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‘Low acuity’ pilot across 390 pharmacies extended by six months

More than 5,000 referrals were made to pharmacies in pilot's first four months
More than 5,000 referrals were made to pharmacies in pilot's first four months

A pilot that involves 388 pharmacies in north-east England delivering advice and treatment for “low acuity conditions” has been extended by six months.

The Community Pharmacy Referral Service involves NHS 111 using PharmOutcomes or NHSmail to refer patients with “a range of low acuity conditions” to a community pharmacy for advice and potentially an over-the-counter (OTC) medicine.

The service operates across Durham, Darlington, Tees, Northumberland, and Tyne and Wear. The extension of the pilot's end date – from March 31 to September 30 – was confirmed by Andre Yeung, the project manager and chair of Northumberland, Tyne and Wear local professional network, last week (April 3).

“This will give us a chance to further test and develop the digital integration of community pharmacy for minor illness,” he said.

5,000 referrals to pharmacies

North of Tyne local pharmaceutical committee (LPC) head of services Ann Gunning told C+D there had been 5,101 referrals made to pharmacies via the pilot up to the morning of April 6.

Eighty per cent of patients reported being “very satisfied” with the service, she added.

“Around two-thirds of consultations end with the pharmacist providing advice only or advice with the sale of an OTC medicine,” Ms Gunning said, and “less than 10% of consultations are referred into a minor ailments service.”

“However, it must be noted that not all clinical commissioning groups in the area commission a minor ailments service, and some commissioned services restrict the patients who can access the service,” she stressed.

Other areas of the country are now interested in implementing the service, Ms Gunning told C+D.

Evidence community pharmacy can support NHS

“The LPCs are very happy about the extension, as this will provide 10 months of data [in total] to allow an evaluation of the service,” Ms Gunning said.

“Community pharmacy can support the NHS by easing the pressure on services, taking low acuity conditions out of GP practices and urgent care settings,” she added.

“This service gives us the opportunity to actually test that and provide a robust evidence base.”

In a statement in January, five weeks into the pilot, Sunderland LPC claimed a doctor had said that during a “chaotic” Christmas period, “there would have been even greater pressure on the system without [the service]”.

How does the pilot work?

In order to provide the service, pharmacies must have fulfilled a number of requirements, including access to IT in the consultation room, declaring that the service will only be provided by a pharmacist, access to NHSmail, access to the National Institute for health and Care Excellence (Nice) Clinical Knowledge Summaries, and access to the summary care record.

Participating pharmacies receive an electronic notification that a patient has been referred, and are expected to follow up with them if they do not attend the pharmacy within 12 hours.

The Pharmaceutical Services Negotiating Committee said at its launch that “symptom groups” selected for the service include rashes, constipation, diarrhoea, vaginal discharge, sore eye, mouth ulcers, failed contraception, vomiting, scabies and ear wax.

“If the patient requires treatment, this can be sold over the counter or supplied via a locally commissioned minor ailments scheme (if available),” the negotiator explained at the time.

Pharmacies receive a £14 fee for every consultation. A record of the consultation and any medicine supplied is made on PharmOutcomes, and a notification sent to the patient’s GP.

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