A National Institute for Clinical Excellence guide to appropriate referral from general to specialist medical services could result in more patients consulting community pharmacists, according to the pharmacist who is project co-ordinator for the recently published guide.
Ms Oriana Dwight, of the clinical pharmacology unit at St George's hospital medical school, London, told The Journal that one condition pharmacists may encounter more frequently is persistent otitis media with effusion (glue ear) - the commonest cause of hearing loss in young children. The guide recommends that glue ear, which in most cases will eventually resolve spontaneously, should normally be managed within primary care. Ms Dwight predicts that the availability of the advice will allow community pharmacists to work more closely, as part of an integrated team, with doctors, nurses and other health professionals as they advise parents or carers on what best to do.
Glue ear is one of 11 specific topics covered by the 68-page booklet, which concentrates on conditions for which there is considerable variation in the level of referrals. The other 10 topics are acne, acute low back pain, atopic eczema in children, menorrhagia, osteoarthritis of the hip, osteoarthritis of the knee, psoriasis, recurrent sore throat in children, urinary tract "outflow" symptoms (prostatism) in men, and varicose veins.
The guide is co-edited by Ms Dwight and the project's external consultant, Professor Joe Collier (professor of medicines policy at St George's).
"GP referral practice: A guide to appropriate referral from general to specialist services" can be downloaded as a PDF file from the NICE website (www.nice.org.uk).