Pharmacies to offer point-of-care test and treatment for acute cough

Under a patient group direction, community pharmacies in Liverpool will be able to supply doxycycline to eligible patients referred through the 'Community pharmacist consultation service'.

Community pharmacies in Liverpool will be able to supply antibiotics to patients with an acute cough following a rapid point-of-care test, the local pharmaceutical committee (LPC) has said.

The service — part of a wider ‘Pharmacy First’ service running in the city — will enable pharmacists to supply doxycycline under a patient group direction (PGD) to eligible patients referred to them through the ‘Community pharmacist consultation service’ (CPCS).

According to the PGD, patients are eligible for a supply of doxycycline if they have an “acute cough with or without sputum and [are] systemically unwell (fever and/or malaise) within the last seven days”, or if the acute cough presents “within the last seven days in patients without systemic illness who are at higher risk of complications”.

All patients will need to undergo a point-of-care test “demonstrating a bacterial infection”.

This is the latest in a suite of PGDs issued by NHS Liverpool Clinical Commissioning Group, authorising pharmacists to supply medications, including trimethoprim 100mg or 200mg tablets for uncomplicated urinary tract infection in women and hydrogen peroxide 1% cream for minor, localised impetigo.

Together, the PGDs form the local ‘Pharmacy First’ service, which has been running since April 2021 in Liverpool, and enables pharmacies to claim £15 per consultation, in addition to the £14 offered if a patient is referred through the CPCS.

This is distinct from the ‘Pharmacy First’ service currently running in Scotland, where community pharmacies can offer free advice, treatment and referrals to patients presenting with minor conditions and prescribe treatment for certain conditions.

Health secretary Sajid Javid said in October 2021 that he was in talks with NHS England about creating a similar service, for pharmacies in England, as part of a drive to take pressure off GP practices.

Matt Harvey, chief officer of the representative body Community Pharmacy Liverpool, told The Pharmaceutical Journal on 11 January 2022 that pharmacies will be able to start using the PGD “within the next week”.

“Community pharmacists in Liverpool will now be able to treat a wide range of conditions that would otherwise have needed a GP prescription,” he said.

“This will help to reduce demand on the wider NHS and allow for increased referrals from local practices through the CPCS.”

He added that the PGD for acute cough “was brought about following feedback from local GPs, and it has taken time to ensure it is robust”. 

Harvey said that pharmacies will be supplied with 3,000 FebriDx point-of-care test kits, which can identify acute respiratory infections, “funded through monies left over from a [Pharmacy Integration Fund] project that had to be abandoned at the outset of the COVID-19 pandemic”.

“The necessity for a FebriDx kit to be used as part of the PGD inclusion criteria will ensure pharmacists supply doxycycline only to patients that need it, thus reducing the risk of inappropriate antibiotic prescribing,” he added.

In May 2021, the government confirmed that a service offering point-of-care testing and treatment for sore throat was under development for community pharmacies across England.

The five-year Community Pharmacy Contractual Framework, published in July 2019, had also set out plans to “commence pilots for point-of-care testing in community pharmacy … to support efforts to tackle antimicrobial resistance” during 2019/2020; however, these pilots are yet to start.

  • This article was amended on 12 January 2022 to clarify that under a PGD, medicines are supplied not prescribed.

Read more: The impact of a community pharmacy cough, cold and flu service on antibiotic prescribing and its acceptability

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Citation
The Pharmaceutical Journal, PJ, January 2022, Vol 308, No 7957;308(7957)::DOI:10.1211/PJ.2022.1.123264

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