People needing medical care across the Midlands are now able to get professional clinical advice and treatment at a place more convenient for them as part of an extended service agreement between community pharmacists and NHS England in the Midlands. Through the Community Pharmacy Extended Care Service, people can visit a local pharmacy instead of their GP for advice and treatment for a range of minor illnesses. Pharmacists can supply medicines to treat the conditions or recommend over the counter medicines.

Kate Scothern, Pharmacist Manager at Edwinstowe Pharmacy has been very successful in providing the extended care service having started pre pandemic with the original scheme.

She said “Between April 2019 – March 2020 we had completed around 500 consultations. The scheme was then paused, and we began participation again as soon as allowed.

We have built up good relations with the GP surgery, and they were keen to refer into the service, so much so that they regularly asked me when we would be starting again as the pandemic progressed.  At present I get 5-10 referrals per week.

I get a great deal of positive feedback from patients, from the beginning of the consultation right through to the 7 day follow up. This has been the case even when the patient has had to see another healthcare professional as the treatment given/recommended did not work as well as it should. I think that this makes patients feel cared for and looked after.

We are in a rural location with sections of forestation – close to various holiday lodges and campsites.  It has helped to be able to offer this service to patients staying away from home, and insect bite consultations have been one of the more common conditions we have seen people for.

A double insect bite during a family holiday

A lady staying at a well-known nearby holiday lodge came to the pharmacy with 2 insect bites; one on her neck and one on her shoulder.  She had had the bites for several days.

Signs of infection were clear and, following the consultation where inclusion criteria were met, she was given clarithromycin via the PGD as allergic to penicillin.  At the follow up, she told me that the antibiotic had not been working so she visited her GP who increased the dose.  This also did not work so she ended up at A&E (following GP instructions) with a change to the antibiotics and a longer course.

She gave very positive feedback to the pharmacy for the service offered and said she had really appreciated what had been done for her. She said that she would have left it much longer if it had not been available and the safety netting advice had not been given to her.

An insect bite which took a turn for the worse

Another example was of a local gentleman.  He came into the pharmacy with an insect bite on his forearm.  Initially antihistamines and hydrocortisone 1% cream were advised.

Following the safety net advice given, he returned to the pharmacy as his symptoms had worsened.  He had drawn around the bite with a pen as advised and the red area had increased considerably, with pain and swelling, and was hot and hard to touch.

Following the consultation, the inclusion criteria were met with no red flags, so he was given a five-day course of flucloxacillin with counselling and safety net advice.

On follow up, the symptoms had resolved, and he was very grateful for the service given.  He appreciated that it had made things easier for him as a patient and freed up a GP appointment for somebody else.

In addition to seeing people for insect bites, the UTI and bacterial conjunctivitis services have also been popular.