The Pharmacy First service takes referrals from general practice into community pharmacies. The pharmacies then provide a minor illness consultation, which may include the supply of a medicine that would otherwise have to be prescribed by a GP.

For Jonathan Coates, GP Partner at St Anthony’s Health Centre, Walker, Tyne and Wear, the service, which has been available from 31 January 2024, has helped his practice team manage demand and forge even stronger relationships with their neighbouring pharmacy.

“We wanted to manage acute demand more efficiently, more appropriately, more timely for patients and also to take strain off us – the people that we are sending to Pharmacy First, often don’t need to be seen by us at all, he explains.

Patient requests at the practice, which has a list size of 6800 and lies to the east of central Newcastle, initially come in by phone or via an online consultation tool. The reception team will assess it and if it’s appropriate for the Pharmacy First service it will often be directly referred to the pharmacy using the online referral system. The patient will receive a SMS text message to let them know they’ve been referred. Alternatively, it will be put forward for consideration by the GP via the triage process.

“I, as the triaging GP, will make a judgment this can be dealt with by the pharmacy or further assessed by the pharmacy knowing that if they’re not happy with it it’ll come back to me to make a further judgment.” Jonathan continues.

Strengthening professional relationships and improving patient care

Neil Heffernan, Pharmacist at St Anthony’s Pharmacy recognises the strength of the relationship between his pharmacy and the GP practice can really benefit patients.

 He says: “It’s a strong relationship which is friendly but professional.  It has allowed us to communicate freely, share experience and improve things quite quickly.”

Jonathan agrees working and learning together is key to successfully delivering the Pharmacy First service.

“We send referrals to pharmacies because we’ve got a really good relationship with our pharmacists… we know them well, trust them, and have daily contact with them.” he explains,

“…a lot of the learning and training for our pharmacy colleagues has been on the job – we’ve worked together so that these feel like shared patients

If the pharmacist bounces something back, we’ve seen patients together, we’ve had some conversation on Microsoft Teams about what to look for next time or what the outcome was. This way our pharmacist is continually learning as well – I’m learning what they can do, but also they’re getting better at dealing with different presentations.”

Seamless system interaction

 The IT infrastructure supporting the service is also making it easier for pharmacists, practices and patients alike.

Neil runs through the detail as follows:

“The benefit of the pharmacy first referral direct from the GP practice or NHS 111 is that we’ve got a good clear audit trail of the problems. It also means on the escalation front you’ve documented everything, and you’ve actually got a hard copy if needed to hand over so that that information stream carries on.

“I think it’s better for the patient journey …Around 85% of cases that are referred to the pharmacy are dealt with in-house. Of the 15% that are escalated, we use our pharmacy IT platform and we also currently print off a copy that gets scanned and put on the system for the doctor to actually look at that day.”

Jonathan adds:

“In terms of the IT, it works pretty well….when we want to make a referral to the pharmacy and there’s two things we do. We’ve got a little local services button in our clinical system which takes about 10 seconds to click the button, choose the pharmacy… and then you put in two or three words about why you’re referring and then that goes off in another 10 seconds.”

The future for pharmacy

Neil sums up the bigger picture for Pharmacy First as follows:

“I think it’s important to use the skills we’ve developed to try and take those low acuity illnesses away from primary care, from walk in centres, from A&E…”

As a pharmacist I feel like I’m more involved with the day-to-day health of the patients – I can explore other healthcare avenues with patients not just the acute side- that relationship building has been fantastic.”

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