The launch of pharmacy first in the UK has been echoed to be a step in the right direction for patients in England. Right? Who does not know the challenges of getting a GP appointment? GP surgeries have also got their challenges but that is not the point of our discussion today. Therefore, pharmacy being and having an open-door policy means this is remarkable news indeed, right? Only time will tell.
Pharmacy first was launched in the UK on the 31st of January 2024. Twenty days on, not all of us agree; even as pharmacist there is a divide opinion of the service and its delivery.
As pharmacist we are here for our patient and we love to help them besides, that is what we trained to do. Given all the necessary tools we can potentially deliver this service to minimise the workload in GP practise, reduce hospital re-admissions rates and more.
I have been quite excited when I heard about the rollout of the pharmacy first. I do wonder though if timing of the service delivery was right. I would have opted for a staggered phase of delivery as many community pharmacist, especially locums have not had the opportunity to train in time for the service.
The Pros and Cons Of The Service
In all order not to sound bias let us look at the pros and cons of pharmacy first in England.
Patients in England can approach their community pharmacy as they have always done but this time for a range of medical conditions that would normally have required their GP surgery to issue a prescription to them.
Let us look at some of the conditions that can now be treated within community pharmacy. The full list of the conditions is listed on the Department of Health website: NHSBA, department of health and social care and Community Pharmacy England.
- Uncomplicated urinary tract infections (ages 16-64 only)
- Shingles- 18 years plus
- Impetigo – 1 year and over
- Sinusitis – 12 years upwards
- Sore throat – 5years and over
- Inserts bites – 1 year and above.
- acute otitis media – Between 1 to 17 years
With Great Compassion in Every Dose, Pharmacist Like Myself Touch Lives, Showing Empathy with Every Encounter!
At the time of writing this blog I did not have real time data as to how many patients using the services. What I can say is that the following are the pros of having this service available to patients and whenever they need us. We can enhance patients’ quality of life through support for self-care, long term condition monitoring. It is safe to say community pharmacies are the gateway to NHS.
- Accessibility – as community pharmacist, we do have open door policy, this means patients can come to talk to us at any point in time during the open hours.
- Convenience – we are always a phone call away to assist with any medical questions and signpost you to the relevant healthcare professionals if we are not able to assist you.
- Trust and confidence – we are like your healthcare guardians when it comes to antimicrobial usage. We can advise when a clinical condition requires you to have an antibiotic and when you can use self-care ways to resolve the condition.
- I am very sure that most patients who may have already used this service will find it incredibly positive to have something like that in place.
- We are trained to spot profoundly serious medical issues (aka red flag symptoms) and refer patients on to relevant healthcare professionals for further assessments and investigations.
These are some of the positive aspects of this service. Given that not everyone in community pharmacy is an independent prescriber, it was an innovative idea that pharmacy first is delivered through patient group directives (PGDs).
With all the positives about pharmacy first let us now delve into the challenges that community pharmacies face that should have been resolved before rolling out pharmacy 1st. Some of the challenges forced some pharmacist to leave the profession exacerbating an already chronic staff shortage.
- There has been funding issues in community pharmacies for far too long, this has had a knock-on effect on the staffing levels.
- Pharmacy staff feel undervalued, overworked, abused, and threatening behaviours from some patients.
- The pharmaceutical services negotiating committee in January 2022 accentuated that urgent attention was needed to reform the current situation in community pharmacies.
- In their news report on the 29th of August 2023, Sky News had a headline; “community pharmacies closing at a rapid rate with deprived areas worse affected”, sadly this will continue to grow if the funding issues are not addressed by the government.
- Community pharmacies are seen as private businesses, but they must have a contract with NHS to provide NHS services to members of the public.
- The rising cost of living has made the situation worse leading some contractors to exit pharmacy altogether.
Community Pharmacist are at the forefront of the NHS in delivering healthcare services to the nation. We must understand that our NHS cannot cope without community pharmacies. There has been a chronic under staffing issues which has left the remaining workforce feel overworked, at least in my opinion having worked in community pharmacy myself. It is my hope that community pharmacies will be able to deliver Pharmacy First safely.
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