Essential facts, stats and quotes relating to Minor Ailment Services
Published on: 7th January 2016 | Updated on: 28th March 2022
This page contains facts, stats and quotes that LPC members may find useful when writing business cases or developing resources to support the commissioning of such a service.
This page is ‘work in progress’ and will continue to be updated with new facts, stats and quotes.
Facts, stats and and quotes on other topics can be accessed on the Essential facts, stats and quotes page.
- Pinnacle Data collected from PharmOutcomes from 1,722,230 patient consultations showed:
- 84.3% of patients would have gone to their GP if MAS was not available;
- in 95.8% of consultations no onward referral to other NHS providers was necessary; and
- only 3% of patients would have purchased medicines if MAS was not available.
- Minor ailments services are already commissioned by Clinical Commissioning Groups (CCGs) across many parts of the country and ultimately NHS England will encourage all CCGs to adopt this joined-up approach by April 2018, building on the experience of the urgent and emergency care vanguard projects to achieve this at scale.
- In 2015 the value of commissioned minor ailments schemes was estimated to be £49.8 million.
- The main benefits of minor ailment schemes/self-care support are the costs avoided elsewhere in the NHS system, in particular avoided GP appointments.
- Minor ailment schemes/self-care support also avoid costs to patients which result from delay in their recoveries and lost time through having to attend less accessible points of delivery in the health system. Both of these also result in costs to society through lost output as a result of increased sickness absence and time off work to attend the GP respectively.
- The data shows that commissioned minor ailments services deliver an estimated net value per intervention of £59.08.
Somerset community pharmacy MAS evaluation (January 2016)
- A total of 1,169 consultations were conducted during the evaluation period. Bacterial conjunctivitis was the most popular ailment treated (49.5% of consultations) followed by urinary tract infections (23.4% of consultations) and allergic rhinitis/conjunctivitis (10.7% of consultations).
- Patients were asked what other service they would have accessed had the Minor Ailments Service not been available. 81% would have contacted their GP, whilst 10% would have accessed an out of hours service and 5% would have attended A&E.
- This would suggest the service saved 157 hours of practice consultation time over the evaluation period.
- Using national cost analysis data, the authors estimate the service saved between £45325 and £45820to the local health economy over the 9 month period.
The key outcomes of the Pharmacy First pilot were:
- 25,956 community pharmacy minor ailment service (MAS) consultations undertaken;
- 79% of all community pharmacy MAS consultations were shown to shift workload from local general practices to community pharmacy (calculated given 88% of all patients seen reported they would have booked a GP appointment had the scheme not been available and a GP re-consultation rate of 9% as identified by correlating a random 1% (270) sample of all consultations against respective GP appointment systems);
- 20,505 (79%) MAS consultations were shifted from local general practice workloads to community pharmacy representing better “health value” when comparing utilisation of skills-set and “costs” of community pharmacy MAS versus the same for a GP appointment;
- 4.5% (1344) of all community pharmacy MAS consultations were shown to shift workload from urgent care to community pharmacy (after applying a 9% re-consultation rate);
- 46% reduction in overall spend on activity in direct comparison to the same quarter the previous year due to improved controls and governance (a saving of £114,000);
- Two hours per week of GP appointments “liberated” per 5,900 registered patients; ranging from 0-14 hours per practice which reflects differences in current take-up/awareness of the scheme across and within participating CCGs;
- 83% (138) patients surveyed following a community pharmacy MAS consultation would recommend the service; and
- 93% (40) of the 81% of general practices responding to a randomly distributed survey (covering all participating CCGs) expressed positive views about the community pharmacy MAS scheme and a preference to see it continue.
“Community pharmacy is the most cost-effective place to treat patients for minor ailments when compared to hospital or GP settings,” said Professor Harry McQuillan, Chief Executive Officer at Community Pharmacy Scotland (CPS), when commenting about a Royal Pharmaceutical Society commissioned study on minor ailments, led by Aberdeen University.
“In fact pharmacy treatment costs the NHS less than half that of a GP consultation. When compared to A&E, community pharmacy management of minor conditions costs just one-fifth against a hospital visit. The study also showed that the outcome for patients is similar no matter in what sector they are treated,” he says.
According to the study, costs per consultation in pharmacy are around £29.30 compared to GPs (£82.34) and emergency departments (£147.09).
CPS would like to see increased access to the Minor Ailments Service (MAS) and an increase range of ailments that could be treated, such as urinary tract infections.
- Recent estimates suggest that 5% and 13% of consultations in emergency departments and general practice, respectively, are for minor ailments that could be managed in community pharmacies.
- Mean overall costs per consultation were significantly lower for pharmacy compared with general practice. According to the study, costs per consultation in pharmacy are around £29.30 compared to GPs (£82.34) and emergency departments (£147.09).
- These results suggest similar health related outcomes and substantially lower costs with pharmacy consultations for minor ailments.
- Convenience of location was the most common reason for choice of consultation setting.
- Substantial savings could be achieved if demand on emergency departments and general practice was shifted to the community pharmacy setting.
- In areas of high deprivation, services that allow access to a limited range of NHS funded over the counter medicines for low income and deprived families to support self-care have been shown to be cost-effective in reducing demand on GPs, walk-in centres and Emergency Departments.
- Common ailments cost the NHS an extra £1.1 billion a year when patients are treated at Emergency Departments or GP surgeries rather than at community pharmacies. Treatment results were equally good regardless of whether patients were treated at a pharmacy, Emergency Departments or GP practice. The cost of treating common ailments in community pharmacies was found to be £29.30 per patient.
- The cost of treating the same problems at Emergency Departments was found to be nearly five times higher at £147.09 per patient and nearly three times higher at GP practices at £82.34 per patient.
- Overall, the study estimates that 3% of all A&E consultations and 5.5% of GP consultations for common ailments could be managed in community pharmacies. This equates to over 650,000 visits to A&E and over 18 million GP consultations every year that could be diverted with a total annual cost saving of over £1 billion.
Paudyal V, Watson MC, Sach T, Porteous T, Bond CM, Wright DJ, et al. Are pharmacy-based minor ailment schemes a substitute for other service providers? A systematic review. The British Journal of General Practice : the journal of the Royal College of General Practitioners. (July 2013)
- Up to 18% of general practice workload is estimated to relate to minor ailments, at a cost of £2 billion annually.
- Similarly, 8% of emergency department consultations involve consultations each year for minor ailments, costing the NHS £136 million annually.
- Research shows that GPs are in favour of diverting the care of minor ailments to other areas of primary care, including community pharmacists.
- By reducing the time spent by GPs on managing minor ailments, it would enable them to focus on more complex cases and could reduce patient waiting times.
- Low reconsultation and high symptom resolution rates suggest that minor ailments are being dealt with appropriately by pharmacy minor ailment schemes.
- Pharmacy minor ailment scheme consultations are less expensive than consultations with GPs.
- The evidence suggests that pharmacy minor ailment schemes provide a suitable alternative to general practice consultations.
- The total number of consultations and prescribing for minor ailments at general practices often declined following the introduction of a pharmacy minor ailment scheme.
- Patient satisfaction with minor ailment schemes provided through community pharmacies was found to be routinely high.
- The mean cost of a GP consultation was £10.58 compared to the pharmacist consultation fee of £4.37 (£2–£7.85).
- The mean value of pharmacists’ medicine reimbursements was £2.13 compared to £2.47 for a prescription from a GP.
- The best estimates of the variables in the economic model gave an approximate cost saving of £550,717 per annum when consulting a pharmacist instead of a GP, based on 308,199 consultations for a minor ailment.
- The economic model suggests that expanding the provision of a community pharmacist minor ailment scheme provides a substantial cost saving over consulting a GP.
- The access/convenience aspect was viewed as a powerful determinant of patient satisfaction with the scheme.
- In this study, only 0.4% of pharmacy consultations were referred to a GP. These findings could therefore be taken to imply the effectiveness of care from the Pharmacy First Scheme.
- It appears that the Nottingham City PCT is successfully using community pharmacies to improve access to medicines and provide a greater choice in primary care for patients with minor ailments.
- The Nottingham City PCT should build on this success to further utilise the pharmacy in their primary care service development.
- If the minor ailments scheme (Pharmacy First) across the North of Tyne PCTs had not been commissioned, over half the patients who used it would have used alternative branches of the NHS with additional costs being over £6,000 per month.
- The health-care costs liberated through this scheme equate to over £80,000 per annum.
- Minor ailment schemes, led by community pharmacists, can release healthcare resources (especially general practice appointments) in patients with self-limiting conditions who would have otherwise sought treatment elsewhere in the NHS.
The Pharmacy First Minor Ailments Scheme in Leicester evaluation (Jan 2011)
- A total of 65 pharmacies participated in the scheme giving rise to 60,754 Pharmacy First consultations during the period of the study.
- The 1.4% rate of rapid referrals and 23% re-consultation rate suggests that approximately 75% (45,000) of those who received a Pharmacy First consultation would otherwise have required a consultation with a GP.
- Overall, the evaluation found that the Pharmacy First scheme had been conducted very successfully and that there was substantive evidence that it saved GP consultations.
- The Evaluation Team believe that the Pharmacy First scheme was the most likely factor responsible for the reduction of Pharmacy First formulary items prescribed by GPs. On this basis the resultant approximate net cost of providing the Pharmacy First service was £76,000. Moreover, the average cost per consultation was £1.25.
- The study also shows that a community pharmacist rather than the GP could reasonably deal with a large proportion of work falling into the definition of ‘primary care’ problems.
- A pharmacist could have managed at least 5,500 (8%) adult attendances at a central London A&E department.
- The opportunity to utilise all the skills of a pharmacist, including drug information, patient counselling and management of minor illnesses, should be encouraged further.
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