Cancer symptom card scheme launched across community pharmacies

Exclusive: The ‘Not normal for you?’ scheme will be rolled out across more than 1,000 community pharmacies in the UK, aimed to overcome barriers for people to see their GP.
gp talking to older man during appointment

Patients showing potential cancer symptoms will be provided with referral cards to present to their GPs, under a community pharmacy scheme.

The ‘Not normal for you?’ scheme, pioneered by Jackie Lewis, owner of the Lewis Pharmacy in Exmouth, Devon, has been rolled out across the Alphega Pharmacy network of more than 1,000 pharmacies in the UK.

Under the initiative, pharmacy staff are trained to identify patient behaviour that could signal cancer or another ongoing health issue, such as repeatedly buying cough medicine, throat lozenges or haemorrhoid cream.

Staff members can then discuss the issue with the individual and encourage them to make a non-urgent appointment to see their GP if appropriate.

The symptoms are written on the back of a ‘Not normal for you?’ referral card, aimed to overcome barriers to visiting the GP with what patients can perceive as being minor symptoms.

“It’s a brightly coloured prompt that sits in your wallet and when you’re in front of the GP it gives you a little bit of confidence,” Lewis said.

Lewis originally thought of the idea for an early cancer diagnosis scheme in 2018.

“I started to see gaps in provision of care really, and thought that pharmacy teams could be useful in helping people with cancer,” she told The Pharmaceutical Journal.

Lewis was awarded £10,000 in funding from the National Pharmacy Association’s (NPA’s) Health Education Foundation to run a six-month pilot of the scheme, which took place across ten pharmacies in Devon in 2019.

Results from the pilot scheme showed that more than 65% of pharmacy users were receptive to discussing their symptoms with pharmacy staff and accepting the referral card.

More than 60% of people visited their GP following a conversation in a pharmacy and a further 30% of people said they planned to do so.

One success story involved a man, who had tried to buy cough medicine in a pharmacy, being diagnosed and treated for lung cancer after the pharmacist identified that he had experienced a cough for more than six weeks and encouraged him to visit his GP.

Helga Mangion, policy manager at the NPA, said the scheme was “hugely important in raising awareness of potential cancer symptoms and encouraging patients to visit their GP for further diagnosis”.

She added: “The project also underlines the hugely important role community pharmacists and their teams can play in helping patients identify and receive potentially vital early treatment for cancer, and their significance within the overall primary care system.”

Following the success of the pilot, Lewis was awarded £10,000 of funding from pharmaceutical firm Bristol Myers Squibb, which was used to print referral cards and roll out the scheme to pharmacies across the Alphega Pharmacy network.

Mandeep Mudhar, head of Alphega Pharmacy UK, said: “Early cancer diagnosis is crucial for effective treatment and the system developed by the ‘Not Normal for You?’ service offers another layer of support that can promote early detection.  

“With 1.6 million people visiting their community pharmacy each day in England, pharmacists are well-placed to support and, as such, we will continue to support the rollout of this service across all Alphega pharmacies and encourage others to consider running this service.”

Recognising that it would not be practical to offer in-person training to all pharmacy staff, Lewis has created a free online training resource called ‘Let’s communicate cancer‘, which uses videos and quizzes to teach pharmacy teams about cancer symptoms, and is hosted on the British Oncology Pharmacy Association website.

Lewis is hoping to expand the scheme in 2024 and is also working with the UK Oncology Nursing Society to organise webinars for other healthcare professionals, such as nurses and primary care network pharmacists, on improving cancer care.

Last updated
The Pharmaceutical Journal, PJ, December 2023, Vol 311, No 7980;311(7980)::DOI:10.1211/PJ.2023.1.204731

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