Pharmacies role in pancreatic cancer diagnosis
The Royal Pharmaceutical Society has launched a plan to increase the role of pharmacies in the early diagnosis of cancer.
What does this mean?
If this plan were to go ahead, staff in pharmacies could assess patients and refer those with red flag symptoms directly to the hospital without the need to see their GP. The plans come at a time when average GP wait times have topped two weeks for the first time.
Seeing a highly qualified pharmacist for minor illness, assessment or cancer screening could result in faster referral and diagnosis of cancer as well as freeing up GP time.
Ade Williams, PCA pharmacy ambassador and lead pharmacist at Bedminster Pharmacy, Bristol says:
“I see daily many opportunities to build on this to improve cancer diagnosis and care. Empowering us to make direct referrals will speed up and improve survival from cancers like Pancreatic Cancer.”
The majority of the country lives within a 20-minute walk of their nearest pharmacy and 95% of the population use their pharmacy at least once a year. Local pharmacies are accessible and well placed within communities. Patients visiting their pharmacy frequently or with red flag symptoms, who may not otherwise go to their GP may benefit from the plan.
Pilot studies, where pharmacists referred patients to their GP or directly for screening or diagnostics have been successful in the case of lung and bowel cancer. A pilot study of 33 pharmacies in Northern England found that a common pancreatic cancer symptom, unresolved indigestion, was the second most common cancer symptom that pharmacists referred for.
“With the future role of community pharmacies in the wider NHS being shaped by the new pharmacy contract, this is definitely the right time to take bold steps that will place them alongside GP and secondary care colleagues, fighting cancers like Pancreatic Cancer.” (Ade Williams)
Pharmacists are well placed to review patients presenting multiple times for over the counter medication and who present at appointments asking for advice. Equipping pharmacies with the tools and knowledge to identify red flag cancer symptoms and allowing them to make direct referrals could increase early diagnosis of pancreatic cancer in patients who may not have recognised their symptoms or presented at their GP. This route of referral could reduce the number of patients diagnosed late or through emergency presentation.
What do we think?
We fully support the increased role of pharmacists in the diagnosis of pancreatic cancer and work closely with pharmacies to raise awareness of the disease amongst staff and their local communities. We provide free eLearning modules and resources for pharmacists and their teams to ensure they have the knowledge and confidence to suspect and refer for pancreatic cancer.
We will be monitoring this plan closely to see if it is adopted and evaluate its process. Pharmacists are being increasingly relied on to carry out health interventions previously left to doctors and other primary care professionals.
The extra strain on the service may make delivering appointments difficult for pharmacy staff and the workforce needs to be supported through changes to roles and responsibilities.
Furthermore, if patients are using pharmacies for a wider range of health issues, the link between pharmacists, GPs and secondary care must be improved to avoid patients missing follow up appointments or having to present multiple times to different health care providers.
Final thoughts from Ade
"Pancreatic Cancer Action have for a long time worked with community pharmacy teams, up skilling our disease diagnosis knowledge and supporting local awareness initiatives.
Integrated working and partnership working offer us the most cost effective way forward. Unleashing the expertise of community pharmacies will definitely advance the cancer survival goals thereby saving many lives."
This consistent message from Pancreatic Cancer Action is now becoming a consensus opinion. Let us all make it happen now.