Is Medicine blocking Nursing and Pharmacy in the SNS?

Florentino Perez Stripe; Thomas Cobo; and Ana Lopez-Casero.

spain prepares to face the challenges of the future National system of health (SNS). And it is that, given the deficit of health professionals, especially in Primary Care, the Ministry of Health is looking for a new model for which it is committed to new roles, such as that of the Advanced Practice Nurse (EPA). In this time of renewal, with an eye on the development of the Primary and Community Care Action Plan, healthcare families such as nurses and pharmacists are willing to assume more powers to be able to continue to develop professionally, while Medicine advocates the idea of ​​a multidisciplinary team, but makes it clear that “clinical leadership” belongs to the physician.

In this regard, Florentino Perez Rayapresident of the General Nursing Council (CGE), argues that, despite the fact that Nursing is willing to take steps forward in professional development, the profession is facing “limitations” y “unjustified reluctance” by other professional groups. “They are preventing us from that professional development that would have a very positive impact on the health system at this time ”, defends Pérez Raya.

As an example of this limitation, the nurse president focuses on issues related to the indication, use and authorization of the dispensing of medicines or other types of competencies in Primary or Emergency Care. Along the same lines, last July, the General Assembly of the General Council of Official Colleges of Physicians (Cgcom) agreed in extraordinary session to present a appeal against the new nursing prescription guideswhich according to the organization chaired by Tomás Cobo produce “helplessness” and a “irreparable harm” to the interests of the medical community.

“Doctors are not obstructionists”

For his part, Tomas Cobopresident of the Collegiate Medical Organization (OMC), defends that doctors “They are not obstructionist, quite the opposite”. “We are collaborators,” she says. Cobo emphasizes that doctors have to continue collaborating with the rest of the health professions “as up to now” and seek conciliation, but “respecting their part of the competence”.

An example of synergy and teamwork that, according to the specialist, was evident in the Covid-19. “During the pandemic, work has been done in a multidisciplinary way, but with the clinician leadership. Who does not understand, in the 21st century, that patient care is multidisciplinary It is that you have understood absolutely nothing. But neither has he understood anything that doubts that clinical leadership belongs to doctors; not as a corporatist issue, but as a burden of responsibility”, remarks the also vice president of the European Union of Medical Specialists (UEMS).

“Los primary care physicians complain about the care overload, in diagnosis and treatment, which are exclusive powers of doctors. Nursing can collaborate in its area of ​​competence, which is that of care”, adds the doctor, who emphasizes that the physician deficit it is a direct consequence of working conditions, which “are not optimal”, which is why many professionals decide to carry out care activities in other settings.

An opinion you agree with Pharmacywhich considers that the profession does not need to acquire more competence, but to develop the ones it already has to put them at the service of the SNS and other health professionals.

Pharmacy runs into political blockade

From the General Council of Pharmacy They have also claimed the need to be able to make more use of some powers related to the control of medication adherencethe pharmacovigilance o to medication review. However, they do not see any type of blockade in the medical community, but rather associate it fundamentally with a political issue. “We don’t have the perception or feeling that doctors don’t let us do it. It is more a matter of the Administration itself, of the regional health services”, explained the treasurer of the collegiate body, Ana Lopez-Casero.

The spokesperson for the Steering Committee stressed that the pharmaceutical profession does not want to demand the implementation of new competencies in the National Health System (SNS), but it does give a “formal” character to those functions that are already recognized in the study plans and current regulations so that they are deployed 100 percent. “We want to be one more member of the team that supports, helps, is at street level and it detects many things that Primary Care cannot because it does not have the broad hours or the capillarity of the pharmacy”, he added.

Although López-Casero has not detected obstacles on the part of doctors, he has observed some reluctance from the Nursing community who sees in the development of these skills “a threat”. For this reason, he has insisted that the road map of the Pharmacy Council does not in any case go through absorb the tasks of “care”. “What we are demanding is our space: everything that has to do with the use of medicines and with collaboration in community health activities,” she pointed out.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Redacción Médica is edited and prepared by journalists. We recommend to the reader that any health-related questions be consulted with a health professional.