Andre Yeung, a senior pharmacist based within the North East and Cumbria Integrated Care System (ICS) outlines his view of the Pharmacy First service which was introduced across England just over nine months ago. Andre has been visiting practices and pharmacies across the North East and Cumbria area learning more about the specific benefits for both practice teams and their patients.

The aim of Pharmacy First

The Pharmacy First service takes referrals from general practice into community pharmacies for minor illness consultations or supplies of medicines.  Referrals are also received from Urgent Care and Emergency Care settings.

The aim of the service is to increase access for patients and address health inequalities, it’s to prevent illnesses from getting worse and it’s also to create capacity for general practice and other urgent care settings such as emergency departments.

As part of my role as clinical lead for the NHS North East and North Cumbria (NENC) Integrated Care Board I wanted to show best practice for Pharmacy First because I feel the potential of this service to help patients and our primary care system is enormous. While filming a video series with practices and pharmacies across the NENC region, I’ve seen some really great examples of how they can work together to deliver care by the right person at the right time, and in the right setting.

Benefits to practices

From 31 January 2024 pharmacists across England have been able to supply prescription-only medicines to treat seven common conditions which massively improves the capacity of pharmacists to manage and treat patients.

Practices have told me that they find this service to be incredibly useful at creating capacity for them and their patients.

Jonathan Coates, GP at St Anthony’s Health Centre, Walker, Tyne and Wear revealed it has allowed the practice team to handle acute demand more efficiently, more appropriately, more timely for patients and also that it takes the pressure off them – the people that we are sending to Pharmacy First, often don’t need to be seen by their GP at all

Practices also report the training of frontline reception staff to be straightforward, allowing them to review patient requests effectively. They’ve also found that their patients adapted quickly and that relationships with local pharmacies have become stronger through working together within the PCN.

In Stockton on Tees, staff at the town’s Tennant Street practice refer between 10 to 20 patients a day to local pharmacies for UTIs, rashes, ear infections and minor skin conditions. The reception and nursing teams told me that having the option of treatment via Pharmacy First is making a real difference by reducing workload significantly and they have confidence that anything that’s a bit more complicated will be referred back to the practice.

Patients are learning that with this service they can be seen quickly at a time and place that is convenient to them.  The receptionist at the practice told me about a patient with a UTI who didn’t know the service was available and got seen quickly and treated the same day, which she was really pleased about.

Sanjay Nath the Pharmacist at nearby Fairfield Pharmacy told me that he can manage and give the right treatment for the majority and even when there is a need to escalate, he’s been able to contact the surgery and get the patient a telephone appointment the same day. Not only that, but he sees the patient later on in his pharmacy with a prescription for the appropriate treatment in their hand. He sees it as a new direction for community pharmacists, an exciting new opportunity to use their skills for the good of patients.

Benefits to patients

Along the way, I’ve heard so many examples of patients getting care in the pharmacy quickly, more conveniently, and to their satisfaction so I know that this service works.

In Crook I heard two patient stories that stuck with me.  Abi Fraser, the pharmacist at the first community pharmacy I visited, told me about a young boy with severe earache who couldn’t access an appointment via his GP surgery or urgent care centre, but dropped in to the pharmacy 5 minutes before closing.

He was examined by the pharmacist and treated with antibiotics which spared him and his family another sleepless night.

It was also lovely to speak to Lesley, who was able to tell me first-hand about her experiences when I met her in person in Crook. She had a new-found regard for the expertise and knowledge that pharmacists have. She was clear that she will have no hesitation of going to a pharmacist in future and actually saw the service as cutting out the middleman – she could get the prescriptions straight away without waiting for them to be electronically transferred from one place to another.

Learnings during the first nine months

Barriers to practices in engaging with this new service may include things like not having strong working relationships with their local pharmacies, not having confident reception team members who have been trained in referrals, not realising the benefits on offer through partnership working with their local community pharmacies or how to send electronic referrals via online systems such as SystemOne or EMISWeb.

However, I’ve seen these barriers be overcome.  It’s usually thanks to one champion within a practice or local area who brings everyone together and leads them through the transition.

Often, they are from a community pharmacy background. Sarah Bryson, the pharmacist at Hillside Surgery Skelton was a memorable example of this. She explained how she could see what the service could deliver for patients, right from the early days – that streamlining processes and building relationships with local pharmacies would mean that patients were seen in the right place at the right time and were taking responsibility for their own health,

And once this happens, it’s really straightforward to administer and there is no looking back.  It’s such a positive change and enables high-quality care to be delivered to patients.

The GP partner at the practice was particularly grateful to Sarah and the admin team for pushing forward the changes as it has enabled her to concentrate on those patients that she really feels do need to be seen by a GP, that otherwise might be missing out on an appointment.

What lies ahead for the service

I’m really positive about the future of this service within primary care.  I’ve no doubt that over the coming months and years practices will overcome barriers and adopt new ways of working to maximise the benefits of Pharmacy First.

Lastly, I think what further supports the use of this service into the future is the fact that most pharmacists will become prescribing practitioners in their own right, and this will further cement their place in our joined up primary care system.

To learn more about Andre’s visits to practices and pharmacies across North East and North Cumbria ICB visit NHS England — North East and Yorkshire » Pharmacy First – benefiting practices and patients

 For more information about using Pharmacy First visit https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/