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The former deputy chief pharmaceutical officer for England Bruce Warner yesterday dismissed recent criticism of pharmacists prescribing from a small section of GPs and insisted that “noise will die down”.

Speaking at the Company Chemists’ Association conference in London, Warner (pictured) said claims from GPs on X last month that independent prescribing (IP) was a risk to patient safety because pharmacists are not trained in diagnostics and are not qualified to “deal with undifferentiated patients” were from “a vocal minority”.

One doctor described IP as “dangerous quackery” while British Medical Association (BMA) council member Mike Henley posted: “The issue isn't the medication. A member of the public with chatGPT can manage that. The issue is the full history, examination, investigations, comorbidities and of course diagnosis.”

When asked if these views, particularly the one expressed by a BMA council member, could in any way hinder the expansion of IP beyond Pharmacy First and the pharmacy contraception service to complex conditions, Warner said: “These aren’t new comments. We hear this every time pharmacy tries to do something new.

“I don’t think anybody is talking about pharmacists coming straight out of university and starting to diagnose complex conditions. Having said that, I remember trying to put pharmacists into general practices in Sheffield in the late 90s and meeting very similar resistance from the GPs.

“They were not keen at all, they couldn’t see the value of it. Once we put them in there for six months and then tried to move them out and put them into a different practice, then they would fight tooth and nail to keep them there because they had seen it in action, they had seen the value of having pharmacists there.

“And I suspect we’ll have the same scenario. We’re starting to see the benefits of Pharmacy First and we’ll start to see the benefits of pharmacists prescribing and I’m sure, over time, the GPs will become much more comfortable with it.”

Unclear if views of “minority” of GPs are shared by BMA or RCGP

It is not clear if the views of a “minority” of GPs are shared by the BMA or the Royal College of General Practitioners. Neither responded when Independent Community Pharmacist asked if they thought pharmacists should be prescribing for more complex conditions such as mental health, cardiovascular and respiratory disease or whether they believed pharmacists should be prescribing at all.

However, Warner, who was elected to the Royal College of Pharmacy’s English Pharmacy Advisory Council this year, was confident any concerns GPs have about IP would disappear once they become familiar with it and see its benefits.

“We’re hearing from a vocal minority and that’s to be expected,” he said. “As it becomes more (familiar) and as patients become much more comfortable with it, I’m sure that noise will die down.

“We’ve spoken a little bit about confidence of pharmacists in providing the service but we do also need to provide confidence to both patients and also to our other health professional colleagues that pharmacy can do this and do this well.

“We will prove that but it doesn’t happen on day one. We need to make that case by doing it well and I have no doubt we will do. So, I suspect that noise will die down.”

Echoing Warner’s remarks, Raj Nutan, vice-president healthcare strategy and service, Cencora Alliance Healthcare, told the conference: “I remember when Pharmacy First launched and we had the same debates with GP practices. We’re a couple of years on now from Pharmacy First and certainly, in pharmacies I visit, the feedback I get is that GPs are becoming more and more collaborative in their approach. They can see the benefits of Pharmacy First.

“There will always be a segment of people who will say certain things but ultimately, we need to leave pharmacists and GPs to collaborate at a local level to try and prove the service works. In parts of the country it has. It’s been fantastic.”

Nutan added: “I agree we need that strong collaboration at local level. I’m seeing it since Pharmacy First was launched. It’s getting better and better.”