For Sarah Bryson Pharmacist at Hillside Practice, the plus points of Pharmacy First are crystal clear.

“If you’re thinking about using Pharmacy First, I would definitely encourage it.

“The benefits have been huge for the doctors, the receptionists, the patients – it’s developed clear pathways and provided a much better service.”

Sarah Lord, GP partner at the practice which has a list of around 9,500 patients is equally emphatic.

“We feel that it’s improved capacity for other patients – it’s enabled simple infections to be treated appropriately elsewhere. As a GP, it’s enabled me to just concentrate on those patients that I really feel do need to be seen by a GP, that otherwise might be missing out on an appointment.”

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. NHS 111 and Urgent and Emergency Care settings can also refer to the service.

From 31 January 2024 pharmacists across England have been able to supply prescription-only medicines to treat seven common conditions.

Introducing Pharmacy First

Sarah Bryson, the pharmacist at the surgery comes from a community pharmacy background and could see what the service could deliver for patients, right from those early days.

“We were very keen to streamline our processes so that patients were seen in the right place at the right time and were taking responsibility for their own health, she explains.

“I could also see the benefits of encouraging this relationship with the local pharmacies and getting that to work”

The administration team were also in favour of making a change. Office Supervisor Claire Howard reflects on the start of the service at Hillside, a rural practice in a former coal mining area:

“We were early adopters – we started care navigating quite early on but obviously over time the amount of things that the pharmacies can do and the things that they can treat has developed.”

Sarah Lord adds:

“…it was brought to us by the administration team. It was discussed at a meeting with all the GPs present to see whether it was something that we felt we would benefit from, as a practice and also for the patients.”

Behind the scenes of Pharmacy First

The receptionist team are responsible for initial checks of patient requests at Hillside which gives online and traditional access routes to patients:

“The patients ring up on a morning and depending on what their symptoms are, the receptionist will review and decide whether they are suitable for a referral to the pharmacy” says Claire

“We also have e- consultations at the practice so when they’re getting processed the reception team look at the symptoms and if it’s appropriate for the pharmacy, they will contact the patient for their consent and then send a referral if they agree to it.”

Once the patient’s consent has been given, it is straightforward to make the referrals within the surgery’s IT system.

Macy Morrish, Senior Receptionist explains the process:

“In our clinical system we have an icon for the pharmacist which we can click on to once we’ve loaded the patient’s records and send a referral along to the pharmacy.

“It only takes a couple of minutes once we’ve got the details from the patient as it links to their NHS record so once that referral has gone through the pharmacy will access everything from there.

“Once the patient’s been seen by the pharmacy, we get a letter back, these normally come through on an email to us with the information from the consultation.

“It will have the details of the problem, what was discussed with the patient and if they were given any treatment. If there were any recommendations for the GP that they want us to follow up or if they were signposted elsewhere – it will have those actions on there as well.”

Claire adds:

The practice’s relationship with the pharmacies seems to be working well.

“We send our referrals to them and if there was anything that they felt was inappropriate or not suitable, they’ve got our direct dial to my desk or they can send a rejection via email. We would pick that up on a daily basis and then navigate elsewhere, usually to the GP.

“As time’s gone on patients have become more accepting of Pharmacy First and they don’t question it now if we say it’s something suitable.”

Patient satisfaction is always at the heart of any decision to try a new service, and views have changed gradually over the first nine months of Pharmacy First.

“When we first started referring to the pharmacies, the patients were a little bit apprehensive. We reassured them as much as possible and let them know that it was a referral to a clinically trained pharmacist, and they would have a consultation with them” recalls Claire.

Practice surveys have seen patient satisfaction levels rise in recent months to over 90%. Patient choice is very important at the practice and there are still alternatives available for those that don’t want to use the service. However, patients are increasingly satisfied with the swift, effective service they are receiving without the need to visit their local GP surgery.

Sarah Lord concludes, “If the patient doesn’t want to be referred to a pharmacy first they are able to speak to a nurse practitioner or a GP but what we have found is that the patients have adapted, they are happy with Pharmacy First and it is working well for the practice. “

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