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We need diabetes-specialist pharmacists to help GPs
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A GP pharmacist based in London told a UCL School of Pharmacy press briefing that “diabetes-specialist” community pharmacist roles should be created specifically to improve treatment for millions of people who have the disease.
Before the pharmacy and national press at the Royal Society, Imran Khan said community pharmacists were ideally placed to alleviate the pressure on general practice, with 4.6 million people in the UK having the disease and someone diagnosed every two minutes.
Dr Elizabeth Robertson, the research director of Diabetes UK who also addressed the briefing, described the problem posed by diabetes as “a crisis.”
Khan said that with ”a little extra training,” community pharmacists can provide diabetes care and information to people, including foot checks, and see them much quicker than a GP can.
“The thing that pains me about community pharmacy is that we have access everywhere. To see me in a GP surgery, you still need an appointment. There’s a tsunami out there,” he said.
“Even for me, it’s three weeks to get an appointment at the moment. I’m not proud of it but I can’t do any more. Community pharmacists are there, they have the access, they have knowledge.
“They can advise on foot checks. Some people miss foot checks. Why can’t community pharmacists do it? If I have somebody whose insulin needs to be re-titrated, I need to send them to a specialised service. I can do it and I have done it but it takes me four or five appointments.
“So I have to send them to the specialised service or to hospital. Guess what the timing is? Sixteen weeks. Can a community pharmacist do insulin re-titration? Of course they can. If they need a little extra training, fine. We get everybody accredited to a level.
“But look at the access they’ve got. You could have insulin re-titration within a week, not 16 weeks, not six months. We’re missing a major opportunity and community pharmacy is there. I don’t understand why we are missing that opportunity.”
Khan added: “(Community pharmacists) are more than equipped to take some of that pressure off GPs. Of course, what the GP does we can’t do. Even myself as a clinical pharmacist in a GP practice, I know the boundaries of competence.
“We have fantastic access in community pharmacy. Why can’t we have diabetes-friendly pharmacists where you can go and get your diabetes information, your foot checks and all sorts of stuff from accredited pharmacists. And when are we going to have diabetes-specialist pharmacists?”
Dr Robertson, who said diabetes needed to be “managed in a personalised way,” warned a lack of investment in research was impeding attempts to understand the different types of diabetes and how care can be improved.
“Every year the NHS spends £10 billion on diabetes care but for every pound spent on diabetes care, only 0.5 pence gets spent on research. This is not enough,” she said.
“There’s so little we understand about the different conditions, we really need to invest more so we can really forge forward with this personalised approach.”
She pointed to figures revealing that in the last 20 years, the number of people with diabetes has doubled while more than 500 people with diabetes die prematurely each week.
“There are 169 amputations, 680 strokes, 530 heart attacks and we estimate there are 2,000 cases of heart failure,” she said.
Dr Robertson also said more than 10,300 people in the UK have end-stage kidney failure because of diabetes and over 1,700 people have their sight seriously affected by the disease each year.
About 425 million people have diabetes globally. That is predicted to rise to 629 million by 2045.
Picture: eROMAZe (iStock)