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Adapting to a new paradigm: Learnings from Pharmacy First Scotland


Adapting to a new paradigm: Learnings from Pharmacy First Scotland

Contractors in England are experiencing their first year of delivering Pharmacy First, but a similar service has been running in Scotland since 2020. Scottish pharmacist Leanne Carey describes the experience as wholly positive

The Pharmacy First scheme was launched in England this year to give patients quick and accessible care and to ease pressure on GP services for a number of conditions that pharmacists encounter and identify on a daily basis.

For my pharmacy in Scotland, Pharmacy First was introduced in July 2020, allowing pharmacists to prescribe OTC items from a specific formulary. This was extended by adding Patient Group Directions (UTI in women, impetigo, shingles, cellulitis and infected bites and allergies,) and then Pharmacy First Plus, using independent prescriber (IP) skills for common conditions in January 2021.

Although the Pharmacy First schemes in England and Scotland differ slightly, there are a number of lessons we have learned which will be applicable to pharmacies across England.

Rolling out Pharmacy First effectively

Firstly, the great benefit of the Pharmacy First scheme is that it elevates the role of pharmacists and staff, allowing us to have more influence in treating patients.

Under the scheme, patients can visit their local pharmacy without needing to book an appointment with their GP for certain minor ailments.

In England, full payment is received by referral from the GP. Pharmacists, equipped with their expertise and knowledge, can offer advice, treatment, and refer patients to other healthcare providers. The scheme also leads to greater job satisfaction; it is much more rewarding to be able to treat a patient than having to refer them to a GP.

Trust and confidence

After the roll-out of Pharmacy First in my pharmacy, we found that the scheme enhanced the patient and customer relationship.

By offering healthcare services beyond dispensing, our staff had the opportunity to build stronger relationships with patients. This has created trust and confidence in our staff’s expertise, which has led to higher patient satisfaction and loyalty.

Our prescription items and retail sales have increased by around 8 per cent each year since the service was established, despite giving more advice than prescriptions.

Patients choose to come to us first for advice, again and again.

We are part of the Alphega Pharmacy group, which was helpful for us in launching the service and getting the most out of it, including providing consultation forms that help staff get the information they need from patients to offer advice or make a referral.

Addressing capacity concerns

Pharmacies across England already have incredibly skilled and capable staff. However, it is understandable that some pharmacies have concerns about capacity.

Pharmacy staff are trained to triage patients, support with advice and OTC medication, and refer to pharmacists or technicians. We also involve pharmacy students training in branch, so they are able to support with checking patient symptoms. This training frees up the time of pharmacists and prescribers and is an excellent learning opportunity for all colleagues.

I have two post-foundation pharmacists at the moment (one full time and one part time) who stayed on after their foundation year training to be supported with the IP course and develop clinical skills to assess patients under supervision, gaining confidence in the process. This has meant I have continued to have capacity to assess patients and prescribe, support other IPs through the Teach and Treat hub I run as well as managing the business.

Making access to care more equitable for all

The Pharmacy First scheme is a significant step forward in transforming the role of community pharmacists and improving healthcare accessibility for patients across England, with more than 95 per cent of pharmacies already signed up. By capitalising on pharmacists’ expertise, the scheme not only benefits patients but allows pharmacists to have a greater role in patient care within their communities.

The Pharmacy First scheme empowers pharmacists to play a more integral role in delivering primary healthcare services. As this initiative continues to evolve, it will no doubt drive positive outcomes for both patients and pharmacists alike, creating healthier outcomes for all.

Leanne Carey is an independent prescribing community pharmacist who has owned and run Alphega member Barnton Pharmacy in Edinburgh for more than 14 years

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