“About 3,000” Pharmacy First consultations took place in the first three days of the new service, parliamentary under-secretary for health and social care Lord Nick Markham told the House of Lords this week (February 6).

Lord Markham was responding to questions from the house on community pharmacy and the new Pharmacy Service that launched last week.

He said that the government hoped that the service would be “a boost to community pharmacies”.

Read more: University awarded £2.4m to conduct three-year Pharmacy First evaluation

Baroness Gillian Merron asked Lord Markham why Pharmacy First was not “phased in” by the Department of Health and Social Care (DH), citing concerns that pharmacies will be “overwhelmed” by the “inevitable extra pressures”.

But Lord Markham said that “early indications” from the sector suggested that it had been “managed well”.

“Right now, we feel that it is so far, so good,” he said.

 

“The holy grail of health policy”

 

Lord Richard Allan told peers that Pharmacy First had the “potential” to be “the holy grail for health policy” if it could improve service for patients at a lower cost.

Lord Allan asked whether the government was now looking at pharmacies for “approving repeat prescriptions”, while Lady Merron asked whether pharmacies will be involved more in “the management of long-term conditions” such as hypertension and asthma.

Read more: No plans to expand Pharmacy First conditions ‘at present’, says Leadsom

Lord Markham said that Pharmacy First was “the first step” toward “expand[ing] provision” of services from pharmacies. 

He said that as “capability increases”, expansion could come in the form of repeat prescriptions or “managing cases such as hypertension and other similar areas”. 

Lord Markham said that “the direction of travel” was for the government to “make sure that this [Pharmacy First service] works well and then build on that”.

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Responding to a question about funding for the service, Lord Markham said that the DH and the Treasury had introduced “appropriate safeguards”.

But he added that any “overspending” would be “good news” for the service “because it shows that it is working”.

 

Seeing UTI to eye

 

Meanwhile, Baroness Merron also asked why the urinary tract infection (UTI) pathway in the service was only offered to women up to the age of 64, but Lord Markham replied that for older patients, “UTIs can be a sign of other comorbidities”.

Baroness Laura Wyld pressed Lord Markham for more “reassurance” on the UTI component of the service as “persistent UTIs can be a symptom of something more serious”, adding that women should “feel empowered to go to their GP if they feel something is not right”.

Read more: PDA slams NHSE for ‘refusing’ to stagger Pharmacy First introduction

Lord Markham said that “from personal experience”, it is “much harder these days to get antibiotics for UTIs” and that this is “generally a good thing” for antimicrobial resistance.

“But in many cases, as my wife often says, she knows when she has a UTI—and boy does she need those antibiotics,” he added.

Read more: GPhC: Pharmacies must ‘assess’ whether they can 'safely offer' Pharmacy First

And John Anderson, the third Viscount Waverley, veered slightly off from the topic, raising his alarm at the price he was charged for a packet of four Gillette razor blades at a pharmacy - £23.50. “Shock horror,” he said.

“It is no wonder we have a cost-of-living crisis if people are having to pay those sorts of exorbitant prices,” the hereditary peer said. Lord Waverley asked whether Pharmacy First had “any relevance in relation to the costs that these people can charge”.

Lord Markham said that he did not think the issue raised by Lord Waverley had “any read-across” to the Pharmacy First service but said that he hoped that pharmacies “would be responsible”.

 

Expansion plans?

 

In November, pharmacy minister Andrea Leadsom said that the government had not made any assessment “so far” into expanding the new common conditions service beyond the initial seven conditions it covers. 

But Dame Andrea said at the time that the “uptake and delivery of Pharmacy First will be closely monitored”.

And the London School of Hygiene and Tropical Medicine (LSHTM) this week announced that it has won a multimillion-pound contract to “generate evidence” on the new Pharmacy First service. 

Read more: Pharmacy First: Pharmacies stuck with ‘cumbersome’ IT systems for ‘weeks’

Last week, the Pharmacists’ Defence Association (PDA) revealed that NHSE had “refused” its request to stagger the introduction of Pharmacy First.

In January, the pharmacy union released the results of a major survey that found almost half of “more than 3,500” pharmacists felt  that pharmacies do not have enough staff to “safely” deliver existing services, let alone the additional services under Pharmacy First.