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The case for a minor ailments service

PSNC explains what a nationally commissioned scheme would look like in England

It has been on pharmacy’s wishlist for longer than we care to remember. The Pharmaceutical Services Negotiating Committee (PSNC) has repeatedly stressed its potential benefits. And contractors have lamented its absence. We are, of course, talking about a national minor ailments service in England.

On the face of it, commissioning the service seems like a common-sense move. Several local schemes have saved GP appointments and managed to provide treatment on-site (see Who uses pharmacy minor ailments services?, below). Despite this success, negotiations for a national service fell at the final hurdle this year

But PSNC is still determined to secure national funding. The negotiator’s director of NHS services Alastair Buxton explains what a national service would involve.

Pharmacies would mimic GP consultations

NHS England is keen for patients to visit pharmacies first for minor ailments – as evidenced by last winter’s Feeling Under the Weather campaign, which discouraged elderly patients from visiting A&E or GP practices unnecessarily. But many patients continue to visit their local surgery as a first port of call. 

To change perceptions, Mr Buxton says it is important for the pharmacy service to “feel right”. He suggests that all minor ailments consultations should take place in a consultation room because patients would not “have these kinds of conversations over the counter” in GP surgeries and are unlikely to want to do so in pharmacies.

Who uses pharmacy minor ailments services?


are 15 years old and younger


are female


were referred by their GP practice


would have made an appointment with their GP if the pharmacy service was not available


needed no onward referral






Data collated by PSNC from 30 local minor ailments services and 473,327 patient consultations, published August 2015

Teams would focus on giving advice, not selling products

Where minor ailments schemes are not in place, pharmacists give out their advice for free. This can place an unnecessary emphasis on selling products. 

A minor ailments service should put the emphasis back on advice, Mr Buxton stresses. By educating patients about self-care, he explains, pharmacists can encourage them to manage their symptoms themselves and avoid using NHS resources unnecessarily. 

Consistency would be crucial

In the case of pharmacy services, familiarity can breed success. But the minor ailments service hasn't had a chance to become familiar due to the lottery of local commissioning – it is up to individual commissioners to decide whether they take the service forward and, even if they do, specifications will vary by region. 

A national scheme could put an end to the dilemma – Mr Buxton explains that patients “want to know that they can walk into any pharmacy and get a relevant service”. So establishing consistency would be an important part of making the national minor ailments service work, he believes.

Alastair Buxton spoke at the Royal Pharmaceutical Society’s annual conference in Birmingham on September 13



Johnathan Laird, Community pharmacist

Registration and payment by registration banding is important to encourage quality not quantity of prescribing. Also encourages patients to form a relationship with one pharmacist. Incorporating read/write access to records as part of the service, although not essential, would enhance the quality of minor ailments prescribing and bring the pharmacist further into the multidisciplinary team. It will be interesting to see what form the scheme takes.

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