A recent analysis conducted by the Company Chemists' Association (CCA) has revealed stark disparities in patient engagement with the Pharmacy First
service across the country, likening the pattern to a 'patchwork quilt'.
It indicated that patients in the highest-performing Integrated Care System (ICS) received seven times more Pharmacy First consultations than those in the
lowest-performing regions.
As of April 21, more than 3,000 CCA member pharmacies had delivered 126,484 Pharmacy First consultations since the programme's launch.
However, the analysis found significant regional variations, with nearly 13,000 consultations completed in the North East and North Cumbria ICS, while only
948 were completed in Gloucestershire ICS.
The CCA calculated that if every ICS had as many consultations as the highest-performing ICS, there would have been an additional 600,000 Pharmacy First
consultations nationwide.
With the Pharmacy First services scheduled for launch end of this month, legislators explored the potential of community pharmacies to offer specific
diagnostic and treatment services in the second public evidence session of pharmacy inquiry this week (January 16).
The new service, which will enable pharmacists to offer advice and prescribe treatment for seven minor ailments, is expected to alleviate the pressure on the
NHS, reduce GP workload, and cut waiting lists.
But MPs and healthcare leaders also acknowledged that there's hesitancy and the mindset of 'GP First, not Pharmacy First' among members of the public.
"We must accept that many patients are used to seeing their GP as their First port of call for many health conditions. Pharmacy First is welcome, but there are
going to be some restrictions on how quickly some patients will want to take up some of those services, rather than seeing their GP," said William Pett, Head
of Policy, Public Affairs and Research, Healthwatch England.
In a recent report released by the Company Chemists' Association (CCA), data from the NHS Pharmacy First service indicates a substantial uptake and
positive impact on patient care just two months after its launch.
The CCA's findings shed light on the service's efficacy in meeting patient needs and its potential to alleviate pressure on General Practices (GPs) within the NHS.
According to the report, over 90,000 Pharmacy First consultations were conducted solely by CCA members within the initial two-month period.
Impressively, 88 per cent of these consultations, totaling 81,627, were deemed eligible for NHS-funded care indicating a significant demand for the service among
patients.
In the First month, the data revealed that more than 90 per cent of eligible patients received necessary care directly through Pharmacy First, bypassing the
need for further referral.
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.
In response to concerns raised by pharmacy owners, the government has decided to adjust the August threshold for the Pharmacy First service from 20 to 15
clinical pathways.
The ability of pharmacy owners to achieve the thresholds for the monthly Pharmacy First payments has been a topic of great concern.
Community Pharmacy England (CPE) has been actively discussing this issue over the last few weeks with the Department of Health and Social Care and NHS England.
Ministers have now decided to adjust the August threshold for the Pharmacy First service to 15, CPE announced today (July 31).
Commenting on this decision, Janet Morrison, CEO of Community Pharmacy England said: "We are pleased that Ministers have listened to our concerns and acted quickly
to make an adjustment so soon after coming into office."
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.
EMIS Pinnacle, the leading Pharmacy First IT supplier, has begun implementing the GP Connect Update Record feature to all community pharmacies in England that
use PharmOutcomes.
Starting June 28, this new feature was made available for use with the Hypertension case-finding service and the Pharmacy contraception service, as announced by
the Community Pharmacy England (CPE).
The GP Connect Update Record will enable community pharmacies to securely share "structured" information with GP practices regarding consultations conducted under
the Pharmacy First programme, which includes minor illness and clinical pathways, along with Hypertension Case Finding and Pharmacy Contraception services
Live testing is underway with EMIS Pinnacle for Pharmacy First minor illness and clinical pathways.
There are plans to expand the system in the future to include updates for urgent supply of medicines under the Pharmacy First service.
EMIS Pinnacle is the third CPCF IT system supplier to offer this functionality, following Cegedim's Pharmacy Services system and Positive Solutions' HXConsult
system.
The nationwide implementation of the Pharmacy First service is viewed as a significant development that benefits pharmacies, primary care, and the broader
National Health Service (NHS). Pharmacy teams are striving to ensure its success despite challenges within the industry landscape. However, not all pharmacists
are able to reap the benefits from it.
Recently, two members of Numark shared their experiences of how the scheme is impacting their pharmacies.
Graham Phillips, who owns Letchworth Pharmacy in Hertfordshire, revealed that patients are responding favourably to the service. "It's all good, people are just
delighted to have easier access to care," he said.
In its First month, Letchworth Pharmacy provided around 100 consultations, and Phillips envisions that as the service matures, they will be able to conduct an
average of 200 interventions per week.
"That will make it financially viable for us and mean that we're acting at scale from an NHS perspective. That's 200 GP appointments we've freed up in a
week - that's a huge capability and capacity bump for the NHS," he added.
Graham credits part of his success with Pharmacy First to the strong relationship he has established with local GPs in his area.
Pharmacists, who are working on the frontline of healthcare, can play an important role in raising awareness about mental health and helping those
experiencing poor mental health.
With this belief, the Pharmacists' Defence Association (PDA) is encouraging its representatives at Boots to participate in Mental Health First Aid (MHFA)
training offered by the company.
Nicola Rees, PDA Rep and Boots pharmacist from Solihull, who has recently undertaken training as a Mental Health First Aider, said that trained pharmacists
can help in reducing the stigma associated with mental health and identifying the early warning signs that someone may be experiencing poor mental health.
Mental Health First Aid training enables pharmacists to "support individuals and signpost to sources of advice and support."
Rees expressed that becoming a mental health First aider has empowered her and greatly increased her confidence in being able to support someone dealing with
a mental health issue, such as having thoughts of suicide or self-harm.
Pharmacy owners can make their claims for February Pharmacy First consultations until 5pm on Friday 15 March 2024, the NHS Business Services
Authority (NHSBSA) announced on Monday.
The deadline for Pharmacy First submission was extended following a technical issue in the NHSBSA Manage Your Service (MYS) portal, which led to the claims
appearing incorrectly in the portal.
The NHSBSA has been working with suppliers and NHS England to investigate and address the problem.
While the problem has been resolved, the NHSBSA has advised pharmacy owners to check their submissions carefully before submitting. If any issues persist,
they are advised to contact their Pharmacy First IT system supplier helpdesk to escalate the matter and not to confirm their claims in MYS until the issue
has been resolved.
Pharmacy owners are informed that the extended deadline is for February only and it includes any consultations completed on 31 January 2024.
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.
The Royal Pharmaceutical Society (RPS) and National Pharmacy Association (NPA) have both urged the new health secretary Steve Barclay to back the 'pharmacy first'
approach in England as mentioned by his predecessor on numerous occasions.
"Sajid Javid recognised the vital role of community pharmacy and the potential of a 'Pharmacy first' to support patient access to care. I would urge the new Health
Secretary to see this through to completion," said chair of RPS in England Thorrun Govind.
Thorrun hopes the new health secretary will engage with pharmacy leaders about how we can make the most of our health and care workforce to support the NHS recovery,
including reducing health inequalities, managing the growing cost of long-term conditions, and utilising the enhanced skills of Pharmacist Independent Prescribers.
Commenting on the new appointment, she said: "This is a crucial time for the future of health and care - with continued pressures on teams, changes to NHS structures
and organisations, and the need for long-term investment in the workforce.
"With a 'refresh' of the NHS Long-Term Plan and the Government's workforce plan expected later this year, these must support a more ambitious approach to advancing
the clinical role of pharmacists across the NHS to better meet changing patient demand, backed by investment in pharmacy education and training.
Acknowledging the ongoing challenges in delivering the required IT systems for the scheduled launch of the Pharmacy First service on January 31, NHS England
reported progress in fulfilling 'many' commitments outlined in its plan to enhance primary care access during a board meeting on Thursday.
However, it noted that the digital infrastructure supporting Pharmacy First, included in the £645 million fresh funding for community pharmacy, will require additional time for implementation.
"Delivery remains challenging due to changes needed in digital infrastructure, and we are working with suppliers to support January implementation," NHSE said.
"A public campaign is planned for 2024."
The Pharmacy First service allows pharmacists to supply prescription-only medicines for seven common health conditions (sinusitis, sore throat, earache, infected
insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women), eliminating the need for a GP visit.
Meanwhile, NHSE is leveraging the widespread accessibility of pharmacies by expanding blood pressure monitoring and introducing direct prescribing of clinically
safe oral contraceptives-an initiative that has been well-received.
Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win
outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs
and A&E.
It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you
can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more
pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years.
If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to
consider.
Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of
community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional?
What is the vision for community pharmacy delivering patient care in the next decade?
The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs
to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which
avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.
Community Pharmacy England (CPE) has asked community pharmacy owners to share their views on preparations for the new national Pharmacy First service, ahead
of the next full Committee meeting at the end of January.
The advanced service, which is set for launch from 31 January, will allow patients to seek advice and treatment for seven common conditions directly from their
local pharmacy, without the need to contact their GP practice. It is expected to help NHS free up 10m GP appointments a year.
However, CPE chief executive Janet Morrison has previously expressed that the Pharmacy First investment is not the panacea for pharmacy's funding woes.
Pharmacy owners' feedback will be used in the Committee's campaigning and influencing work to press for an uplift to core funding, CPE said.
Pharmacy2U has joined thousands of pharmacists in launching the new NHS Pharmacy First service in England.
The new service, which was First launched on 31 January 2024, enables pharmacists to treat seven common health conditions without the need for a GP appointment
or prescription.
Over 95 per cent of all community pharmacies in the country (10,265 in total) have signed up to provide the service, which is aimed at easing pressure on GP
services while giving patients quick and accessible care.
Under the Pharmacy First service, the online pharmacy is offering same-day appointments to manage six conditions: sinusitis, an infected insect bite, sore
throat, UTIs, shingles and impetigo.
Pharmacy2U's CEO Kevin Heath said that they support the initiative fully and that the service will play a major role in providing patients easy and direct
access to pharmacists.
The National Pharmacy Association (NPA) has urged the NHS to take urgent action to prevent faults in the IT system underpinning the government's flagship
programme.
The NHS Business Services Authority (NHSBSA) recently confirmed that the issue in the Manage Your Service (MYS) portal had been resolved, and consequently, the
deadline for submission of claims for February Pharmacy First consultations was extended until 15 March 2024.
However, NPA members said that they are still facing problems, with the portal recording fewer consultations than entered by pharmacies, potentially leaving
them out of pocket by thousands of pounds.
Paul Rees, chief executive of the NPA, highlighted the significant achievement of pharmacies in delivering tens of thousands of consultations in the First month
of the Pharmacy First programme, stating that this accomplishment is "a testament to their skill and dedication."
The UK's National Health Service (NHS) has become the first healthcare system in the world to provide a new blood group genotyping test for people with
rare inherited blood disorders.
From Monday (22 January), thousands of patients suffering from sickle cell disorder and thalassaemia will get access to the world-first 'blood matching'
genetic test, which will help reduce their risk of transfusion side effects while offering more personalised care.
In England, it is estimated that around 17,000 people are living with sickle cell disorder, with 250 new cases reported each year, and there are about 800
thalassaemia patients, with less than 50 new cases a year.
Health Minister Andrea Leadsom said: "Thousands of people living with sickle cell disease and thalassaemia will be eligible for this new world-first blood
test which is set to transform their care.
A Company Chemists' Association (CCA) analysis has shown that 'Pharmacy First' service in England could free up 30m+ GP appointments each year.
It has urged the Government and NHS to be even 'bolder in their ambition and go further and faster'.
The recent 'Delivery plan for recovering access to primary care' announced a 'Pharmacy First' service for England, mirroring similar approaches in Scotland and
Wales.
The association has estimated that with the added capability to supply non-prescription medicines and prescribe additional prescription-only medicines, an ambitious
'Pharmacy First' service could free up 30m+ GP appointments annually.
Harnessing community pharmacies to deliver care for minor health conditions will effectively create 11,000 urgent care centres in England.
The health secretary, Steve Barclay was asked over the delay of 'Pharmacy First' model in England that was proposed by the Pharmaceutical Services Negotiating
Committee (PSNC) last year, at the Health Committee evidence session held on Tuesday (31 January).
Taiwo Owatemi MP (Chair of the Pharmacy APPG) asked whether he was adhering to his statutory responsibility to ensure continued access to medicines and cited the
CCA's closures in areas of deprivation research.
Barclay replied that the government is 'investing more'. He said, "We put an extra 100 million on top of the 2.6 billion a year we commit to community pharmacy to
expand the range of clinical services. We've got over 2 million patients that have been referred to community pharmacy from NHS."
He further added: "One of the issues I'm very keen on is to explore what more we can do in pharmacy not least given the pressures on GP and the opportunity to look
at what it is currently people go to GPS for where potentially the risk to do more at the pharmacy and we're already doing that."