Community Pharmacy Minor Ailments Service
| Description | A service whereby community pharmacists can help in the treatment of minor ailments, complimenting and enhancing the current services offered in GP practices by doctors and practice nurses |
|---|---|
| Setting | Primary care |
| Populationting | Any person registered with a participating practice (to be extended to all registered patients in Lincolnshire, once service funding is agreed by the new Primary Care Trust) |
| Intervention summary | To reduce the workload associated with minor ailments in general practice, by diverting appropriate patients to the Community Pharmacy Minor Ailments Service, providing improved access for patients, whilst making full use of all health care professionals within Lincolnshire |
| Outcome Summary | High reduction, or elimination of patients presenting with minor ailments at participating practices, whilst generating over 5000 consultations in the participating pharmacies |
| Startup Cost | No start-up costs, except the time and commitment of myself and my colleagues helping me with the clinical aspects of the service. |
| Running Cost | Approximately £12 000 per annum At the moment the running costs are approximately £6000 per annum for administration and about the same for the drug costs, although this will rise proportionally to the amount of practices involved. It costs approximately £8750 per 5000 consultations, and then any drugs costs associated, which equates to approximately £15 000 per 5000 consultations. |
| Funding | Initially from the Medicine Management Collaborative initiative fund and then subsequently from a recurrent budget. |
| Started | April 2004 |
| Ended | Ongoing |
| Location | Lincolnshire, England |
| Contact |
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Background
The aim of the project was to prove that community pharmacists could help in the treatment of minor ailments, complimenting and enhancing the current services offered in GP practices by doctors and Practice Nurses.
For exempt patients, the only way they can receive medication for free is to obtain a prescription issued by a GP or nurse. It was felt that this system could be improved with the introduction of a minor ailments service and the involvement of a pharmacist.
The idea was simple:
- Devise a list of ailments, which could be dealt with by pharmacists;
- Devise a mechanism for patients and pharmacists which was simple and easy to understand; and
- Agree a reimbursement structure for pharmacists, for the patient consultation.
What is the problem you are trying to solve?
For exempt patients, the only way they can receive medication for free is to obtain an FP10, which can only be subscribed by GPs, nurse prescribers or supplementary prescribers, for which an appointment is needed. This takes valuable resources of both time and money for the NHS.
What was needed was a method where patients could self diagnose and have that diagnosis confirmed by a health professional. They would then receive the required treatment, be it medication or advice, for free, all at one location and without needing to arrange an appointment. For this reason, the Community Pharmacy Minor Ailments Service (CPMAS) was born.
What local organisations are involved?
At present 17 pharmacies and 11 GP practices are involved. This represents approximately 17 % and 11 % of Lincolnshire respectfully. It is envisaged that once the new Primary Care Trust (PCT) structure is confirmed, this may well be extended to cover the rest of Lincolnshire.
How many people are running this project and who are they?
At the moment, the service is run by one person, Darren Juggins, although it is envisaged that administration support for payments would be required if the service expanded.
What local population are you targeting?
The target population is anyone who is exempt and is suffering from a minor ailment which is listed on the service leaflet. This includes children, young adults in full time education, patients who are exempt due to medication conditions, pregnant mothers, patients over 60 years of age and the unemployed.
Whilst patients who are not exempt can benefit from the scheme, it may sometimes be more cost effective for the patient to receive advice and purchase the item over the counter from the pharmacist. Where items are not available over the counter, it may be more convenient for patients to pay a prescription charge to the pharmacist who has Patient Group Directives for certain treatments.
How many people are you targeting?
The population of Lincolnshire is in excess of 700 000 people, of which the target audience is any patient that is exempt, which may be suffering from one of the minor ailments listed in the scheme.
Interventions
What interventions are you using to address the problem?
The CPMAS offers treatments for 25 common minor ailments, including head lice, vaginal thrush, nasal congestion, urinary tract infection, and many others.
All the patient has to do is turn up at a pharmacist, where they are asked to prove that they are registered with a participating practice and that they are exempt from paying for treatment.
Once confirmed the pharmacist undertakes a brief consultation and offers the patient advice and, if necessary, medication, which is identified in the service formulary.
The patient receives the necessary advice and treatment and the pharmacist is then reimbursed by the PCT each month.
It is very simple and very efficient.
Is the project design based on evidence? If so, please state reference.
The Medicines Management Service Collaborative, in which West Lincolnshire Primary Care Trust (WLPCT) participated, identified advantages that could be gained from the implementation of such a scheme. WLPCT was among the first to implement a working scheme and has provided help and support to others embarking on similar projects/services across the country.
Outcome
What outcomes or planned outcomes are you measuring?
Measurables include the number of appointments taken by pharmacists, patient satisfaction, practitioner satisfaction, and pharmacist satisfaction.
Do you have any outcomes or results yet? If so, what are they?
To date, well over 5000 appointments have been taken by pharmacists which would have otherwise been taken by GPs, nurses or supplementary prescribers. This has not only allowed more people to access these professionals, but it has enabled the 5000 patients to have a far simpler mechanism to accessing service and receiving the appropriate medication for their ailment.
The data received to date identifies that a large proportion of the patients accessing the service do so for ailments associated with sore throats, headache, earache, and temperature. This is closely followed by head lice, hay fever and nasal congestion.
Is your project relevant to a government target or guideline?
No.
Feedback
What obstacles did you have to overcome to set up this project?
Funding was initially provided by the Medicines Management Collaborative funding received from the National Prescribing Centre. Whilst this has now stopped, recurrent funding has been made available from the PCT. The next challenge will be establishing the service across the county, which covers 102 GP practices and 104 pharmacies.
What have you learned about the project so far?
Simple ideas work! But you need to ensure that you have the appropriate team to keep the project or service aimed in the right direction. At present, the service is run alongside many other projects and it would be more appropriate for some of the payments work to be carried out by administrative staff, so we would ensure that this is built into the initial costs and workload requirements.
What would you do differently?
Very little. We are revisiting the documentation at the moment, making it simpler to use and adding those ailments that both the GPs and pharmacists have been requesting. The next challenge will be approaching the new Trust board for additional funding to see the service grow to cover the whole of the Lincolnshire community.