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pharmacists will be encouraged to treat minor ailments walesAugust 5 2015

The Choose Pharmacy common ailment scheme being piloted in Wales could potentially have a £43 million benefit over five years. An evaluation of the two pathfinder areas has identified a reduction in GP consultations and prescriptions being issued, and suggests benefits would outweigh costs.

In 2013 the Welsh Government announced it would pilot pharmacy schemes to reduce the pressure on GPs in Wales, who have an estimated 5 million consultations each year for common ailments.

The resulting Choose Pharmacy scheme has allowed authorised pharmacists to supply patients free with medicines from a specified list for a specified number of common ailments. The scheme was initiated in two pathfinder areas: 19 community pharmacies in Betsi Cadwaladr and 13 within the Cynon Valley locality of Cwm Taf.

Among the key findings for the service were:

  • demand has increased with 2,074 Choose Pharmacy consultations taking place between September 2013 and October 2014
  • uptake varies significantly by condition, with the top five most common ailments accounting for 68% (1,405) of consultations.
  • the most common condition presented was hay fever, accounting for 24% (507) of all consultations, followed by conjunctivitis and head lice
  • the number of GP appointments avoided per month across both pathfinder sites range between 111 and 1,658 (with 547 appointments being the most realistic estimate)
  • analysis suggests that the best estimate of the benefits of delivering Choose Pharmacy nationally over a five year period ranges from £5 million to £75 million depending on the scenarios modelled, with the most realistic scenario suggesting a benefit of £43 million.

The ‘Evaluation of the Choose Pharmacy common ailments service: Final report’ has been written by the Welsh Government’s Knowledge and Analytical Services. It makes a number of recommendations on how the service could be developed for a national roll-out, including the need for raising awareness and understanding of the service, more training, and extending referral pathways.

Community Pharmacy Wales has welcomed the publication noting that the Evaluation concludes that “the impact and economic evaluation suggests a positive return on investment in Choose Pharmacy over the next five years based on the performance of the service in the two pathfinders.”

Russell Goodway, CPW Chief Executive, said: “The evaluation suggests that the service has been most effective where GP surgeries and pharmacies work closely together and where the service has been best understood by NHS Wales stakeholders.

“Clearly, as with every new service, the pathfinder project has identified a number of areas where the service could benefit from changes in scope and operation and CPW will now be considering this report and its recommendations in detail and, at the appropriate time, discussing the potential for a national roll out with Welsh Government Ministers and officials.”

Among the barriers to uptake identified in the report were patients’ preference to see a GP, patients’ perceived seriousness of their ailments, and the limited formulary might have restricted uptake of the service.

“All stakeholders noted that significant cohorts of patients will prefer to see the GP for advice and treatment for common ailments,” says the report. “Changing the behaviour of these patients was considered to be particularly challenging – especially if they have visited the pharmacy at a time when the pharmacist was unavailable to undertake the consultation.”

Mr Goodway added “We believe that an appropriate NHS community pharmacy common ailments service will go a long way to assisting in reducing pressure on GP surgeries and meeting the Welsh Government’s policy priorities in its Primary Care Plan and Prudent Healthcare initiative, such as Making Every Contact Count. However, we appreciate that Welsh Government must also be convinced of its benefits.”

Links:

Welsh Government announcement    

Evaluation summary    

Evaluation of the Choose Pharmacy common ailments service: Final report    

CPW response      

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