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  • General practice pharmacist scheme evaluation indicates ‘improved capacity’ as the main benefit

    General practice pharmacist scheme evaluation indicates ‘improved capacity’ as the main benefit

    Tuesday, 31 July 2018 15:31
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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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a and e signJune 10 2015

Substantial numbers of patients attend A&E because they are advised to do so by other healthcare providers, a study has reported. In addition, Patients are aware of alternatives to A&E, but many still attend A&E because they are unable to access help elsewhere.

Announcing the study published jointly by the Royal College of Emergency Care and the Patients’ Association, the organisations have renewed calls for other out-of-hours services to be co-located alongside A&E departments.

The study presents the outcome a survey of 924 patients between September 2014 and February 2015 who accessed A&E services for urgent healthcare needs and who were asked about the choices, decisions and experiences of patients.

Of the patients surveyed, all had previously attended an A&E department for an urgent healthcare need. The survey found that 69% of patients when surveyed had attended A&E without seeing any other healthcare provider on this occasion. “However, 31% had previously sought assistance for the same episode of illness or injury. In four out of five cases, this was at a location other than A&E.”

Excluding respondents who arrived at A&E by ambulance (17%), patients were asked if they had ‘self-presented’ to A&E or were referred. The study found that 51.8% of patients decided to go to A&E themselves, 39.2% attended on the advice of another part of the healthcare system, 7.2% attended on the advice of a friend, relative or colleague, and 1.8% did not remember.

When asked to select their preferred treatment location for urgent health needs, only 0.44% said they would want to be treated in a pharmacy, although 61% were aware of pharmacies as an alternative service for urgent health needs (ahead of walk-in centres at 59% but behind GP out-of-hours services at 66% and the GP surgery at 77%).

A&E departments were the first choice for almost half of the respondents (47%) and GP surgeries were the second most selected choice (33%).

“Our findings demonstrate that the NHS not only needs to ensure that patients are fully informed of services such as out-of-hours GPs, walk-in centres and the NHS 111 service, but must also ensure that these services have sufficient capacity and are available when required,” say the RCEM and Patients’ Association in a joint statement.

They add that the findings also demonstrate the power of the A&E brand. “As patients continue to attend even whilst being aware of the alternatives, the Patients Association and the RCEM recommend co-location of other out-of-hours services with A&E departments to simplify patient decision making whilst ensuring that all patients are streamed to the most appropriate care provider in a safe and timely manner.”

Responding to the study, Ash Soni, President of the Royal Pharmaceutical Society, said: “Patients and A&E staff could both be helped by a national NHS Minor Ailment Service provided by community pharmacies to give fast, same-day access to treatment for minor health problems. Research shows that treatment results for patients are equally good whether they are treated for common ailments at a pharmacy, A&E or GP practice.

“In addition, the cost of treating patients with these problems at GP practices is three times higher than at a community pharmacy. A&E treatment costs are five times higher and it’s estimated that a total cost saving of £1.1billion could be made if all minor ailments were treated at community pharmacies.

“Unfortunately, current provision of minor ailment services is patchy. Only 1 in 3 pharmacies in England provide it as it is commissioned locally, not nationally. This ‘hit and miss’ approach means both the public and health professionals remain unclear about the treatment that community pharmacies can provide, which drives patients straight back to overburdened A&E services.”

Links:

Patients’ Association/RCEM joint statement     

RCEM and link to report (download from News column)     

RPS response     

Practice News

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