The government’s NHS Choices website (nhs.uk) is the UK’s leading online health and social care information service, receiving 11 million visits from the public each week. It features evidence-based information about hundreds of health conditions and treatments, healthy living advice, and allows users to search for local services, such as hospitals, GP practices and, of course, community pharmacies.
Pharmacy contractors in England will be increasingly aware of NHS Choices, now that it has been announced that one of the qualifying terms of the new Quality Payments Scheme is having an up to date NHS Choices pharmacy profile. It’s going to be more important for other reasons too. The site is currently undergoing a ‘transformation’ of its content, says NHS Digital, so that pages on the site will also actively signpost patients to appropriate services. Significantly, this will include signposting to community pharmacy where appropriate.
Richard Moore, product group lead for NHS Choices, speaks to P3’s Carolyn Scott about the work that’s being done, offering his tips to pharmacies getting to grips with involved with updating their pharmacy details, and how to cope with the public’s Amazon-style pharmacy reviews – which he expects to see more of in future. Mr Moore works in collaboration with NHS England to support their activity around the Quality Payments Scheme.
“We are changing the [NHS Choices] site over the next two to three years to meet some of the paperless 2020 objectives [for the NHS] set by ministers. A lot of these objectives for paperless 2020 are around digitising the NHS, and part of our work is about improving self care and triaging people to appropriate services – so improving access to services.”
“We will completely change NHS Choices in the next two to four years,” he says. The information provided to the public in the NHS Choices A-Z condition articles, for example, are moving from ‘library-based content’ to ‘action-based content’, he explains.
Where someone with a minor ailment could visit a community pharmacy for self care advice, rather than going to see a GP, the NHS Choices pages will reflect this. “If it is clinically appropriate to triage people to a pharmacist for self care, then the action within the article would be to signpost people to a pharmacist. That meets the self care agenda and reduces avoidable contacts with GPs, but is also supporting the community pharmacist in terms of all the wide range of services they offer apart from supplying their prescription.”
“Currently, what we are doing is running some ‘beta’ [test] pages for March 2017 for around 20 conditions. Then the objective is for 175 conditions by September in beta, to roll out in March 2018 as a live service. Some of those conditions will have an action driving people to pharmacy.”
Pharmacy contractors will play an important part by updating the pharmacy information data on the site, a requirement of England’s Quality Payments Scheme. Much of the pharmacy details on the site are out of date, he says. “The first piece of the jigsaw is how can we improve the quality of our data, and that’s where the Quality Payments Scheme comes in. We have a lot of data that is out of date. A lot of the PCT leads used to take that responsibility and pharmacists haven’t yet fully embraced the opportunity to go into Choices and update their profile.”
A basic profile for each community pharmacy in England will already be on the site. “We work with the BSA to bring over the basic contract information: the name of the pharmacy, the address and the telephone number – but that’s it. Now we need pharmacists to add opening times etc.”
He describes updating the system as “straightforward and intuitive”. An overview section is presented as a box for information to be directly typed in. “I would use the overview section to describe the type of pharmacy that pharmacy is, the type of community they serve and some of the statutory services they offer.” Adding a photograph of the pharmacy frontage is recommended.
Other sections that pharmacies need to update have drop-down options, and essential services will be pre-ticked. A general pharmacy services section includes essential services, advanced services and other services that patients may find useful, such as consulting rooms. A second section is for local commissioned services – those commissioned by CCGs and local authorities – and a third section is for listing any non-NHS pharmacy services.
Multiples are able to use an API (application programming interface), which allows them to post all their opening times, service information and facilities, from their own database into the site.
Another step for contractors will be to upload the pharmacy’s patient survey – by the 30 April deadline. “The way to do that will be to create a news article on the page and upload the pdf. The title of the news article needs to be in a certain format so that it will be recognised and recorded as completed.” More information will be available on how to do this, he says. Pharmacy details on the NHS Pathways system, the clinical tool used for assessing, triaging and directing contact from the public to urgent and emergency care services such as 999, GP out-of-hours and NHS 111 will also automatically updated in the future. “We are not there yet, but that’s the aspiration.” For the moment, the information will be shared with the Pathways team as a separate file.
The project is good news for community pharmacy, says Mr Moore. “This means that the amount of traffic hitting pharmacy profile pages will increase, there will be a lot more integration from condition articles, and the same data will be on the 111 platform for people calling in rather than using the website – so they get the same signposting. Overall the quality of the service signposting in the NHS, both on the digital service and the telephony service, will be improving.”
Once information about community pharmacies is up to date NHS Digital plans to increase the search capability for patients. “Better data will allow contextual searches, for example: ‘I’m looking for Calpol and it’s 11 o’clock at night. Which pharmacies are open?’ Or if it’s an embarrassing condition, a patient might be interested in a pharmacy with a consultation room.”
One area that may be trickier for community pharmacies to handle is ratings and reviews submitted by the public. People can already do this, but the number of reviews for pharmacy is small compared to the other healthcare practices listed. With more signposting the number of reviews and ratings is expected to increase, says Mr Moore.
Anyone can comment, but the NHS Choices team moderates comments before they are put live on the site. “There are certain rules around the review and those moderation rules are available on the website. We then send an email to the comment administrator [at the pharmacy] to say that a review had been posted about your pharmacy on NHS Choices, with a link to that comment.”
Negative reviews are inevitable, but it is not necessary to have a 100 per cent 5-star review track record, he says. People expect to see negative comments amongst a range of other reviews, he suggests, but having the right balance is important. “Providers should not be wary of negative reviews. If a service has a large number of reviews, and the majority are good, but with a few negative ones, then people will rate that highly. But, if there is just one very positive review, then people might actually be a bit suspicious of that.”
Providers are allowed to encourage patients to review them on the site, but they can’t solicit or put patients under pressure to review. The pharmacy has a right to reply, and should use it well, he says. “If you do get a negative review, then appear attentive to your patient in your reply,” suggests Mr Moore.
Writing a response is good practice for pharmacies. “Potentially this encourages a dialogue between patients and a provider – and it is best practice for providers, even with good comments, to acknowledge the comment and thank them for their review. And if it’s a bad one: try to get a better understanding of why service fell short and then take steps to improve their service based on that feedback,” he advises. There is a ‘transparent’ appeals process if a review seems very unreasonable, says Mr Moore. For example, if a pharmacy raises an issue with a negative review, NHS Choices will automatically take down that review while the appeal process takes place. “We talk to patients and the provider and then we typically make a judgement on whether we continue to publish that comment. It’s fair and transparent and it has the patient in mind.”
Does the moderator at NHS Digital know for certain that a person who has commented is a patient at the pharmacy or general practice? “No, we don’t, although the terms and conditions state that the person must be a user of that service. Sometimes this may be a reason why a provider might object to a comment. We would go back to the patient because we have their email address, and ask them to validate that they are a patient at that practice.”
Generally, providers shouldn’t be afraid of negative comments, says Mr Moore, based on his experience of dealing with other healthcare sectors. “A practice might have one negative review, and say that actually doesn’t bear any relationship to their practice. What we’d say is, encourage your patients to rate you on Choices and that will get the balance up to be reflective of your service.”
What you need to do:
Edit and validate pharmacy opening times, service information and facilities information, add an overview, photographs, staff details and contact information. Full guidance will be issued through PSNC.
Between 7 February and 30 April – edit or validate the pharmacy details Between 1 May to 30 November – repeat the process to confirm.
How to get started:
Contractors should contact firstname.lastname@example.org for a login in – ask for web editor rights for your pharmacy profile. You will also want to ask for comment administrator rights.
“We’ve deliberately kept free text boxes as minimal. All the facilities and services sections are drop-downs.” Pharmacy photograph: Uploaded as a jpeg or png file. A good quality snap of the pharmacy taken with a decent iPad or mobile will be suitable, says NHS Digital.
Uploaded as a jpeg or png file. A good quality snap of the pharmacy taken with a decent iPad or mobile will be suitable, says NHS Digital.