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