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3 CCGs buck decommissioning trend with pharmacy minor ailments service

Pharmacies in the scheme are reimbursed £5 per consultation and the cost of any medicine supplied
Pharmacies in the scheme are reimbursed £5 per consultation and the cost of any medicine supplied

Clinical commissioning groups (CCGs) in the Black Country have bucked the trend of decommissioning minor ailments services, by launching a “pharmacy first” scheme.

Since June, patients in Dudley, Sandwell and West Birmingham, and Wolverhampton CCGs have been able to access advice and treatment from participating pharmacies for conditions including cystitis, infant decongestion, sore throat, and sprains and strains.

So far, 43 pharmacies in Dudley, 73 pharmacies in Sandwell and West Birmingham, and 47 pharmacies in Wolverhampton have signed up to deliver the ‘Pharmacy First’ minor ailments scheme.

According to the service level agreement, each pharmacy is reimbursed £5 per consultation, as well as the cost of the medicine supplied to the patient. Patients can access the scheme up to six times in a 12-month period.

Treatment under the service – which has been commissioned from June 2018 until March 2019 – is available free for patients who are exempt from prescription charges and registered with a participating GP surgery.

Patients who are not exempt from prescription costs can also have a free consultation with a pharmacist, and pay “much less than a prescription charge” for their medicine, Dudley CCG said.

Bucking the trend

The CCGs’ funding for the pharmacy service comes after a number of CCGs decommissioned their minor ailments schemes.

In October, pharmacy minister Steve Brine was asked by Labour MP Paula Sherriff what the government is doing to “specifically buck [this] trend”. In response, Mr Brine said: “Things have moved on…The clock has moved on.”

However, Dudley CCG told C+D it is “committed” to supporting a “self-care message”, by promoting pharmacy as patients’ first port of call for minor conditions.

The service follows on from a minor ailments service for under 16s that was commissioned by NHS England West Midlands as a local enhanced service from 2014 to 2018. The CCGs “collaborated to ensure the continuation of this service” for this year, Dudley CCG said.

“Public engagement events held by the CCG and the local authority over the years have repeatedly demonstrated that our patients value such a service, from both an access point of view and the expertise of their community pharmacist,” it added.

“Prudent to provide service”

Jonathan Boyd, head of medicines quality at Sandwell and West Birmingham CCG, said it would be “prudent” to provide the service, due to the “high levels of deprivation in the area”.

“[The service means] those who may not have the resources to seek treatment for themselves, and their children, could access quality care from their local community pharmacist, and incentivises [the] rational use of primary care resource in the population,” he added.

LPC “proud” to provide the service

Pete Szczepanski, Dudley local pharmaceutical committee (LPC) chief executive officer, told C+D the LPC worked “very closely” with the CCG to get the service commissioned, and was “proud” to be providing the scheme.

“[We] must demonstrate to our commissioners the value to patients’ healthcare, and also the financial savings that can be made by treating certain common ailments in the community, via our network of highly respected and valued community pharmacists,” he said.

Is there a minor ailments scheme commissioned in your area?

Reeyah H, Community pharmacist

I really can’t be bothered to fill in the countless forms on Pharmaoutcomes just to get £5. I’m glad it’s been scrapped in Birmingham as it was just inviting people to come and claim for free medicines they don’t need! 


Jonny Johal, Pharmacy Area manager/ Operations Manager

I have worked in those areas mentioned, and I am afraid Dave Downham’s concerns are justified. I did experience a high level of potential mis-use/abuse, and there was nobody there to police the system, the claims process then was also seriously flawed (last I worked a MAS in Sandwell was about 6 years ago). There were no audits by anyone that I came across either, if there were indeed auditable trails which I was not aware of.

As for Sandwell and West Birmingham, I think it is the membership of the CCG which is of interest, those doctors taught me alot.

Meera Sharma, Primary care pharmacist

That is the reason a lot of areas withdrew MAS schemes, it was fraught with misuse/abuse. I'm amazed that NHS England has not questioned these CCGs in current climate for agreeing to this! Defies logic.

Dave Downham, Manager

I like the idea of capping the number of times the scheme can be accessed. How effective is the policing of it, though?

Meera Sharma, Primary care pharmacist

You have got to wonder about some of these decisions - it's  not bucking the trend, more like creating a postcode lottery. In current financially challenged climate, you are going to be hard-pressed to get sympathy for launching this, when other places are struggling just to get enough GPs! Not impressed

Marc Krishek, Pharmaceutical Adviser

Struggling to get a GP is in the main due to shortages not funding/ The service should relieve pressure on urgent care and GP appointments.

As a new system, it hopefully well-managed.

Reeyah H, Community pharmacist

Isn’t it the same thing with a different name?! 

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