An upcoming British Medical Association conference will debate whether community pharmacies should be made to focus on their ‘traditional’ work of dispensing rather than clinical services – and whether antibiotic prescribing rights should be “removed” from the sector. 

The BMA’s general practice committee (GPC) will host a conference of local medical committees (LMCs) in London on Friday November 2022. The packed agenda includes a debate towards the end of the day on the topic of ‘community pharmacy,’ with the conference to consider a motion proposed by Gateshead and South Tyneside LMC that states NHS England should fund pharmacies “appropriately” for their dispensing work rather than asking them to deliver consultation-based services.

The motion also proposes: “Noting six of the seven conditions for which pharmacists are paid to provide antibiotics can be ‘diagnosed’ without actually seeing and examining the patient under their contract, antibiotic prescribing rights be removed from community pharmacy and the money put into pharmacy dispensing fees.”

The claim that conditions can be diagnosed or antibiotics prescribed under Pharmacy First without a pharmacist examining a patient is false. GST LMC has been approached for clarification, as has the GST local pharmaceutical committee. 

The LMC motion also attacks “the wastefulness of paying a seventh of a practice’s GMS fee per patient for a blood pressure check that then generates more work for the practice” and says the hypertension case finding service should be “terminated with immediate effect and the money put into pharmacy dispensing fees”. 

The LMC argues that the pharmacy sector’s survival should “not be made contingent upon doing work traditionally and contractually the remit of general practice” and that NHSE should stop pitting the two sectors “against each other in zero-sum games for scant funding”. 

Several other LMCs have proposed motions raising concerns around Pharmacy First and the perceived antimicrobial resistance risks surrounding the service and arguing that pharmacy’s funding model should revert to focusing on dispensing rather than promote a growing clinical services agenda. 

Devon LMC will propose that there should be a “clear assessment” of the impact of the service on GP surgeries’ workload and of whether pharmacists are deploying PGDs in a way that ensures “appropriate antibiotic stewardship”.

Similarly, Cambridgeshire LMC will argue that the service is failing to meet its stated aim of saving up to 10 million GP appointments each year and that the GPC should work with Community Pharmacy England to investigate “prescribing rates, antibiotic stewardship, clinical outcomes, dispensing waits, the proportion of patients immediately redirected to general practice and re-presentation to GPs for the same issue”. 

In a separate debate, Devon LMC will put forward a motion stating that “repeated medicine switches for cost saving purposes” by pharmacies “increases costs” by triggering more GP consultations with patients “to manage the fallout of switches”. 

Community Pharmacy England has been approached for comment.