Why England’s Pharmacy First sore throat service needs point-of-care testing

Over the past few years, there has been a sore throat test-and-treat service implemented in Wales and, more recently, in Northern Ireland, based on their pilots. In England, we still have a sore throat service that does not include a point-of-care test (POCT) component.

Results from pilots in Northern Ireland showed that 50% of the patients that had a FeverPAIN score of 4 and 5 tested negative and were therefore not offered an antibiotic. Without the POCT in England, we would issue an antibiotic. If you scale this, the plan is to issue 190,000 courses of antibiotics to patients who do not need them.

Also in the Northern Ireland pilot, the pharmacists could test patients with a FeverPAIN score of 2 or 3. More than one-fifth (22%) of this group were found to be positive and were offered antibiotics. In England, these patients with a highly transmissible infection would have been sent home without proper diagnosis and treatment to infect their friends and family.

A recent publication from NHS Wales also showed that the number of antibiotics issued within the Pharmacy First scheme was much lower than the number issued within general practice.

It is time for NHS England to add POCT to the Pharmacy First scheme to reduce the number of unnecessary antibiotics issued and prove an even more valuable service to patients, supporting the movement of minor ailments from general practice to community pharmacy.

Mark Robinson BPharm MSc MRPharmS, retired