The Dispensing Doctors organisation, a member of the Rural Services Partnership and the Rural Health and Care Alliance have recently launched their Rural Practice Manifesto:

The DDA’s 2019 Rural Practice Manifesto

By DDA chairman, Dr Richard West

Welcome to the Dispensing Doctors’ Association’s Rural Practice Manifesto for the 2019 General Election.

As the election campaign begins in earnest, the NHS will run Brexit a close second as a key area over which the political parties are best-placed to preside.

The DDA invites election candidates to work with the DDA to answer the following calls to action:

1. Involve the DDA in the second phase of the consultation on drug reimbursement, so that dispensing practices and their patients are not disadvantaged when the changes are implemented
2. ‘Rural proof’ Primary Care Networks (PCNs) and support the call for an updated rural NHS funding formula that recognises the increased costs of delivering a robust and resilient health service in rural areas
3. Protect the unique rural GP one-stop-shop service that improves people’s access to scarce healthcare resource
4. Recognise that rural medical practices are the hub of their local communities, offering traditional family doctor GP services, creating skilled jobs for local people, and reducing social isolation
5. Lobby for urgent improvements to the rural infrastructure, particularly, public transport and broadband
6. Recognise that dispensing income is vital for the sustainability of high quality rural general practices

Taken together, these developments will see pressure removed from local district general hospitals providing my patient-centred care, closer to home as the NHS develops GP policy around the country.

The DDA encourages candidates from all parties in rural constituencies to visit their local dispensing practices during the election campaign.  Only by meeting the patients and the healthcare team will candidates see for themselves the vitally important, and often unsung, role of the dispensing doctor practice.

As usual, the special nature – and requirements - of rural GPs seem very far off the political radar. For the eight million patients of rural GP surgeries, and the doctors who provide the service, this is concerning – particularly given the predilection of NHS policy for general practice “at scale” despite the acknowledged workforce challenges, particularly in rural areas.

With its more elderly demographic, and higher incidence of chronic disease, rural general practice does not easily fit into NHS plans for appointment at 8am-8pm consultations, or with a virtual GP over Skype.  For many rural patients, the local surgery is at the centre of the community and it does not just offer them their GP service.  In addition, deprivation is more difficult to find and deal with and is often not accurately reflected in the NHS funding formula for practices in rural areas.

Rural practices located in areas where a pharmacy is not economically viable can also the highly popular, one-stop-shop GP dispensing service. This often subsidises the provision of the GP service, when it might not otherwise be viable. Many people are unaware of this and assume that the service will continue to be there because it always has been. Unrelenting pressure on dispensing margins and the search for ‘efficiencies’ within GP dispensing services will do little to secure a reliable future for this much-loved service.

The DDA’s Manifesto is designed to alert candidates from all parties, and their communities, to the importance of dispensing GP practices.  They are the hub from which health and social services should be delivered in the future and, if local health economies are not to be destabilised further, they must be preserved and invested in over the next five to ten years.

Dr Richard West MBE

Chairman of the Dispensing Doctors’ Association

Partner, Woolpit Health Centre, Suffolk 

The DDA has produced 2019 election manifestos, and for GPs in each home nation a GP briefing paper containing instructions for using the DDA’s manifesto resources and further background information on the manifesto points.  Resources provided on the website include:

• a press release to be sent to local newspapers,
• template GP practice website copy,
• a practice letter for election candidates and
• a patient letter for election candidates.

Please see their [online] Political Lobby resources for further details.