A community pharmacy-run sore throat test and treat (STTT) service is to be restarted across two health board areas in Wales, following a pause during the COVID-19 pandemic, a spokesperson for the Welsh government has told The Pharmaceutical Journal.
The STTT on-the-spot throat swab scheme, which uses rapid antigen detection tests (RADTs) for the diagnosis and management of people with group A streptococcal infections, was launched in selected pharmacies in the Cwm Taf Morgannwg University and Betsi Cadwaladr University health board areas in the autumn of 2018; the first NHS-funded STTTs in the UK.
The service was launched as part of NHS Wales’ ‘Choose Pharmacy’ service and was due to be expanded to cover all seven health boards, but was suspended in March 2020 because of the COVID-19 pandemic.
In November 2020, a report from Health Technology Wales (HTW) — a national body working to improve the quality of care in Wales — said that RADTs for the diagnosis and management of people with group A streptococcal infections should not be routinely adopted in community pharmacies, despite “some promising evidence”.
However, in its guidance, HTW did acknowledge that there was “a demand” for the service in Wales, adding that, where it was already being put into practice, it would be “beneficial” to encourage studies.
“Further research is recommended to demonstrate the clinical effectiveness of RADT in the community pharmacy setting,” it said.
Speaking to The Pharmaceutical Journal, a spokesperson for the Welsh government said: “Health Technology Wales’ guidance confirms our view that rapid antigen detection testing in community pharmacy shows promise.
“Whilst there was insufficient evidence of clinical or cost effectiveness for HTW to support routine adoption, they concluded the role of community pharmacy RADT testing should continue to be examined through further research.
“After a pause during the COVID pandemic, we are now restarting the sore throat test and treat service in two health board areas.”
The spokesperson added: “We will continue to work with health boards and academic partners to continue the roll out of the service as part of well-designed observational studies.”
The sore throat test and treat service in Wales
Rapid antigen detection tests are point-of-care tests that can be used in primary care to help diagnose cases of sore throat caused by group A streptococcal infections and guide antibiotic prescribing decisions. Currently, best practice for testing is to take a throat swab from the patient, which is then sent away to a laboratory to test for the presence of the bacteria.
Andrew Evans, chief pharmaceutical officer for Wales, commissioned Health Technology Wales to assess the use of the test, specifically in community pharmacies, because of its potential to alleviate pressure on GPs and improve the stewardship of appropriate antibiotic prescribing.
In August 2020, a survey of 510 people who accessed the community pharmacy sore throat test and treat service found that 98% said they were satisfied with the service and, after using it, 99% of respondents stated that they would return to a pharmacy for subsequent sore throat symptoms.