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The devil's in the detail of Boots' sore throat service

"The sore throat service will play an important part in shifting people’s perception of the pharmacist," says Stuart Gale from the Frost Pharmacy Group

Boots' sore throat 'test and treat' service needs more clarity, says Stuart Gale

What a time to be a pharmacist. To say I have mixed emotions at the moment would be an understatement.

It’s now almost a year since the Department of Health (DH) fired the starting gun on a period of extreme uncertainty for community pharmacy, when it first announced English funding cuts on December 17.

Then, when we did finally receive some clarity about what the proposals would entail last month, we were told the devastating news that  there will be a 12% cut to funding between December 2016 and March 2017, with a further 7.4% drop in the next financial year.

On top of the negative impact these cuts will have on added-value services for patients, the move has shattered morale across the profession. In imposing the cuts, the DH has demonstrated a complete lack of recognition for the hard work and valuable contribution community pharmacy makes to people’s health and, ironically, the financial savings it makes for the NHS.

Then, this week, just as we’re at our low point, NHS England gave the sector a boost by adding a pharmacy-led sore throat ‘test and treat’ service to its NHS Innovation Accelerator scheme (NIA), with a view to rolling the service out across the country.

The sore throat service puts community pharmacy front and centre of patient care. It also makes use of pharmacists’ clinical capabilities to alleviate pressure on GPs and reduce reliance on antibiotics. This is exactly how I’d like to be using my skills and knowledge.

An added benefit is that, together with the success of other services such as flu vaccinations, the sore throat service will play an important part in shifting people’s perception from the pharmacist as a checker of pill boxes to the health professionals that we are.

My spirits were lifted – for a moment.

However, once again there is lack of detail in the proposals. I appreciate that taking the service from a pilot to the NIA is part of a process, and detail will be developed in time. But given the backdrop of funding cuts, it would be good to have some idea of the practical side and how we will be remunerated for providing the service. Or will we be expected to offer it for free?

It is not known when the service will be rolled out nationally. While community pharmacy has shown it can rally and deliver a quality service at speed – I’m thinking about flu vaccinations in particular – it would be nice to have sufficient time to put a robust plan in place to maximise the success of the scheme.

Community pharmacy has so much to offer. But the ways in which the DH and NHS are communicating their plans is demoralising and disengaging for the profession. Community pharmacy leaders must play an integral role in defining the future of the sector, which includes deciding how best to utilise the Integration Fund.

Stuart Gale is chief pharmacist, owner and manager of the Frost Pharmacy Group in Oxfordshire.

8 Comments

Jonny Johal, Pharmacy Area manager/ Operations Manager

I think Stuart Gale is trying to provoke a debate about the definition of "pharmacy". He obviously think the supply role is worth giving up, even though it generates most of his profits. His 'pseudo-clinical' inclinations are telling. There will be a time when he has to choose between running pharmacies or second class clinics.

Valentine Trodd, Community pharmacist

Yes, the devil is indeed in the detail... so who's saying this test is evidence-based and effective? Not NICE. NICE does not recommend throat swabs or the rapid antigen test - https://cks.nice.org.uk/sore-throat-acute#!scenario

The pilot study was carried out in Boots stores, by Boots employees and funded by Boots. Hardly objective scientific research! http://jac.oxfordjournals.org/content/71/11/3293.full.pdf

Furthermore there has been no full cost-effectiveness analysis – let alone an independent cost-effectiveness analysis – of the Boots scheme. Without comparing the pilot to usual care, we have no way of knowing whether more or fewer antibiotics were prescribed. 

b t, Manager

Lansley knew that Commissioners did not know how to commission. This is the central weakness of the commissioning process and it lets rascals that want to fleece the NHS do so easily and profitably.

The whole system was designed so and Lansley (like Milburn, thus New Labour and Tories are equally bad) is now "consulting" for private equity.

Welcome to Bongo Bongo land of NHS England !

Jupo Patel, Production & Technical

And yet in his ludicrous article Waldron labels this service a beacon of hope. If he said that with a straight face I'll give him credit.

Valentine Trodd, Community pharmacist

You know, it's really sad to see otherwise intelligent people falling over themselves to grasp at straws such as this scheme. I guess it's a measure of how far the 'profession' has fallen and how desperate we are to look vaguely 'clinical'.

Shaun Steren, Pharmaceutical Adviser

https://www.theguardian.com/commentisfree/2016/nov/15/sore-throats-pharmacies-nhs

The author of this article reminds me of somebody who has never thought about the opposing side of his own argument. Of course, the declaration at the end offers explanation. 

 

Jupo Patel, Production & Technical

Quite amazing C&D allows these articles. 

Jupo Patel, Production & Technical

Really?

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