Integrating pharmacy fully into the primary care team

Since teamwork, especially in small, cohesive task specific groups,1 is the central plank on which primary care is now being built, greater interaction between pharmacists and general practitioners could be fruitful. Nevertheless, personal communications from ministers and civil servants reiterate the traditional view that “the separation of prescribing and dispensing ensures that the skills of doctors and pharmacists are used to best effect and that the public has access to both professions.” It is time that these attitudes received the same scrutiny that the rest of primary care has received, especially as the cost of distributing medicines through pharmacies accounts for 30-40% of the total medicines bill.2 Changes in dispensing are under way in other countries,3 involving, for example, mail order. But these fail to build on potential professional collaboration, the desirability of which was implied in a Nuffield report of 1986: “closer relations between GPs and community pharmacists would be in the interests of patients and … more efficient use of resources within the NHS.”4 An opportunity exists for …