The Pharmaceutical Journal
Vol 275 No 7375 p597
12 November 2005

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Patients could register with pharmacist and GP

Community pharmacists could be the point of registration for patients and employ a GP to provide medical services from their premises, according to the NHS Confederation.

This is the logical extension to the belief of trust chief executives that the days of patients registering with a single GP are over.

In a survey carried out by the confederation 75 per cent of trust chief executives said patient registration is still important but 78 per cent said patients should no longer only be entitled to register with one GP.

The most popular model for registration in the future favoured by chief executives is to allow a patient to be registered with an “alternative medical provider”. This could be an independent sector primary care provider, including community pharmacists, working under the auspices of the NHS.

Just under a third, 30 per cent of the 60 chief executives who took part in the survey, favoured patients being registered with a number of different GP practices. This option would allow them to register with a GP who had a specialist interest in any given condition such as diabetes. Eleven per cent said they preferred the option of dual registration so that patients could register with a practice near to their place of work as well as their home and 21 per cent came out in support of the present single registration system.

Commenting on the findings, NHS confederation chief executive Gill Morgan said: “There is a clear need for change — now we need to look at how this would work in practice and how it would impact on GPs.”

Deputy policy director at the confederation, Jo Webber, said there was no reason in the future why community pharmacists could not employ a GP in their pharmacy to help provide specialist services under an alternative provider medical services (APMS) contract.

She said: “There are some nurses who, under APMS, are employing GPs and I don’t see why pharmacists can’t do something like that as well. I know from my work with PCTs that pharmacists are entrepreneurs. I think they should look closely at some of the messages which will be coming out of the White Paper on out-of-hospital care.”

The White Paper, due to be published later this year, is expected to change the present system of single GP patient registration.

Hamish Meldrum, chairman of the GPs committee of the British Medical Association, said any moves to change the present registration could fragment patient care. He added: “It is interesting that the NHS Confederation makes the distinction between registering with an alternative private provider and another GP, which could be interpreted as signalling the intention to increase the private provision of NHS primary care.”