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Is the rise of GP pharmacists really such a good thing?


30 Aug 2017

Should we be so quick to pack pharmacists into GP surgeries, asks The Pharmacist’s GP blogger Dr Livingstone

‘Let me through, I’m a noctor.’

Just in case you didn’t already know, a noctor is someone who isn’t a doctor, but acts a bit like one. Think advanced nurse practitioners, pharmacists in general practice et al: they’re an increasingly common feature in the contemporary medical landscape.

Whether this is by design or necessity is a moot point. On the one hand, it’s true that noctors are cheaper than doctors, and probably true that – with training and protocols – they could do a substantial part of a GP’s daily work.

But on the other, they’re being ushered into practices so hastily that the policy smacks of bodies-on-the-ground desperation.

And it seems to have reached some sort of peak with the news that a surgery in west London is going to be the first ever pharmacy-led practice – with five pharmacists and two salaried GPs.

Radical and brave perhaps, but their ‘key role in triage and management of common ailments’ might set alarm bells ringing given the practice context and the truism that pharmacists are not diagnosticians.

After all, GPs, being generalists, are good at many things, and one of their key skills is spotting the needle of pathology in the haystack of trivia. It’s a tough job involving a fair amount of risk, some triumphs and the occasional disaster.

Whether pharmacists are willing and able to take on this role remains to be seen. But there’s also the issue of whether patients will accept noctors as their first port of call.

That’s assuming they even realise what’s happening, given that my experience in the hospital sectors suggests the lines between who is, and isn’t, a doctor are, for patients at least, increasingly blurred.

Maybe that’s the idea: put whoever is available in the primary care frontline and don’t worry about details like training, qualifications and so on.

In other words, trust me, I’m a noctor. Good luck with that.


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