ACT wants pharmacists to take on more medical services, to help out GPs

The ACT party is proposing to ease pressure on GPs by getting pharmacists to treat more everyday conditions, have them manage long-term medication and conduct skin checks.

ACT leader David Seymour announced the party policy at the Northern Club in Auckland on Tuesday.

Seymour was speaking at a Health Innovators' Summit hosted by health insurer nib and supported by the New Zealand Initiative.

Calling himself the "medicine guy", Seymour also briefly outlined some of the focus he's had as Pharmac minister.

He then discussed what he called a tangible step toward making better use of the talent in healthcare.

As announced in April Seymour said from June this year pharmacists can treat things like head lice, scabies, and oral rehydration.

Seymour wanted this extended to chest infections, ear infections, skin infections and acute pain.

He said if a pharmacist can treat the condition directly, the patient gets a good result, and it saves a number of appointments in another part of the system.

He indicated some patients would still need a GP and some symptoms would still need urgent medical attention, but that was "exactly how triage works".

The second part of the party proposal was managing long-term medication.

Seymour said for many people their main interaction with the health system was ongoing management for a condition. He said they might know their medication is working and "simply need it renewed", or they need a blood test to check the dose is right.

"But instead of a quick, practical interaction with a trained health professional, they are sent back into the GP queue."

He said ACT would allow pharmacists to manage that for appropriate patients, including ordering blood tests where needed, while GPs would retain the overall clinical visibility and responsibility.

"Results would be integrated into the shared health record. Pharmacists would manage routine monitoring and identify when a patient needs to be referred back to their GP."

Not all patients would be suitable, but a large number of stable patients could have "routine medication reviews" managed more conveniently through their local pharmacy he said.

The last proposal was to allow accredited pharmacies to provide skin lesion triage and monitoring.

Under this proposal, the pharmacist would use a dermatoscope and an approved AI risk-assessment tool to assess a lesion, Seymour explained.

He said it wouldn't be a diagnosis, but a "triage" in which there would be two possible outcomes.

"If the lesion is above the risk threshold, the patient would be referred to a GP or specialist," he said. The dermoscopic image would be attached, meaning the next clinician receives useful information "rather than starting from scratch."

"If the lesion is below the risk threshold, the image would be securely stored, and the patient would be scheduled for longitudinal recall," he said.

They would then receive a reminder to come back and get another check.

Speaking to reporters after the announcement, Seymour was asked if this would just transfer the pressure from GPs to pharmacies. He said pharmacies don't have to take on the extra work but the experience currently was that people can see their pharmacist quicker for a vaccination then they can see their GP.

Seymour said they hadn't done "mathematical modelling" to give an absolute indication of how much sooner people might be able to see their GPs due to the policy, "but the things we know for sure is that it's going to be more affordable, more efficient and faster than cramming everyone into a GP for minor ailments.

"How big that benefit is? We can't say right now, but we believe there is a benefit, and that's a good reason to do it."

Asked about Labour's policy to deliver three free GP visits for people, Seymour said it was a "soundbite policy for political reasons rather than an actual sensible approach to healthcare economics."

He said Labour's policy would see more people seeing a GP when their problem could have been solved another way, but the party wasn't providing the additional money or training additional doctors to serve it.

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