It's one thing for GPs to gripe about community pharmacists, says our medic blogger Dr Livingstone. But it's a different kettle of fish entirely when practice pharmacists do the same


As regular readers will no doubt have worked out, I am a GP at the very cutting edge of modern practice and evidence-based medicine. Which means, of course, that I devour every available medical journal with an appetite that borders on the obscene.

But I have to confess that Research in Social and Administrative Pharmacy has somehow passed me by. Until now. Because the latest edition has been brought to my attention by those who know I have an interest in, and a bit of a view on, inter-professional harmony in general and the GP/pharmacist relationship in particular.

So imagine my excitement on reading ‘General practice pharmacists in England: integration, mediation and professional dynamics’. Excitement and, it turned out, shock. Some of the comments in this article surprised even me, especially in the juicily titled, ‘intra-professional tensions’ section.

One GP pharmacist, for example, talks of community pharmacists being ‘less than scrupulous’ in their ordering of repeat prescriptions, ‘taking the mickey’ by over-ordering repeats and generally ‘ripping off’ GPs/the NHS. Wow. I’d never say that. Think it, maybe. But not say it.

And throughout the research are comments hinting that, in the brave new world of primary care, pharmacists will be seen as low-value stop-gaps who exist only to ease the strain on higher functioning, over-worked GPs. Indeed, one of those interviewed went so far as to describe community pharmacists as shop-orientated ‘checking monkeys’ – and before you blow your stack in indignation, I should point out that this actually came from a practice pharmacist.

What is clear is that the new dawn of subsidised roles in Primary Care Networks (PCNs) may not be quite as bright as some are anticipating. You might be looking forward to a patient-facing role of minor illness management and independent prescribing, only to find that you’re shut in a cupboard with a bare light-bulb and a massive pile of repeat prescriptions.

Judging by this research, avoiding ending up as some primary care under-class is going to take some work – and an effective and rapid PR job. That needs to start first with persuading your sector of its own worth, because, by the sound of it, you have the sort of esteem issues that I tend to see in acne ridden, socially phobic adolescents. And then it needs to change the attitude of doctors. Because if you thought I was bad, you should meet my colleagues.