services envisaged include vaccinations, help with quitting smoking, and management of long-term conditions like asthma and diabetes.
The "health MoTs" - checks for heart disease, stroke, diabetes and kidney disease for the over-40s announced earlier this week, are also a target.
Many chemists are also already involved in tackling teenage pregnancy, with powers to distribute the morning-after-pill.
The British Medical Association (BMA) broadly supports the move, while the Royal Pharmaceutical Society of Great Britain (RPSGB) also welcomed the news.
"Research has shown that the vast majority of the public has easy access to pharmacies: 99% of the population can reach a community pharmacy by car, by walking or by public transport within 20 minutes," said Paul Bennet, RPSGB chairman.
Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee said better use of pharmacists could save GPs an hour of consultation time a day.
"We have a tremendous resource in community pharmacists - we've got 10,500 in England alone - and they see people with minor ailments every day of the week.
"There is a real opportunity to use the community pharmacy network to take a burden off GPs."
But David Stout, director of the Primary Care Trust Network, said that while involving pharmacies was a good idea in practice, it was not always easy for PCTs to find the funding.
"Unfortunately everything costs money, and when you commission services from a pharmacy to free up doctors, you're still paying the same amount to each GP practice - so it doesn't release any funds."
"PCTs are working under significant financial constraints, and have to prioritise."
The Conservatives also support the idea of using chemists, but said the government had promised in 2005 to do more on this front when it introduced the new community pharmacy contract.
This gave pharmacists the ability to operate as "supplementary prescribers" - handing out repeat prescriptions to prevent patients having to go back to their doctors.
But according to the Tories, figures show that in England just 101 pharmacies provided supplementary prescribing services in 2006/07 out of more than 10,000 community pharmacies.
"All the evidence shows that, three years later, the government has failed to use the contract to deliver the new services it promised," the party said in a statement.
The Confederation of British Industry (CBI) says involving pharmacies could in the long term save money.
"Seeing a pharmacist costs far less than a GP appointment, and as people are generally seen when they are relatively healthy, problems can be identified before they become a significant long-term risk," its director of public services, Dr Neil Bentley, said.
But Professor Steve Field, chairman of the Royal College of GPs, said although he welcomed extending the role of pharmacists it may not save GP time.
"By involving pharmacists in preventative healthcare and screening, GPs will actually be busier as we will be identifying more patients who might otherwise slip through the net.
"We believe that there are opportunities for pharmacists to work much more closely with patients - but this needs to be done in partnership with GPs and primary healthcare teams, not instead of."