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“Knowledge speaks, but wisdom listens” is a line that often gets attributed to Jimi Hendrix.

With hindsight, I might have thrown the rock legend’s soundbite at England’s former deputy chief pharmaceutical officer Bruce Warner during the Company Chemists’ Association’s conference in London in June, as I listened to him assess the “noise” coming from “a vocal minority” of GPs who had trashed pharmacist prescribing on social media.

The thread of GPs’ flagellation of independent prescribing was that pharmacists shouldn’t be diagnosing and shouldn’t be “dealing with undifferentiated patients” because they are not trained to.

I initially regarded their opinions as outbursts. Warner appeared to have little time for their dissension. The “noise”, he said, “will die down…these aren’t new comments. We hear this every time pharmacy tries to do something new.”

I empathised with Warner. Occasionally, GPs push back, especially when they think pharmacy is encroaching on their territory. Frankly, it wasn’t surprising some railed against pharmacists prescribing.

Perhaps GPs were reassured to hear Warner say pharmacists aren’t going to come “straight out of university and start diagnosing complex conditions”. But pharmacy shouldn’t expect the “noise” to go away any time soon.

In fact, pharmacy would be foolish to ignore it. A few weeks after the CCA conference, the Royal College of General Practitioners (RCGP) president Victoria Tzortziou Brown aired her reservations to this magazine. Her reflections were valid. 

She said practices and pharmacies must have “robust IT systems, clear referral and escalation pathways, appropriate training and reliable mechanisms for sharing information” before pharmacist prescribing is expanded beyond Pharmacy First.

She said any expansion should “be evidence-led, properly resourced and independently evaluated” and its impact on patient outcomes, continuity of care, antimicrobial stewardship, cost-effectiveness, equity of access and workload must be considered.

The independent prescribing pathfinders, I hear you say, were designed to assess governance, reimbursement and digital requirements. But let’s keep an open mind. Let’s not think further evaluation is not needed.

I was encouraged to hear the National Pharmacy Association has been talking to the RCGP, and others, about the pharmacist prescribing journey.

That kind of open communication will make the journey a lot smoother.

Neil Trainis is the editor of Independent Community Pharmacist.