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NHS England to scrap minor ailments service in 14 London boroughs

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London will become an extended pilot site for the digital minor illness referral scheme
London will become an extended pilot site for the digital minor illness referral scheme

NHS England has decided to decommission a minor ailments service in 14 London boroughs because the scheme is “not fit for purpose”, it told C+D.

NHS England London – the regional body that commissions pharmacy services across the capital – told C+D last week (July 16) it will stop the minor ailments service in 14 London boroughs (see below), to adhere to national NHS guidance advising GPs to “curb prescribing” of over-the-counter (OTC) medicines for 35 conditions.

“The current service specifications are not fit for purpose, and do not fit with current pathways and the national development of pharmacists’ roles.

“Patients are accessing the [minor ailments] service as a regular repeat service for medication such as paracetamol and ibuprofen, rather than a service to manage minor illnesses that are acute in nature,” it said.

NHS England London recommended decommissioning the scheme last month (June 18), following a review into the enhanced services it inherited from Primary Care Trusts after an NHS reorganisation in April 2013.

“The deployment of pharmacists in general practice (a national initiative) will support the management of appointments for minor illnesses and improved signposting of patients to community pharmacies for the management of self-care,” NHS England London Region added.

The minor ailments service will be decommissioned once a “go-live” date has been agreed for the implementation of the digital minor ailments referral service, the commissioning body confirmed.

London will become an “extended pilot site” for the digital scheme, which is currently being piloted in the north-east of England. However, NHS England stressed to C+D that the service “is not a replacement for the minor ailments scheme”.

“Daunting” prospect for pharmacy

A pharmacy contractor in one of the boroughs where the scheme will be scrapped told C+D the prospect was “daunting”.

Raj Radia, owner of Spring Pharmacy in Hackney, said: “There is a lot of deprivation where we are. People will still wait for a bottle of paracetamol at a GP surgery because they can’t afford to buy one, or they will go to A&E.”

Mr Radia claimed smoking, obesity, and mental health is a big problem in the area, which is “one of the most deprived areas in the country”.

“60,000 patients a year will turn to GPs”

The Health in Hackney scrutiny commission – a council group that scrutinises local health and social care services – warned NHS England in a letter dated March 16 that an additional 60,000 patients in the area could “seek scarce GP appointments” every year if the service was not available. 

But NHS England London told C+D that “clinical commissioning groups (CCGs) that have already decommissioned the scheme have seen no impact on GP appointments”.

Councillor Ann Munn, chair of the scrutiny commission, said there was a strong business case to continue funding the service as it would save the NHS money in the long-term.

Ms Munn has written to NHS England London to request that funding for the scheme be devolved to City and Hackney CCG to commission an “equivalent” service – with a decision expected this week. 

Earlier this month, C+D reported that Fylde and Wyre CCG decommissioned its ‘Pharmacy+’ minor ailments service on July 1, as the NHS prescribing guidance meant the scheme had “naturally [come] to a close”.

Where has the London minor ailments service been decommissioned?

  • Camden
  • City
  • Hackney
  • Haringey
  • Islington
  • Merton
  • Newham
  • Redbridge
  • Sutton
  • Tower Hamlets
  • Richmond
  • Waltham Forest
  • Wandsworth
  • Westminster
9 Comments
Question: 
Has a minor ailments service been recently decommissioned in your area?

Nalin Shah, Community pharmacist

Mas was a mess , open to abuse and total waste of pharmacy time.

rip

Caroline Jones, Community pharmacist

Since walk-in centres opened up the whole population seems to have some kind of medical emergency! It beggars belief

 we all managed to survive! It has also worsened the 'I'm entitled' brigade and the need for everything to 'be dealt with my someone else yesterday'.....minor ailments are what it says on the tin.....they can wait; they are not a medical emergency!

Brian Smith, Pharmacy technician

Finally, this rubbish is coming to an end after watching the usual suspects bleed the scheme dry the second they all clocked on to it.  It was awful that certain families would come in week after week, give us a well rehearsed oscar winning performance and walk out with all sorts for free. I know they did this regularly with other pharmacies and then sell the medicinal items on for a small profit. It must be finally stopped and abandoned. Those in genuine need can see a gp. Those not in need will find another scheme they can fleece.

Caroline Jones, Community pharmacist

As for people clogging up GPs and A&E for Paracetamol.....maybe at the start but if these services follow the guidelines aswell 

 

 

 then they will be offered advice to

purchase if needed! In all honesty I can count on one hand the number of times I've needed to use paracetamol and ibuprofen on my children....often way overused due to the promotion by the manufacturers!

 

 

Caroline Jones, Community pharmacist

They are correct....most people use the MAS as a shopping list to stock up! They are not using the consultation service they just demand what they want and go from pharmacy to pharmacy to get it! For it to work there needed to be a robust IT system that linked up to their GPs.

It's about time people start managing their own complaints.....diprobsse and sudocream available!?!?

 

Jonny Johal, Pharmacy Area manager/ Operations Manager

The truth is the mushrooming of MAS only increased contractors’ remuneration, pharmacists workload and not taken any pressures off surgeries or A&E depts. 

Peter Sainsburys, Community pharmacist

I agree. It seemed like such a brainwave, but like most good ideas, was very difficult to put into practice.

In theory it should have saved millions.

The problem is that it was impossible to quantify the saving.

A B, Community pharmacist

Any scheme designed to get people away from GP surgeries/ a+e  is usually quantified by multiplying the cost of an appointment by the number of interventions.

Like you say, it should have saved a lot time and money for the NHS. But if it was ever going to do that it needed a national roll out with proper funding and promoting.

With more pharmacists doing minor ailments clinics in GP surgeries the community MAS was never going to be expanded.

 

Peter Sainsburys, Community pharmacist

It seems strange that the government hates a scheme which saves them money. Maybe the potential for abuse was just too great?

Anyway, the government appears to view the pharmacy industry like a wart on it's big toe, so not surprised they are cutting funding for almost everything. Getting ready for Amazon to take over?

Hope you've all got plans for what to do post-pharmacy. Even Simon M with his dedicated patient base will be looking down the back of the sofa to pay the bills after the next wave of cuts.

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