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'No scenario' where digital minor ailments schemes benefit patients

C+D has reported on minor ailments schemes being decommissioned across England
C+D has reported on minor ailments schemes being decommissioned across England

A pharmacy group director has said he "struggles to see any scenario" where the chief pharmaceutical officer's vision of "digitally-led" minor ailments schemes would have “any benefits to the patient or the NHS”.

Peter Burrows, pharmacist and director of 11-strong chain M & B Healthcare, told C+D last week (November 10) a digital alternative to existing minor ailments schemes would “only lead to more barriers to treatment for the elderly and vulnerable”, while “adding cost and bureaucracy to an already overburdened NHS”.

Mr Burrows was responding to comments from England's chief pharmaceutical officer Keith Ridge on the trend for decommissioning pharmacy-led minor ailments schemes.

Dr Ridge told the all-party pharmacy group (APPG) last month that he believes “we’re in a transition phase from the traditional minor ailments scheme, through to something that is much more digitally-led”.

In response, Mr Burrows told C+D: “Traditional minor ailments schemes [are] inexpensive, easily accessed without appointment [and] in the heart of communities that need them most.”

“What we predicted has occurred”

Mr Burrows predicted earlier this year that his local clinical commissioning group’s (CCG’s) decision to scrap its minor ailments scheme would increase health inequalities. Last week, he told C+D: “What we predicted has occurred.”

“Health inequality across Wirral is increasing,” Mr Burrows claimed. “We can offer treatments for the patients to purchase, but a lot of them simply cannot afford it.”

He also claimed that families are making appointments with GPs, in the hope they will be prescribed the required medication.

“This is taking up valuable GP resources. More worryingly, certain ailments are going untreated.”

“Well-used and valued by patients”

Nat Mitchell, pharmacist and director of JWW Allison and Sons in Cockermouth, told C+D his pharmacy delivers a CCG-commissioned minor ailments service.

“The scheme is limited to [pharmacy] medicines, but it is well-used and valued by patients,” Mr Mitchell said.

“Cutting the pharmacy budget or number of commissioned services will undoubtedly result in increased waiting times, poorer provision and increased costs elsewhere in the system.”

At the APPG meeting last month, Dr Ridge pointed to NHS 111 as an example of a “digital pathway” aimed at managing minor ailments. But Mr Mitchell argued that any service led by NHS 111 would be “convoluted and expensive”.

He added that his pharmacy has “deregistered” from the pilot scheme that directs patients who call NHS 111 for urgent repeat medication to a community pharmacy, as it was “so poorly thought out and executed”.

Ensuring NHS England implements the government commitment for every CCG to commission a minor ailments scheme by 2018 was one of the recommendations in the ‘Murray’ review into pharmacy services – which Dr Ridge revealed in the same APPG meeting last month that NHS England will not be responding to.

Is your local minor ailments scheme under threat?

Steve Jeffers, Community pharmacist

Digital recording of information about what was supplied and why is important but digital access via NHS111 or any other route is a nonesense.
Peter is right and has evidence that the more socially disadvanted sections of society are being excluded from NHS led healthcare by short sighted decommissioning of local Minor Ailments schemes by CCG's.

NHS England and the DH need to get a grip and stop the patchwork healthcare offering that now exists in England and follow the Scottish model of a universal pharmacy led Minor Ailments offering. Promoting this effectively would go a long way to solving the winter pressures facing A&E departments

Sibby Buckle, Community pharmacist

Ridiculous to say this! Digital healthcare is the way of the future - we offer our minor ailments scheme through pharmoutcomes and it's just as easy, if not easier than the old paper based system, once all healthcare staff and pharmacists are trained to use it. And it's popular with patients and GP's.

C A, Community pharmacist

I'm going to have to agree with Peter, that is the old fashioned locally commissioned MAS, the new digital one that Ridge is on about will be digital review of the paitent by off-site pharmacists or something like that (111 anyone?) , and then they will be referred back to the pharmacy like NUMSAS, and it will be the future and brilliant! though it will cost eleventy billion pounds... or everyone in pharmacy will hate it (like NUMSAS).

Peter Burrows, Community pharmacist

Sibby, you are offering a locally commissioned MAS, the likes of which are being scrapped by CCGs across England.

Paul Dishman, Pharmaceutical Adviser

Yes, but in Keith Ridge's mind: digital=good.



Barry Pharmacist, Community pharmacist

So local MAS scheme (x) = possible minor medical problem (y) + resolved by presenting at a local pharmacy (z).  

But new improved digital MAS (x) = phone call to NHS111 (y +20 min wait +8 min NHS111 telephone consultation) + NHS111 e-referral (z+ 10 min extra work + patient can't go to their usual pharmacy) = 1 step forward 2 steps back.

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