To think the new see a pharmacist thing could be a disaster

[Dancebaby1989]

So really unwell yesterday and today- massive swollen tonsils, temperature, headache, red blisters in throat, tonsil stone. Decided to do an e consultation for GP and they booked me into to the pharmacist under the new government scheme- no issues at all.
get to pharmacist and he gets out a book of flow charts and when I explaining my symptoms is sat googling them and words from the flow chart- asked him if he need me to explain anything as am a nurse and he stated he had received no formal training they had just provided the flow charts.
end consultant and prescription complete but he never actually did any observations or even looked at my throat and while I know I need them I feel this is such a poor role out of this (not his fault) and could be dangerous

Honestly, my local pharmacist is so much more knowledgeable than doctors sometimes. He's on the ,'front line ', so to speak and he has such a wide knowledge of various things, viruses that are going around, what medication works best and what things to try. My doctor has perscribed me medication that has been discontinued or not in circulation any more. 😬😬😬😬

It’s an incident waiting to happen. Not pharmacists fault obviously, but what the hell are GPs for?

If the pharmacist is not a prescriber, then he will only be able to give antibiotics for a defined set of circumstances, it’s not the same as using his professional judgement as to when to prescribe. Also assuming you’re in England the scheme is new so you might be his first patient with a throat infection.

The Pharmacy First scheme has been in place in Scotland for a wider range of conditions for a while. We also have Pharmacy First Plus. In general it’s a good idea to take the pressure off GPs, though not sure the pressure on community pharmacies is much less!

I think it depends if we are trying to make healthcare more accessible overall or trying to divert it from the GP. I’m hoping Im making sense, like if this is a bonus rather than a replacement then it should be fine. But if, like OP, people who ought to see a GP are getting fobbed off with a pharmacist it’s going to get worse. Things like UTI’s really ought to have a sample sent off for culture too. I have had infections that have been resistant in several occasions. It’s just days more suffering and needless antibiotic use.

It will work well if the pharmacist you see is as highly trained as they can be. If you see the type you saw it's going to be a complete disaster.

A lot of it isn’t anything new - for example pharmacists can already do antibiotics for uti’s and the algorithm has a low bar for declining and signposting to GP. However I do have concerns that no one is doing basic observations and things like sepsis will be missed.

I think like all things medical it depends on who you get seen by. I only got referred for a breast lump because I have private healthcare, my gp was dismissive and then said if you’ve got private you may as well see. My local pharmacist is amazing, I’d far rather see him than my gp as he listens. I think it’s a great idea as for the things on the list pharmacists will be more than capable of dealing with.

I've never met a pharmacist whose opinion I'd trust.

Frankly, I don’t know how they have the time. On the few occasions I’ve needed prescriptions they sent me away and to come back in an hour.

My concern is that pharmacists won't have access to a patient's medical history so may prescribe inappropriately. For the rest, I've had mixed experiences with pharmacists, but I can say the same about GPs.

I saw a pharmacist who was absolutely adamant that my son had chickenpox when he clearly didn't (and was bloody rude about it in the process), so I can't say that I would trust their judgment particularly highly.

@TheShellBeach hi again 🤣
im a pharmacist, the pharmacist should definitely have looked down your throat, to exclude things like quinsy etc however we have had so little time to read what circumstances were allowed to prescribe and not, he was probably looking at the criteria (which is pages, upon pages). We didn’t even get access to the computer system until the day it set off… that was fun!

I imagine it will work well for simple issues like skin conditions, repeat prescriptions, gastro problems.

Yes things will get missed. But God I wish we had this where I am for simple things. I'm also a RN, frequent UTI's. I'm able to dip my urine, call the GP, tell them I need trimethroprim, can't get an appointment for a week as "non urgent". So I buy it online now, maybe that's the aim of this government, to get us all self treating and buying online.

It is worrying that they aren't doing NEWS, looking for signs of sepsis etc.

I wonder if the pharmacists actually want to do this, or are having it thrust upon them?

@Puddingpieplum im a pharmacist, we definitively do the NEWS2 score if we think necessary, we’ve been trained in that for years, nothing new to us. I think this pharmacist just seems very unprepared but in the pharmacy community there’s been a large furore as many chains have been pushing their pharmacists to do it and cancelling locum shifts if they don’t certify if they’re competent yet. It’s been a lot at our busiest time of year

It is going to be beneficial in some ways.

For instance recently someone I know was given an incorrect prescription, for something they’re allergic to. The pharmacist was perfectly capable of changing to the safe equivalent but not allowed to, the doctors was close to closing and it was a panicked dash to get the GP to reissue a new prescription.
A few times times now I’ve had prescriptions for a product in one strength and the pharmacy has only had a different strength available. Fine just take two of these instead of one of those. But that’s not allowed, have to go through the doctors surgery, another phone call, another task for the GP.

Also if you can tell somethings infected, like tonsils, or a wound, being able to get antibiotics from a pharmacy is handy because doctors appointments are so hard to get.

EDIT to add, I’ve also been given a prescription for something not available from the out of hours clinic via 111 which was awful as there was no way of getting back in touch with them to get it reissued and pharmacists weren’t allowed to prescribe an alternative. In that scenario it would mean another day on 111 callback, or a trip to A&E?

Yes the communication between GPs and pharmacies is going to be dreadful isn’t it 😔

Agree. Never gone about Tonsils but I've asked for other advice. They listened and gave a response without asking why I'm here and just sat on Google, or asking me what I'd like!

My Pharmacists are always rushed off their feet not sure how much they welcome new job. Do they get paid extra per person? What about other staff who don’t get paid extra to take on more of the load?
one of mine has given me rubbish information before “don’t take that drug with that” when nobody else has mentioned and the huge leaflet says nothing about it in the box. Doesn’t inspire extra confidence.

Will also add I’ve had GPs Google things in front of me too. I’m not criticising, no one knows everything. And I’d rather a doctor / pharmacist double check and be thorough than be pig headed and wrong!

Once I had to take print outs to prove the suitability of a certain medication. The doctor was genuinely happy to learn something new!

@Berlioz23 that's what I wondered. Some pharmacists are very scientific and fascinated by the drugs but not so keen on patient interaction, and some are just wonderful with the public (in my vast experience of working with pharmacists). If you're the former and you're suddenly being pushed to do consultations and examinations you aren't going to be very happy in your work. I imagine single handed pharmacists are able to opt out, but in the chains will be forced to do it.

Ours is so chaotic, the one nearest the doctors surgery wants to send you away. But you’re stood right there - I need to get back to work/kids/home whatever.

I went to the pharmacist with tonsillitis, they didn’t even look - had they checked they’d have sent me to A&E and not home with a throat spray. I had quinsy!

At 111, we regularly have to tell people to see the pharmacist for a consultation. Majority of the time, people call back saying the pharmacist can't help and that they need antibiotics from the gp. If they can prescribe antibiotics for certain conditions then that's great. That would take a lot of pressure off the gp.

Eh?
I've never asked a pharmacist to look down my throat.