Derbyshire LPC Chairman’s January 2017 Blog – Minor Ailments: Major Opportunity
I am delighted to announce that following a successful pilot study of a minor ailments scheme in the Swadlincote area, Southern Derbyshire CCG has now commissioned the service from community pharmacy contractors. I’m sure you will agree that this is a major opportunity to show what we can do to help patients access the treatment they need in a timely and safe manner.
The “Pharmacy First” scheme was launched on 1 December and will be reviewed in March 2019. It has already had a vote of confidence with EVERY community pharmacy in Southern Derbyshire signing up to deliver the service. Erewash CCG practices will also participate, but it will not be available in North Derbyshire CCG or Hardwick CCG areas.
Southern Derbyshire CCG’s vision and five-year plan includes promoting self-care to free up GP time for the management of more complex long-term conditions and to reduce the reliance on secondary care or out of hour’s services.
One in five GP consultations are for minor ailments and the treatment of minor ailments was found to account for 18-20% of GP workload with 90% of these consultations solely for minor ailments. In the SDCCG area, this equates to around half a million consultations per year, and, potentially, these consultations could be done in a community pharmacy.
For those of you with long memories, you will recall that there was a scheme called “Pharmacy First” over 10 years ago in the Derby area which was decommissioned at the end of March 2011. The original scheme was paper-based, very labour intensive, and somewhat cumbersome to deliver. Other areas in Derbyshire operated similar schemes and they all had their own formularies, which didn’t make it easy when working as a relief pharmacist! However, the new scheme is underpinned by PharmOutcomes, which will ensure ease of operation.
Each ailment has an associated protocol and the consultation will involve:
- Service user assessment (must be present in the pharmacy) – there are inclusion and exclusion criteria for each condition
- Provision of advice and written information as set out in the protocol
- Completion of the Pharmacy First Consultation Proforma on PharmOutcomes
- And, only if appropriate, supply of appropriate medication from the formulary
Where patients present with symptoms that need urgent referral the pharmacist should record the reason on PharmOutcomes. The system will then generate a pre-populated letter, including the reason for referral and supporting information, which the patient can take with them. The pharmacist will counsel the patient on whether or not the referral is urgent or non-urgent, so the patient can decide what they need to do to access the treatment they need.
Pharmacists need to complete a Declaration of Confidence (DoC) for Minor Ailments Services before being able to offer the service. These DoCs will be checked by the PharmOutcomes system when the pharmacist logs-on for the first time. There will be a four-month grace period for completion of a relevant CCPE pack (e.g. “Common Clinical Conditions and Minor Ailments”, which is based on the training required to deliver the Scottish MAS).
Southern Derbyshire CCG has gone to great lengths to ensure that the scheme is a success. They have provided comprehensive supporting documentation and put on training for pharmacy team members.
With 100% sign-up it’s now down to community pharmacy to deliver the scheme as professionally and as effectively as possible. Successful delivery could mean that more ailments are added to the scheme and the CCG may also consider commissioning additional services from us. This is a major opportunity for pharmacists in Derbyshire to show how they can support self-care.