ICSs must iron out pharmacist prescribing ‘inconsistencies’, says Andrew Lane

Integrated care systems (ICSs) must work to ensure that all pharmacists are offered appropriate prescribing opportunities, Andrew Lane has said.

Speaking at a Health and Social Care Committee event looking into the autonomy and accountability of ICSs today, the National Pharmacy Association chair praised ICCs for breaking down ‘silos’, but questioned the ‘inconsistencies’ between systems.

For example, Mr Lane said that in Gloucestershire, where he chairs the local pharmaceutical committee (LPC), he has had discussions with GPs about how to help them get UTIs ‘off their desk’, but said there is no patient group direction (PGD) in the area to allow pharmacists to prescribe antibiotics for UTIs, unlike in other ICSs.

He continued: ‘More important things can be done by GPs; GPs want to get UTIs off their desk, so surely the system should be able to have PGDs for UTIs enabled? Our surrounding systems already have that in place.

‘So I think that’s just an example. You do have inconsistencies - and how you provide the accountability to ensure that that is covered across all systems is still a bit unclear.’

Mr Lane also suggested that ICSs should start planning now for the transition to all new pharmacists becoming prescribers at qualification for 2026, and could use PGDs before then to help current pharmacists to prescribe.

He explained: ‘In the interim, you can plug that gap with PGDs, so you don’t have to wait for a prescribing pharmacist to come along before you can prescribe antibiotics for UTIs.’

When asked whether the right leaders were in place across ICSs, he said the situation was ‘extremely patchy’, and repeated his call - also made in an interview with The Pharmacist last month - for LPCs to ‘get involved very early on’ in ICS discussions.

However, Mr Lane praised the introduction of ICSs for pulling ‘silos’ from across health and social care together ‘for the benefit of the patient’.

He continued: ‘In other words, we leverage the best value of the pharmacy pound for the taxpayer in the system. And if we all focus on that, the money in the system will follow the patient, and the process will end up being the right process for the patient, particularly because we’ll have all the patient groups involved as well in that discussion.'

This comes after Mr Lane, acting in his capacity as NPA chair, released a statement yesterday calling for ‘urgent intervention’ from the Government and the NHS in England, with pharmacies already having to reduce services because chronic underfunding has made current service levels unsustainable.