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Xrayser: Superdrug's free sore throat service is difficult to swallow

"There are several reasons why Superdrug's free sore throat service makes me angry"

Xrayser usually loves a freebie, but the news that a pharmacy multiple has launched a free sore throat testing service has failed to impress him

Usually, I’m happy to get something for nothing, and “free” is my favourite price. But when it comes to professional services, there are several reasons why Superdrug's free sore throat service makes me angry.

To start with, I’d argue it’s unnecessary. For years, a sore throat has been assessed by diagnostic criteria involving history and observation to support management of the condition. The FeverPAIN and Centor criteria are simple, evidence-based, supported by the National Institute for health and Care Excellence (Nice), used by GPs across the country to determine the likelihood of a sore throat being bacterial in origin, and can be easily carried out in the pharmacy.

In my pharmacy, we assess people with sore throats on this basis. We almost always send them on their way with simple analgesia, glycerine pastilles, and a note that says “not for antibiotics“.

Let’s face it, as conditions go, the “red flags” for a sore throat are pretty clear. If someone is on an immunosuppressant, or stood at the counter sweating, drooling, and speaking like a Punch and Judy show, we’re probably not going to just bung them some Strepsils. However, in these circumstances, it’s not easy to swab someone’s throat, so a “sore throat service” might not pick up epiglottitis.

But the main reason I’m angry that Superdrug has launched a free sore throat service is the word “free”.

There’s always a discussion about what we do for “free” in community pharmacy. We constantly feel the grass is always greener, and bemoan the pressures and stresses upon us. While there’s nothing wrong with a bit of that, it feels – as one of my Twitter followers pithily opined, that “Pharmacy is on its arse” – and as though we can be a profession that feels hard done by and sorry for itself.

Therefore it doesn’t help when someone slaps us on the arse, for free. How many times can we make the same mistake? Free monitored dosage systems, free deliveries, free branded drugs...and sure enough, outcomes are guaranteed once you provide a free service.

Patients expect a free service and so won’t pay for it privately. The NHS doesn’t value a free service and so won’t pay for it to be a funded service. And, without it being a national service, our clinical colleagues and 111 don’t value it, either. They need to know that the service is conducted to a national standard – like emergency hormonal contraception – and they can signpost any patient to any pharmacy.

At a time when the profit from dispensing is no better than counting smarties, we need paid clinical services to demonstrate our worth and to pay our bills. In the last five years, we have only achieved that with the pharmacy flu vaccination programme, which is now a valued service that has generated significant income.

This free sore throat service will not “reduce the pressure on GP surgeries” when the loss of pharmacies from the high street means there is nowhere to go for self-care, and that sticks in my throat.

A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser


Good article, however we as pharmacists need to stop giving more life to these notion of "pharmaciste reducing pressure on GP's". Why should we help reduce pressure on them? what are they doing to reduce pressure on us? People are treating us as we're some accessory healthcare profession to the GP's. We need to focus on improving pharmacy for pharmacists. I could not care less if GP's benefit from it or not.

Adam Hall, Community pharmacist

I partially agree with what NewLocum Pharmacist says. However, when he says we are treated as an accessory profession to GPs, he's correct. We ARE an accessory profession. I DO think we should be providing services which "reduce pressure on GPs" - BUT! Firstly, anything we do to make more appointments available through the GPs is good for patients because the current situation for patient access to GPs is woeful. If we can deal with the things that we can, that will free up those appointments. HOWEVER any service we provide to do this MUST BE PROPERLY REMUNERATED! You want Free? Step outside - air is free. Everything else has a cost attached and that must be taken in to account. Am I shocked at a multiple launching a new free service - Yes and No. No, because the multiples take a short-term view with apparently little concern for unintended consequences; Yes, because all pharmacies have been affected by reductions in funding, so I am amazed they continue down this short-sighted route. Improving pharmacy for pharmacists will only come if services are properly funded. It's an old saying that money doesn't buy you happiness - no, but it does allow you to make better choices, rather than forcing you down one road or another.

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