Scotland’s minor ailments service has a lot that’s good about it, says Noel Wicks

Some ideas are just so good that they keep coming around again and again. One such idea is that of an English national minor ailments/common ailments service through pharmacies. It doesn’t take a rocket scientist to figure out that, with costly A&Es bursting at the seams and long waits for doctors’ appointments, a service such as this is the only logical way forward.

When you think about it, we already have the infrastructure, the capability and the scope to create the capacity for such a service. I’m sure the amount needed to set up the service would be minimal compared to any other recent national initiatives you care to mention. I appreciate that the ongoing costs of providing this would not be inconsiderable, but, in my opinion, and in relation to the alternatives, it surely can’t represent anything other than value for money.

Hopefully, in the near future there will be a sudden outbreak of common sense from the government and by winter 2015 pharmacy really will be the ‘first port of call’ for common conditions.

I hope the common sense outbreak extends as far as the design of the service. The worst possible result would be to end up with a paperbased system that excludes the majority of people, restricts the pharmacist’s choice of medicines or limits the conditions covered.

I’ve seen some or all of the above restrictions at play and I have to say it really does undermine not just the service, but the pharmacy giving it. This is one area that Scotland has got completely right in designing its minor ailments service. The registrations and prescriptions are all done electronically through the PMR in real time. This makes doing consultations a doddle, as the patient’s details are often already available in the PMR system.

In Scotland, although there are local formularies from the various health boards, the reality is that any OTC medicine can be prescribed through the minor ailments service so long as it’s not blacklisted. This is important, because as the person taking clinical responsibility for the prescribing, I may well have a different opinion or requirement from those that went in to the formulary. So, while these act as useful resources, they do not make the system one of ‘prescribing by numbers’.

It’s not all perfect, though, as some patients don’t qualify for the service because Scotland carried over the exemptions from the old prescription charge system. With everyone now exempt from prescriptions charges, this can cause quite a bit of confusion. We also have issues with doctors abrogating their prescribing responsibility in consultations by telling patients to go to the pharmacy to get things such as paracetamol. They are quite happy for the costs of the drugs to come from a budget other than their own, but miss the point about making the patient go through another consultation to receive a treatment on the NHS.

However, all things considered, the system works well, and it must surely now be a case of ‘when’ and not ‘if’ there is a national common ailments service for England.

Noel Wicks is an independent pharmacist