More than 60 community pharmacies access cancer red-flag symptom card scheme

Exclusive: The ‘Not normal for you?’ scheme enables pharmacists to identify patient behaviours that may signal cancer and refer patients for red-flag symptoms.
older couple at pharmacy counter with pharmacist

At least 44 members of the Alphega Pharmacy group and 20 other community pharmacies have accessed a cancer referral scheme since it launched in October 2023.

The ‘Not normal for you?’ scheme, pioneered by Jackie Lewis, owner of the Lewis Pharmacy in Exmouth, Devon, enables pharmacists to refer patients for red-flag symptoms and behaviours that could indicate cancer.

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

Symptoms are written on the back of an orange referral card, which patients can present to a GP for confirmation.

The referral card is intended to act as a prompt for patients to book a GP appointment, increasing the likelihood of diagnosis after potential symptoms have been identified by pharmacy staff.

Following the launch of the scheme across the Alphega Pharmacy network of more than 1,000 pharmacies in the UK, with some other pharmacies choosing to take part, Alliance Healthcare is now expanding the scheme to all UK pharmacies.

Lewis told The Pharmaceutical Journal: “The scheme has been very well received and it’s good to know that it may be making a difference”.

As part of the rollout, Alliance Healthcare will provide pharmacies with free marketing materials, including leaflets and referral cards, as part of their standard delivery.

Pharmacies that order the materials can also access the free online training programme ‘Let’s communicate cancer’, which is hosted on the British Oncology Pharmacy Association’s and National Pharmacy Association’s (NPA’s) websites.

Lewis initially rolled out the ‘Not normal for you?’ scheme to 10 pharmacies across east Devon, after she was awarded £10,000 in funding from the NPA Health Education Foundation in 2019.

Following the success of the pilot, she received a further grant from pharmaceutical firm Bristol Myers Squibb, which enabled her to develop materials, upscale and roll out the project.

Lewis is now looking for further funding so that she can collect and analyse data on the number of referrals made under the scheme.

Mandeep Mudhar, head of Alphega Pharmacy UK, said: “The ‘Not normal for you?’ scheme has been positively received by Alphega Pharmacy members and engagement continues to increase.”

Lewis is also involved in training pharmacy teams in Cornwall, which are participating in the ‘NHS supporting early diagnosis of cancer’ pilot.

The pilot, which The Pharmaceutical Journal reported in March 2024 had made its first referrals, is intended to enable community pharmacies to refer patients with red-flag cancer symptoms directly to secondary care or rapid diagnostic services, without the need to visit a GP.

Last updated
The Pharmaceutical Journal, PJ, April 2024, Vol 312, No 7984;312(7984)::DOI:10.1211/PJ.2024.1.308986

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