Pharmacists may be forced to pause landmark scheme to treat minor illnesses
Patients hoping to benefit from a new scheme that sees high street pharmacies prescribe medicines for conditions including ear infections and sore throats could be turned away over safety concerns.
Pharmacy First, a Government and NHS England scheme aimed at freeing up millions of GP appointments, will launch across England on Wednesday, allowing patients to get antibiotics without consulting a doctor for the first time. Versions of the scheme already exist in Wales, Scotland and Northern Ireland.
It is understood that over 90 per cent of pharmacies in England have signed up to provide the service, including major high street retailers Boots and Superdrug.
Under the service, pharmacists will be able to write their own prescriptions for medications, including antibiotics, to treat seven minor conditions: ear infection, impetigo, infected insect bites, shingles, sinusitis, sore throat and uncomplicated urinary tract infections.
Pharmacists have welcomed the opportunity to expand the care they can provide to patients, but some have raised concerns about delivering the service amid mounting pressures.
The Pharmacists’ Defence Association (PDA), which represents 37,000 pharmacists across the UK, has advised its members to consider temporarily withdrawing offering advice and treatment for the seven common conditions if they are not confident they can ensure the safe and effective operation of the pharmacy.
An email shared with the organisation’s members on Tuesday said: “The PDA reiterate that operating the Pharmacy First Service is at the sole discretion of the Responsible Pharmacist (RP) each day in each pharmacy.”
It continued: “PDA members are therefore advised that if, as the RP they are not confident or competent around the provision of the seven clinical pathways and PGDs, or if they do not have the necessary resources including sufficient, competent staff to safely do so, they should follow the their employer’s business continuity plans and consider the protocol outlined in the Pharmacy First service specification.”
The protocol outlined by NHS England states that if the service must be temporarily withdrawn by the pharmacy contractor, they must inform the NHS Directory of Services Provider and Commissioner helpline as soon as possible to stop referrals being made to the pharmacy.
Paul Day, director at the PDA and PDA Union, told i the instruction from NHS England means “if you arrive at the pharmacy and there’s not enough staff… there’s too much other work, whatever it might be, the Responsible Pharmacist is there to make sure that what is done is done safely and they can say, ‘well, actually, we won’t do Pharmacy First today because it’s more important that we have to do the dispensing’ or whatever it might be.”
i understands at least one major high street pharmacy brand is advising its pharmacists to temporarily suspend the service on occasions when skilled staff are not available.
Pharmacies that have agreed to deliver the service are required to do so for all seven conditions. It means they face pausing access to the service entirely on days when competent staff are unobtainable.
In Scotland, a separate initiative of the same name, which expanded the scope of the minor ailments service launched in 2020. During the launch in Scotland, there was a staggered approach to the rollout of conditions that pharmacies could treat.
Analysis by Community Pharmacy England shows there were a total of 1,376 permanent pharmacy closures between October 2016 and November 2023. The closures are now said to have reached an unprecedented level with more than one pharmacy closing each day.
Those that remain open are struggling with sweeping medicine shortages, staffing issues and funding shortfalls.
Anil Sharma, who owns five pharmacies in Cambridgeshire and three in Suffolk, said he believed the scheme could be beneficial for patients but would add more pressure on to pharmacists.
Mr Sharma added: “For us in pharmacy, it’s going to add a lot more pressure to our already highly pressurised stressful job. But we have no choice. If we want to stay afloat, we need this new money.”
Debra Ainge, CEO of iethico, which connect pharmacists with medicines needed for their patients, said: “There is a concern that obviously they’re really stretched already, and therefore have they got the extra time to take on extra responsibilities.”
A DHSC spokesperson said community pharmacists are backed with £2.6bn in Government funding a year.
They added: “Over 93 per cent of pharmacists across the country have signed up to deliver additional services through Pharmacy First and we are providing up to £645m in extra funding to support a smooth rollout of the service.”
