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Times are a-changing Ė Imperceptibly???

Heather Pym
A Division of General Practice Perspective

Issue 65: October 2007
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On many occasions when visiting GPs in my work of promoting QUM I am asked if I know of any GPs available to assist in practices.
I wish I did have a few suggestions up my sleeve but sadly GPs are scarce – probably more scarce than pharmacists if the ‘shortages’ are to be believed.
I think with pharmacists that many have left the profession for better conditions in other climes or are not satisfied or able to be waiting in the wings until called in for a locum position. Economics generally, these days, does not allow the insecurity and spasmodic demand for many ‘locums’ to be out there to meet the fluctuating demand.

While overseas recently I read in the Daily Mail in London that one in three patients sees a nurse instead of a GP. 
Patients are almost twice as likely to see a practice nurse than their GP than they were in the early 1990s.
It may be surprising but trends in Australia could be heading this way.
In our Division of General Practice practice nurses are well supported and encouraged to be involved with patients in immunisation, diabetes care and now mental health.
I often rely on them to identify patients who would benefit from an HMR and most of the practices with higher frequency of ordering HMRs are those that employ a practice nurse to do this.

GP’s time is at a premium and something has to give to cope with the everyday volume of services required.
In the UK the nurse consultations are longer and satisfaction levels with patients are high.
GPs are dealing with the more complex cases while other members of the team see the more straightforward problems.

The UK also has made provision for special pharmacists to prescribe most of the range of drugs on the NHS list.
This also has lifted the burden from GPs in routine work demands and freed up their expertise for more complex patients.
With increasing health care demands in Australia and a shortage of GPs, at least in the short to medium time frame the opportunities to utilise practice nurses and perhaps practice pharmacists is timely.
For pharmacists to be actively involved in some of these clinical initiatives perhaps the undergraduate courses will have to focus on these skills and prepare a new generation of pharmacists to take up new roles.

To re-engineer the current workforce in light of the shortages and skills deficiency would be a more than an extraordinary feat but something that could be considered if it encourages young pharmacists to remain interested in their profession and ‘stay on’.

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