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NHS director: National minor ailments scheme may not be suitable

Professor Jonathan Benger: Different communities have different requirements
Professor Jonathan Benger: Different communities have different requirements

A national pharmacy minor ailments scheme should not be "imposed" on communities it does not suit, NHS England’s national clinical director for urgent care has told C+D.

“Having commissioners with a local understanding can be more effective” than “imposing” nationally-commissioned NHS services on local populations,” Professor Jonathan Benger told C+D after his session at a Westminster Health Forum on integrating urgent and emergency care last week (November 16).

Certain NHS services – such as those tackling “minor illnesses” or “common conditions” – may “not necessarily suit…some pharmacy communities,” he said.

“What pharmacists can and are able to do may be different in one part of the country to another part,” he added.

Professor Benger was responding to a question from C+D, on whether a national scheme to direct patients with certain ailments to pharmacies would work across England.

While there should be a “national direction for travel”, NHS England's schemes should be “flexible” and “tailored” to local population needs, which can be “very different in London than in a rural community”, he suggested.

Professor Benger's comments come less than a month after pharmacy minister Steve Brine said "things have moved on", when asked how the government and NHS England plan to "buck the trend" of local minor ailments schemes being decommissioned by clinical commissioning groups.

However, Professor Benger also stressed that pharmacists have an important role to play as part of the urgent care system, “in terms of supporting patients with minor ailments”.

Challenged by long-term conditions

“Much of the urgent and emergency care system is challenged by long-term conditions,” Professor Benger added.

If patients feel “a little bit unwell over the winter period”, they could “follow advice from a pharmacist” and “prevent [health] deterioration”.

However, “by the time a patient visits a pharmacy” it is often “too late” and they have to be referred to a GP, he said.

NHS 111 pharmacy programme advisor and Yorkshire Ambulance Service NHS trust pharmacist Usha Kaushal also told C+D at the event that pharmacists can be “very cost effective in NHS 111”.

Ms Kaushal explained that pharmacists are “ideally trained” to handle calls such as “toxic ingestions”.

“The types of calls we answer are specifically pharmacy calls, such as emergency contraception and repeat prescriptions,” she added.

Urgent supply pilot extended

In October 2016, the Department of Health launched the Pharmacy Urgent Care pilot programme to allow patients who call NHS 111 for urgent repeat medication to be directed straight to a community pharmacy, instead of an out-of-hours GP surgery.

The pilot – scheduled to be rolled out in stages across England until March 2018 – will now be extended by six months “to allow a proper evaluation of the service to be completed”, the Pharmaceutical Services Negotiating Committee confirmed last week (November 19).

Has your pharmacy signed up to the Pharmacy Urgent Care pilot?

Hemant Patel, Community pharmacist

Here is the NHS’s shopping list:

Now can we stop baking at the wrong tree? Pharmacy leaders have a responsibility: make community pharmacy relevant to identified needs which are prioritised for funding. Failing to do that leads to unrealistic expectations at grassroots levels and the sector loses credibility with the commissioners. Have u ever tried to sell something bro a customer who doesn’t plan to purchase what you are pushing? 

Dave Downham, Manager

Do unrealistic expectations amount to being paid a reasonable amount for services provided? How can the sector lose credibility with commissioners when it has none?

Wolverine 001 , Pharmacist Director

Healthcare which is free at the point of service does not work!!!! please stop this nonsense argument about a minor ailment service (an utter joke) and blood pressure readings - is this the best we can come up with???

Andrew Paxton, Community pharmacist

Yes, we did ages ago, but when I approached 111, I was told that the only pharmacies registered were one in the middle of town and one in a local village. I approached the CCG about this and have been assured that we are now registered.

Sunny Jim, Pharmacy Buyer

People should be encouraged to buy products OTC rather than rely on central government to provide a national ailment scheme 

Ilove Pharmacy, Non Pharmacist Branch Manager

No, it's much better value to truoble the GP for a 20p pack of paracetamol and 99p sugary linctus. 

Dave Downham, Manager

Don't worry, James, central government have no intention of providing a national ailment scheme.

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