Millions of pounds could be saved if more pharmacists prescribed medicines, the Royal Pharmaceutical Society has said.
But the organisations that represents thousands of pharmacists has warned few of its members have been involved in drawing up the Sustainability and Transformation Plans.
It comes as the NHS pushes for medics to slash overall prescribing. The society suggests hundreds of millions could be saved if more pharmacists were able to prescribe.
But Neal Patel, pharmacist and spokesman for the RPS, said: ‘Sometimes pharmacy is absent from them.
‘That’s a huge concern for us if pharmacy hasn’t been considered.’
Across five plans alone health chiefs hope to cut £186.6m (Suffolk and North East Essex, North East London, South West London, Hampshire and Isle of Wight, and Cheshire and Merseyside) in prescription costs.
Mr Patel said the savings could be made if there were more prescribing pharmacists, freeing up GP time.
Complex patients with multiple conditions could be seen by pharmacists who could reduce the number of medications, in turn reducing the risk of adverse reactions between conflicting drugs and cutting emergency hospital admissions.
Mr Patel said: ‘When pharmacists look at patients all round, and at all the medicines they’re taking, the majority are prescribed for people with long-term conditions.
‘It’s not unusual for people to have one, two, three or four conditions, with five or six drugs for each. It’s not hard to start to have 15 or 20 medicines you’re taking.
‘You get side effects because of the combination is causing more harm than good, and suddenly because some of those started a long time ago, you might want to start reducing the side effects by reducing drugs.
‘We look at a patient as a whole to start reducing the burden of the medicines they gave and a side effect to that, they reduce the chance of them going into hospital.’
Late last year the society revealed just 3,319 out of 54,500 pharmacists - six per cent - were trained to prescribe medicines.
New figures obtained by this newspaper from the General Pharmaceutical Council show this has increased to 3,782 in England.
In Scotland there are 891 and in Wales 293. Separate figures from the Pharmaceutical Society of Northern Ireland say there are 313 in the country.
The figures come as STPs propose major savings on prescribing costs.
Under its plan, medics in Nottinghamshire propose relying on prescribing pharmacists within two years.
In a section saying what it hopes to achieve the plan said: ‘Greater resilience, capacity and capability in general practice teams including prescribing pharmacists, advanced practitioners and new support roles working in partnership with multi-disciplinary teams.’
Separately, Mr Patel warned a quick switch to generic drugs could affect patients suffering from illnesses, including epilepsy, arthritis and irritable bowel syndrome.
Kidney transplant patients could also be at risk of their body rejecting the transplanted organ if the drug they are on is switched to a cheaper alternative, branded or generic.
‘There’s a big cost differential between branded medicine, and if the medicine is exactly the same then the CCG should do what it can to reduce cost,’ Mr Patel said.
‘There might be a clinical need for branded medicine if we swap it for a cheaper one, then it may not have the same effect.
‘Some medicines, the bio-medicines, that have a specific effect on the body, you can’t just replace those with a generic medicine.
‘If you start with a generic one then you need to stay with that and if a branded one then you need to stick with that.’
Meanwhile, many STPs suggest ‘social prescribing’ to move away from traditional clinical treatment.
The plan for West Yorkshire and Harrogate says: ‘We will stop medicalising issues and ensure people get the right support from the right professional.
‘We will look outside the clinical model to deliver a more holistic service to our local populations and achieve better outcomes; prescribing will not be the default position.’
In one case, changes proposed in the Cheshire and Wirral STP aim to improve ‘opportunities for community-based social prescribing’.
Meanwhile in Southampton, Hampshire, the mental health charity Mind is already offering gardening courses as treatment.
The 10-week courses run at Mayfield Nurseries are prescribed by GPs, and aims to ‘improve people’s’ wellbeing, confidence and self-esteem’.
An NHS England spokesperson, said: “Within the context of the Five Year Forward View priorities our intention is to work with the profession to increase the number of pharmacist prescribers and enable them to take a greater role in the management of long-term conditions.
“NHS England is investing £42m over the next year to more fully integrate pharmacists into primary care and this will include increasing the number of prescribing pharmacists, particularly in General Practice and Care Homes settings. Demand for pharmacist prescribers is also increasing in the hospital sector, which demonstrates the value put on pharmacists in prescribing roles.”