The Scottish Government and BMA Scotland have today published their 2018 General Medical Services Contract in Scotland.
The proposed contract includes specific areas of interest to pharmacists and pharmacy, namely:
- A refocusing of the GP role, enabling some tasks currently carried out by GPs to be carried out by members of a wider primary care multi-disciplinary team to improve patient care.
- Over three years, a sustainable pharmacotherapy service will be developed, which includes pharmacist and pharmacy technician support to the patients of every practice. Additional funding has been secured to increase the number of pharmacist training posts from 170 to 200 per year from 2018/19.
- By the end of the transition period, ‘GP pharmacists’ will deal with acute and repeat prescribing and autonomously provide pharmaceutical care through medication and polypharmacy reviews.
- The contract will recognise that GPs are not sole data controllers of the GP patient record, but are joint data controllers along with their contracting NHS Board.
Dr John McAnaw, Chair of the Scottish Pharmacy Board, welcomed the announcements and said: “On behalf of the Board and the Royal Pharmaceutical Society in Scotland (RPS in Scotland), I welcome the £12 million in 2017/18 for the GP Pharmacy Fund as part of the new GMS contract, building on previous Scottish Government initiatives and funding through “Prescription for Excellence”. This aligns with the recent strategy document “Achieving Excellence in Pharmaceutical Care“, and gives recognition to the unique contribution pharmacists make to improving patient care.
“It is vital that pharmacist expertise is used appropriately as part of the multidisciplinary team and we would signpost all GPs and pharmacists to our joint policy statement with the Royal College of General Practitioners Scotland (RCGP Scotland). Our joint policy with RCGP Scotland outlines guiding principles for pharmacists working in general practice to ensure patients obtain the maximum benefit from the complementary skills and expertise of both professions.
“The RPS in Scotland strongly believes that patient care can be improved through greater collaborative working between GPs and pharmacists, and indeed with the wider health and social care team working across their local communities. Our Long Term Conditions Policy (LTC), for example, outlined how pharmacists as part of the multi-disciplinary team can improve LTC care. We hope that the new contract will ensure that patients see the most appropriate practitioner for each episode of care.
“It is important that pharmacists recognise they have professional autonomy for their area of expertise, working alongside GPs and other members of the primary care team. Professional accountability must remain within the pharmacist’s own jurisdiction and we are therefore pleased to see this autonomy explicitly stated in the document.”
The RPS in Scotland is keen to hear more detail on some of the elements in the proposed contract, and looks forward to having further discussion with the Scottish Government to ensure we continue to best support our members and the pharmacy profession in Scotland for the benefit of patients and the public. Areas where further dialogue would be helpful include:
- The descriptors of the outlined pharmacotherapy services contain some anomalies. We would also like further reassurance that the need for flexibility, determined by local circumstances, will be taken into account.
- The new contract appears to have been developed in isolation from the community pharmacy contract, where a more collaborative approach could potentially have further improved patient care and outcomes as well as efficiencies. An opportunity to align the two contracts over the next few years will hopefully be possible.
- While we support the changes proposed around the data controller role, we would urge a greater sense of inclusiveness across all health professions when the Scottish Government develops national standards for e-health governance.