Supporting people to self-care
Supporting people to self-care
Community pharmacy’s traditional role in supporting people to self-care for minor illnesses is an important way in which to manage demand for other NHS services, in particular general practices. One of the most important strengths of the sector is the network of over 11,000 pharmacies across England, which effectively act as healthcare walk-in centres where people, live, work and shop.
However, the wider promotion of pharmacies as a location to treat minor illness and the national commissioning of a minor ailment service to provide care at NHS expense to those who would otherwise visit the GP practice could bring a number of advantages. It could increase choice and improve access to services for patients; free up more capacity in general practice; avoid unnecessary visits to A&E departments; and also support the appropriate management of people using the NHS 111 service.
The scale of minor illness
Research commissioned by PAGB and PSNC and conducted by IMS in 2007, revealed that the treatment of minor ailments accounts for 18-20% of GP workload, incurring a significant cost of around £2 billion a year to the NHS. It was estimated that annually 57 million consultations are for minor ailments (51.4 million of which are for minor ailments alone), resulting in over an hour a day of consultation time for every GP and the writing of 52 million prescriptions.
PSNC and LPCs have promoted the national commissioning of a minor ailments service for many years and in the 2008 Pharmacy White Paper the then Government proposed that a national service should be discussed by the Department of Health (DH) and NHS Employers with PSNC. During those discussions the principal block presented to progress was the inability of DH to reallocate funding in the GP contract to community pharmacy, in order that DH did not ‘pay twice’ for the management of patients with minor illness.
PSNC had hoped that it would be able to reach agreement with the NHS on such a service as part of the 2015/16 settlement and in lengthy discussions with the NHS a detailed proposal for this was developed. NHS England subsequently decided not to pursue this. This has been very disappointing and PSNC believes it will have a negative impact on both the NHS and patients, who are missing out on a valuable professional service that could both improve care and reduce pressures on GP practices and the wider health service.
The commissioning of a national community pharmacy minor ailments service alongside a sustained information campaign aimed at the public on appropriate use of NHS resources could ‘re-train’ the proportion of the population that default to use of A&E or GP practices when they could safely access treatment at a community pharmacy. This wholesale change in public behaviour requires concerted effort by the NHS over a lengthy period and the uniform availability of services, so a consistent message can be directed at the public across all areas. The subsequent benefits of reducing pressure on A&E services and creating time in general practice which can be re-deployed to coordination of care for patients with complex needs could have much wider benefits for the healthcare system and patient outcomes.