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To maximise the benefits of the Pharmacy First service for patients, the NHS, and community pharmacies, Community Pharmacy England (CPE) has advised the community pharmacists to to establish a robust relationship between community pharmacies and local general practices. The news comes after several reports highlighted issues regarding GP referrals for the seven minor ailment conditions under the Pharmacy First services. According to the reports, many pharmacists claimed that "many GPs in England are not sending patients to them to be treated - and that some are refusing to participate at all in the "groundbreaking" Pharmacy First scheme". In response to foster better relationship with the GPs, CPE has said that strong local collaborations will enable general practice teams to confidently refer patients to the Pharmacy First and other community pharmacy services where appropriate. Moreover, the organisation emphasised implementation of long-term changes in practice will take time. The current focus on integrating GP referrals to Pharmacy First will likely require sustained effort over several months or longer.

As an Alphega pharmacy mentor, Sue Dobson has worked with pharmacists across the country, helping them adapt to the growing responsibilities and challenges they face in their profession. One of the most exciting developments in recent years has been the Pharmacy First initiative, which positions community pharmacists as key players in patient care, especially through GP referrals. However, Sue has seen firsthand that the success of this initiative depends largely on the strength of the relationships we build with GPs and how we integrate these referrals into our day-to-day operations. Some pharmacists have thrived by establishing strong, collaborative relationships, while others have struggled to break down initial barriers of trust. In this conversation, she speaks with Anil Chauhan, a Preston pharmacist who, along with his partner Yasar Hussain, has made GP referrals a seamless part of their practice. Their success story is a great example of how perseverance, trust-building, and a proactive approach can truly make a difference in the Pharmacy First model. Sue Dobson: Anil, you and Yasar have done a great job with the Pharmacy First initiative and GP referrals. Can you start by sharing how you first got involved with GP referrals and what made it successful in your practice?

Ensuring comprehensive healthcare services for the community necessitates collaboration between pharmacies and GP surgeries. However, several pharmacists have voiced concerns about a lack of cooperation from their local GPs in implementing the Pharmacy First (PF) service. In a survey conducted by the National Pharmacy Association (NPA) covering 470 pharmacies across England, three-quarters of pharmacists (77 per cent) indicated that local GP practices are not appropriately referring patients to the new service. The survey highlighted instances of patients either not being referred or being referred but found ineligible for support through Pharmacy First. Additionally, one in five NPA members (19 per cent) felt that their local GP practices were not engaging with the initiative at all. Commenting on the issue, NPA chair Nick Kaye said: "Feedback from across our network suggests that the rollout of Pharmacy First varies considerably from area to area.

The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million a year - are now being carried out by community pharmacy teams in England. This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year. PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations were recorded, with the average pharmacy completing 19 consultations per day. This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week. The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy coming from these routes; grossed up to a national level that means 117,000 cases per week. These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).

Pharmacies are valuable healthcare assets, meeting increasing public demand. However, a substantial portion of their capacity is consumed by unfunded work. According to Community Pharmacy England's (CPE) 2024 Pharmacy Advice Audit, community pharmacies conduct over 1.3 million unfunded consultations each week, equating to 69 million annually. The average pharmacy completes around 22 of these consultations daily, each taking approximately 5.6 minutes of staff time -adding up to over two hours daily. This represents nearly 50 per cent more consultations than in 2020 and a 78 per cent increase in time spent on unfunded healthcare advice since the 2020 audit. The audit, which surveyed over a third (3,916) of community pharmacies in England earlier this year, also highlights that pharmacies handle nearly 150,000 informal referrals from GPs and NHS 111 each week. All these referrals could have been routed through the Pharmacy First service, which would have potentially secured over £115 million in funding for the sector, the CPE noted.

A recent report by the Company Chemists' Association (CCA) has revealed a significant disparity in patient engagement with the Pharmacy First service across the UK. In response, Santosh Sahu, Founder and CEO at Charac, has emphasised the need for technological reform to address "the interoperability gap between pharmacists and GPs". Sahu identified the lack of GP referrals for Pharmacy First consultations as a key issue, attributing it to inadequate IT infrastructure. He urged the sector to "implement technological reforms to enhance interoperability between pharmacists and GPs, enabling them to share patient records, identify care pathways, and address health needs more effectively".

Since its launch on January 31st, the Pharmacy First service by the Company Chemists Association (CCA) has achieved a significant milestone, completing over 200,000 consultations to date. This milestone underscores the service's vital role in providing same-day NHS care through community pharmacies across England. Recent analysis by the CCA has revealed a pressing need to bolster GP referrals, with disparities observed between different Integrated Care System (ICS) areas, resulting in what's described as a 'postcode lottery' for patients. CCA Chief Executive, Malcolm Harrison, emphasised the importance of sustained funding for Pharmacy First beyond 2025, ensuring its availability for patients, community pharmacies, and the wider NHS.

More than half of people (52%) do not feel confident in treating backache and less than half (44%) uses community pharmacists' advice as their first step on self-treatable conditions, a self-care attitudes 2022 survey has revealed. PAGB, the consumer healthcare association, surveyed over 2,000 adults across the UK about their attitudes towards self-care and access to health services. According to the survey, the public is in favour of self-care but many people lack the confidence and knowledge to care for the most common self-treatable conditions including backaches, headaches, diarrhoea and constipation. Four in five respondents (79%) said that people should take more responsibility for their own health and three-quarters (73%) believe that the NHS should make self-treatment easier. Behaviours around the current use of pharmacy varied - with less than half (44%) using community pharmacists as their first step in in getting advice on self-treatable conditions - but longer term attitudes were encouraging, with 69% supporting the idea of GPs being able to make referrals to pharmacists. Respondents also supported expanding the role of pharmacists so that their skills can be better utilised.

The Company Chemists' Association (CCA) has urged NHS England to expand the Pharmacy First service by increasing treatment options, adding more conditions, and integrating Independent Prescribing into the service. This would further promote pharmacists as antimicrobial stewards while enhancing patient access to urgent care, it said. Managing patient demand for antibiotics remains a challenge for healthcare professionals, including pharmacists. However, a new report by CCA confirms that pharmacists are acting as responsible providers of antibiotics, in line with Antimicrobial Resistance (AMR) guidelines. The service allows pharmacies to provide advice and treatment, including prescription-only medication, for seven common conditions: earache, uncomplicated urinary tract infections (UTIs) in women, sore throat, sinusitis, infected insect bites, impetigo, and shingles. Patients can access the service via GP referrals or by visiting or contacting a pharmacy directly.