Conjunctivitis, vaginal thrush, hay fever and head lice have been the conditions treated most often through the Welsh common ailment service (CAS), which aims to make pharmacists the first port of call for advice and treatment of common illnesses (see ‘Common and minor ailment schemes’).
An interim report, published on 29 January 2015, reveals that conjunctivitis accounted for 174 of the 827 consultations delivered during the first eight months of the pilot service, which ran in 32 pharmacies in Gwynedd, North Wales, and the Cynon Valley, South Wales.
The report suggests that several positive outcomes are emerging from the pilot, which began in September 2013. These include the strengthening of GP-pharmacist relationships, improved patient understanding of the support available in pharmacies, and improved job satisfaction for pharmacists. Take-up was patchy, however, as half (418) of the consultations were performed by pharmacists in just 6 of the 32 pharmacies involved.
The report’s authors have made several recommendations to help secure the success of the CAS as it moves towards a national roll out. These include: improving service awareness and understanding among GP practice staff, patients and other healthcare professionals; making the IT system used to record consultations more user friendly; and ensuring consistent availability of the service.
Pharmacists and GPs involved in the pilot both reported problems delivering the service during busy dispensing times. The median time taken for a consultation was just under 4.5 minutes. The report’s authors also point out that locum pharmacists are not always accredited to deliver the service, which is frustrating for patients who have been directed by GP practice staff to seek treatment from a pharmacy.
The final report is due to be published in May 2015.
Common and minor ailment schemes
Many GP consultations are for conditions that are self-limiting, such as constipation, dyspepsia, hay fever, coughs and sore throats, or that are not self-limiting but that can be treated with medicines available without a prescription from pharmacies, such as athlete’s foot. Pharmacists already spend much of their time advising on these conditions, recommending over-the-counter (OTC) products or referring patients to other healthcare professionals.
A community pharmacy common or minor ailment service is a scheme that encourages patients to consult a participating pharmacy, rather than their GP, for a defined list of common or minor ailments. The pharmacist will supply medication from an agreed formulary, give advice, or refer the patient to the GP if necessary. Medicines are supplied free of charge, removing the payment barrier that can stop patients choosing to see a pharmacist instead of their GP.
According to research conducted in 2007 on behalf of the Proprietary Association of Great Britain (PAGB), an organisation that represents manufacturers of OTC medicines, 57 million GP consultations per year involve a discussion about minor ailments, 90% of which are for minor ailments alone. The research also found that 20% of GP consultations involve minor ailments, and 18% are for minor ailments only. Most of these consultations (91%) result in a prescription being issued, at a cost of £370m.