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No time to waste! Politicians ‘of all colours’ must expand Pharmacy First

CCA chief executive Malcolm Harrison says his report into the Pharmacy First rollout shows a ‘postcode lottery’ emerging across the country, and that there is capacity for hundreds of thousands more consultations if the government accelerates...

Over the weekend, I was pleased to see the Conservatives heeding the advice of the CCA and others by announcing their plans to expand Pharmacy First if they win the next election.

The Tories want to include chest infections and acne and move the pharmacy contraception service into its higher tiers, allowing pharmacies to offer patients contraceptive patches and injections.

They claim  this would free up 20 million GP appointments per year by the end of the next Parliament, once scaled up. This number actually falls short of what our modelling tells us – that an ambitious and fully-funded Pharmacy First service could free up more than 30 million GP appointments a year.

Read more: Xrayser: Will a community pharmacist running in the General Election backfire on our sector?

I think expanding Pharmacy First is a no-brainer, and frankly, I’d hope that all political parties, irrespective of their political leaning commit to continuing and expanding the service.

Pharmacy First is reinforcing the accessibility and appointment-free care that pharmacies provide and the data we have collected from 3,000 of our members’ pharmacies supports this. An impressive 92% of eligible Pharmacy First patients are getting the care they need within a pharmacy – so concerns that patients would ping-pong between GP surgery and pharmacy are unfounded.

Patients are also accessing Pharmacy First across the week, including outside of typical working hours, highlighting the value of pharmacies’ extended opening hours. Nearly a third of Pharmacy First appointments are provided out-of-hours.

Read more: Pharmacy First has left GPs with a “reliable service” for their patients

In the first month of its launch, almost a third of all CCA members’ Pharmacy First consultations were administered in the 20% most deprived communities. Due to the ‘positive pharmacy care law’, commissioning pharmacies to deliver national services immediately benefits those in deprived communities. Tackling health inequalities is a key NHS objective and Pharmacy First does that.

So, if Pharmacy First is already delivering, what should happen next?

Firstly, we need to see an increase in GP referrals. Despite electronic referrals representing only 18% of all Pharmacy First consultations, they are closely linked to the total number of Pharmacy First consultations. Indeed, the three integrated care systems (ICSs) with the highest numbers of consultations also had the highest number of electronic referrals.

Our latest report shows that a ‘postcode lottery’ is emerging across the country – if every ICS had as many consultations as the highest performing one there could have been an additional 600,000 Pharmacy First consultations.

Furthermore, the NHS’ public marketing campaign simply has not delivered what the NHS needs.

Read more: 'Undervalued and underappreciated' is also undeserved and unfair

All these issues need urgent attention. We need integrated care boards (ICBs) to provide further support to their General Practices, to increase patient referrals, and we need much more impactful, high-quality marketing campaigns to help raise awareness of Pharmacy First with the public.

And while funding for Pharmacy First is only assured until March 2025, there’s little time to wait.

We urge the next Government to commit to funding Pharmacy First beyond 2025. This would give contractors the confidence to invest in staff, premises, and training. It would give GPs the confidence to refer patients into a service that’s here to stay. It would also give the profession a powerful message. Pharmacists I’ve spoken to feel very positive about the service – even through the pressures of all the existing work they continue to deliver.

Having the assurances of funding beyond 2025 also gives policymakers the room to expand the service. The obvious first move would be to broaden the eligibility for some of the existing conditions. The second move would be to consider the next set of conditions Pharmacy First should cover, as the Prime Minister has promised to do.

Looking further ahead, Pharmacy First should be used as the foundation to develop new and innovative prescribing services, so that patients can benefit from the prescribing capabilities that all new registrants will have from 2026.

Read more: How Pharmacy First allowed me to save a patient from waiting at A&E

Of course, I recognise that further funding for Pharmacy First is not, by itself, a silver bullet for the sector. It does not solve the historic underfunding of community pharmacies, nor does it address our concerns regarding current and future workforce shortages. It certainly does not solve the worsening medicine supply issues we face.

We, like others, will continue to campaign on these fronts.

The reality is that Pharmacy First has been a long time coming, and we are unapologetic in our desire to promote it and secure funding beyond 2025. There is no time to wait or waste.

We will push for a Pharmacy First expansion – it makes sense for the profession, for patients and the NHS, and dare I say it – it’s something that politicians of all colours must get behind.

Malcolm Harrison is the chief executive of the Company Chemists’ Association.




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