April Blog; MAS
Pharmacy First Update
Spring has now sprung and I’m not sure where the time goes. As busy pharmacists the months, and indeed years, seem to roll on at an ever-increasing speed.
It was way back in early December 2016 that Southern Derbyshire CCG (SDCCG) and Erewash CCG (ECCG) launched their Pharmacy First Minor Ailments Scheme. Since then around 12 thousand people have benefitted, and with one in five GP consultations taken up by minor ailments, 18-20% of GP workload, this must have helped relieve at least some pressure on our local GPs’ time.
A recent two-month SDCCG scheme report, covering the period between 1st November and 31st December 2017, showed 2,234 ‘provisions’ or ‘personal interactions’ with community pharmacy contractors. This was 1,757 in SDCGG and 149 in in ECCG – a 6.7% increase in activity from the previous two-month period. Interestingly, the majority of people accessing the scheme were under the age of 13 (65%) and the remaining activity was spread fairly evenly across other age groups.
In fact, out of the 2,234 patients who accessed the scheme during November and December only six were referred on to another healthcare provider; to their GP, with a 50% split of urgent (within 24 hours) and non-urgent. Referrals were all made in line with the Pharmacy First Protocols.
It was also found that the two main reasons for accessing the service were temperature/fever (44%) and head lice (13%).
132 Community Pharmacies in Southern Derbyshire and Erewash are signed up to participate in the scheme, and, of these, 113 provided service to eligible patients in the two-month report period. If these pharmacies hadn’t delivered the service 95% of the consultations would have transferred to GP appointments!
The report concluded that: “the Pharmacy First Scheme continued to have a good uptake with some community pharmacies seeing a high number of patients. G.P practices and participating community pharmacies continue to promote the scheme to patients and ensure eligible patients are signed up to the scheme.”
The scheme was reviewed in March this year to determine its viability by the four CCGs’ (Southern Derbyshire, Erewash, Hardwick & North Derbyshire), because of the introduction and implications of their new Self-care policy. The schemes users, providers and other stakeholders were included in the review and the outcome will be revealed in due course.
We are also now conducting a small-scale extended care pilot study, supported by NHS England North Midlands (NHSE-NM), which will look at Ear, Nose & Throat (ENT) and Eye conditions. The pilot study will involve up to eight pharmacies in Derbyshire and 15 in Nottinghamshire. All of the participating pharmacists have attended a CPPE course with a focus on ENT and Eye, so that they have the necessary skills to support patients with these conditions.
PGDs are a key element of the service and they will facilitate the supply of antibiotics after an appropriate assessment. Participating pharmacies have been supplied with the necessary medical equipment, at NHS-NM expense, to use during the consultations (e.g. 3m Littman otoscopes, Braun Thermoscan thermometers, and consumables).
The overall aim of the service is to ensure that patients can access self-care advice for the treatment of ENT and Eye, and, where appropriate, can be supplied with antibiotics or other appropriate treatments, at NHS expense, to treat their condition. As part of the service patients will be examined and a full assessment made of their condition. This will ensure compliance with PGDs and help the pharmacist make appropriate decisions on the most suitable treatment to address the patient’s symptoms.
The money for the pilot is non-recurrent funding and the success of the pilot will determine whether the extended care service is commissioned in the future. On completion of the pilot the service will be evaluated to consider its usefulness with a view to applying for further funding to extend it to both a wider number of pharmacies and, potentially, to cover a greater range of conditions. Watch this space!