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‘Frustrating’ NHS 111 service fails to acknowledge pharmacy

Practice Just 3 per cent patients calling the NHS 111 helpline in the 10 pilot areas were advised to use pharmacy or dental services, newly published figures reveal

Croydon LPC secretary Andrew McCoig has branded the government's NHS 111 patient helpline service "frustrating", after figures suggested that less than 3 per cent of callers to the service in pilot areas had been referred to pharmacy for help with their condition.

The figures published last week (August 3) analysed all calls made to the NHS 111 helpline - designed to be a one-stop resource for patients with non-emergency health queries - in the 10 pilot areas up until the end of June. They showed that only 3 per cent of callers had been advised to use pharmacy or dental services, despite almost half (49 per cent) being referred to primary and community care in total.

The 10 pilot areas of the NHS 111 helpline had referred just 3 per cent callers to pharmacy by the end of June

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The Department of Health (DH) said 92 per cent of NHS 111 callers reported that they had been satisfied with the service they received.

And a spokesperson said: "The NHS 111 service is aimed at people with urgent healthcare needs, so it is not surprising that most callers are directed towards healthcare providers like minor injury units, urgent care centres and GPs, who can best cater to their needs."

But pharmacy leaders suggested more patients could be referred to pharmacy for help in the first instance.

"The NHS said it wanted to reduce A&E and ambulance use but that's not happening and GPs aren't happy because people are going to them rather than pharmacies," said Mr McCoig.

And Mike Holden of Pharmacy Voice warned that it would be a "huge concern if the 111 system clogged up GP out-of-hours surgeries and A&E when pharmacy is the best first port of call for the vast majority of health concerns".

Mr McCoig said the NHS 111 algorithms, which advisers use when they answer calls from patients, were holding pharmacy back. When the service launched in his area, he had expected up to 40 per cent of callers to be referred to pharmacies. But pilot figures released in February showed that fewer than 1 per cent of NHS 111 callers had been directed to pharmacy, and the latest figures suggested that no NHS 111 callers had been sent to pharmacy or dental services in Croydon.

"The algorithms aren't directing people towards pharmacy," Mr McCoig told C+D. "There's a real desire to make use of pharmacy for minor ailments but the NHS 111 algorithms actually prevent it – [the service] seems to send people in the same direction as the 999 service at the moment," he said.

"We're genuinely hoping we can override the national policy but you can see we're going to end up with the same old story – NHS Direct was exactly the same as this," Mr McCoig continued.

Mr McCoig's comments followed ongoing concerns about the NHS 111 service from across the NHS. At the British Medical Association's (BMA) GP conference in May doctors expressed concerns that the service could result in more patients attending GP surgeries, walk-in centres and A&E departments and said patient safety could be compromised.

Last week, the BMA backed a government decision to extend the deadline for the implementation of NHS 111 by six months in areas where more developmental work is needed.

How can pharmacy convince the DH of the role it could play in the NHS 11 scheme?

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Kevin Western, Community pharmacist

Perhaps the ideal answer is to get the BMA to push Pharmacy as a pathway from the 111 service - the DoH listen to them more than us, they get fewer referrals and we get more work so we should all be happy.

Rajive Patel, Community pharmacist

""Croydon pharmacies could stand to treat as many as 40 per cent of the callers to the NHS 111 service, LPC secretary Andrew McCoig has told C+D.""

Perhaps you can get an opinion from the LPC secretary to see if Croydon has seen 40% of callers to 111 directed to pharmacies??

Z ZZzzzz, Information Technology

The article states no-one in the Croydon area was directed to pharmacies or dentists. Thus Mr McCoig's frustration.

Raymond Lee, Community pharmacist

Where are the figures, so we can analyse the detail?

Emma Weinbren, Marketing

Hi Raymond - the full data set is on the Department of Health website here:

The Excel spreadsheet goes into quite a bit of detail about how referrals are broken down across different areas etc. Thanks and hope that helps.

Al C, Community pharmacist

the problem with 111 is that it relies on protocols which are populated with profiles of providers. i.e. it contains a list of conditions each healthcare professional can treat or offer advice. I would be confident that the “exclusion” of pharmacy is primarily as a consequence of the person filling in the profile not being aware of the services pharmacy can provide. To ensure this is not repeated then the LPCs should contact the PCT/CCG manager responsible for this task at once as these profiles are currently being constructed across the country.

David Laidler, Community pharmacist

The problem seems to me when the 111 respondent goes beyond their guidelines.
A recent example was a patient who called the helpline early Saturday morning with acute diarrhea. He was not told to call in to the pharmacy for advice, but a told to go to the pharmacy for a specific product, use of which would have contradicted current guidelines.

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