London minor ailments service wins second reprieve

Exclusive: A minor ailments scheme in London that was deemed “inequitable” by NHS England as it only covered 14 of the city’s 32 boroughs has been extended for the second time.

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A community pharmacy-run minor ailments scheme (MAS) covering 14 London boroughs which was due to be wound up at the end of March 2019, has won a second reprieve.

NHS England London confirmed on 7 March 2019 that the service will continue to be funded until an alternative scheme, designed to take its place, has been agreed.

However, if a new future model cannot be agreed, then the traditional MAS service will be terminated, it said.

It is the second time that the 14-borough-wide MAS has been saved since summer 2018.

NHS England London said in a statement: “The current MAS will continue to be commissioned and paid for during 2019/2020, until the process for an alternative scheme has been exhausted with the clinical commissioning groups, after which, either a revised scheme that does not conflict with the over-the-counter (OTC) guidance will be commissioned or formal notice will be served on the existing services.”

The body had originally planned to stop funding the scheme in summer 2018 on the grounds that it was not a fully London-wide scheme and was, therefore, “inequitable”. It also claimed that the service was “not fit for purpose” and that some patients were reportedly using the MAS to obtain regular supplies of paracetamol and ibuprofen, rather than when they had an acute need.

But the MAS was granted a stay of execution in August 2019 — with funding promised until the end of March 2019 — after community pharmacists and GPs argued that its closure could affect vulnerable people who rely on the service.

Ending the MAS would also put increased pressure on GP and hospital services which were already stretched, they said.

Confirmation of the latest reprieve came as it emerged that talks were continuing in City and Hackney — which is part of the 14-borough service — to develop a MAS exclusively for use by “socially vulnerable” people.

City and Hackney Local Pharmaceutical Committee said that details of how that service would operate were still being discussed by a working group made up of community pharmacists and representatives from the local clinical commissioning groups, public health services and NHS England.

NHS England issued guidance in March 2018 that limited routine prescribing of OTC products for 35 minor or self-limiting conditions. The OTC ban is expected to save the NHS around £136m per year, but will not apply to some patient groups, including those who are assessed to be “socially vulnerable.”

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Citation
The Pharmaceutical Journal, PJ, March 2019, Vol 302, No 7923;302(7923):DOI:10.1211/PJ.2019.20206263