No plans to commission national minor ailment scheme in England, says pharmacy minister

There are no plans to commission a national minor ailment scheme (MAS) in England, pharmacy minister Steve Brine has said in a letter to shadow health minister, Julie Cooper.

In the letter, dated 3 May 2018, Brine told Cooper that the MAS had been discussed in detail and explained that they “are commissioned locally according to the needs of the local population”.

“However, over 11,000 pharmacies are providing clinical support including obtaining urgent medicines supplies through the Quality Scheme for pharmacies introduced in 2017,” Brine continued.

In October 2016, the then health minister, David Mowat, said he expected locally commissioned minor ailments schemes to be delivered through pharmacies across England by April 2018 to help relieve pressures on the NHS.

But, one year later, in October 2017, chief pharmaceutical officer for England, Keith Ridge, told the All Party Pharmacy Group that minor ailments schemes across the country were transitioning to more digitally led services, such as the NHS urgent medicine supply scheme, and that clinical commissioning groups were beginning to decommission minor ailments schemes.

Cooper told The Pharmaceutical Journal that she was “hugely” disappointed by the letter’s contents.

“Not least because the government made a commitment in 2016 to introduce a national scheme,” she said.

“Such schemes are massively beneficial for patients, particularly in the most deprived areas, and enable community pharmacies to take some of the strain off GPs.

“I do not believe that the minister has a full appreciation of the professional capabilities of pharmacists, and this decision is further evidence and represents a missed opportunity.”

A study published in Research in Social and Administrative Pharmacy (online, 14 May 2018), examining the view of those working in the commissioning, influencing and delivery of the pharmacy MAS in the North East, identified a number of barriers to implementation of the MAS across England^[1]
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Among the stakeholders there was recognition that the MAS lacked stable and sustainable funding streams in “an unsupportive economic climate” exacerbated by the lack of awareness of the potential role of community pharmacy among other healthcare professionals and the public.

It was also suggested that the current challenge to widespread adoption and future sustainability of the service could be ascribed to the perceived ill-informed and lack of evidence-based  decision making behind the initial service design and implementation.

“Pharmacy minor ailment services have been provided by community pharmacies across England for the past two decades [but] the service is unstandardised across the country and has failed to generate sufficient evidence to support a model of care delivery for national commissioning and adoption,” the authors said

“Commissioners, community pharmacists and representatives of pharmaceutical organisations acknowledge that the challenges of implementation and future provision of the service are diverse and complex.”