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Pharmacy First

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4 in 5 people in England can reach a community pharmacy within a 20-minute walk, and over 95% in England have signed up for the new Pharmacy First scheme.

The Pharmacy First scheme was launched on 31 January 2024 by the Government and NHS England and is available across England. Our Life Sciences Solicitors explore the details of this initiative.

The intention behind the introduction of the scheme is to ease pressure on GP services and to provide patients with quick and accessible care.

Under this scheme, community pharmacists are entitled to supply prescription medicine (including antibiotics and antivirals) to treat seven common health conditions without requiring a patient to visit a GP first and obtain a referral. Instead, individuals are encouraged to go ‘pharmacy first’.

The seven common conditions are sinusitis, sore throat, earache, an infected insect bite, impetigo, shingles and uncomplicated UTIs. 

Individuals may self-refer or be referred to participating pharmacies by their GP, NHS 111 and urgent and emergency care.

It is not a mandatory scheme; individuals can still choose to visit a GP, but Pharmacy First is intended to provide an alternative route to accessing medicine for these conditions.

Pharmacy First is capped at 3,000 consultations a month, which pays the participating pharmacy £15 per consultation under the scheme and a bonus payment of £1,000 per month when the pharmacy meets a minimum threshold of consultations provided in that month. 

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pharmacy first

Other pharmacy-led schemes introduced by the Government

  • Since October 2019, the NHS Community Pharmacist Consultation Services scheme has enabled patients to be referred to community pharmacies for minor illness or an urgent repeat medicine supply. 
  • Since December 2023, under the Pharmacy Contraceptive Services scheme, certain oral contraceptives (being the combined oral contraceptive and the progestogen only pill) are available from local pharmacies, which enables up to a quarter of all women on oral contraception to obtain their prescription from their local pharmacy.
  • Pharmacies have committed to delivering 2.5 million free blood pressure checks to at-risk patients by spring 2025, which is estimated to prevent more than 1,350 heart attacks and strokes in this period. 

These schemes all aim to reduce the number of patients visiting a GP with common conditions by 10 million appointments a year by next winter (comprising a reduction in patients attending for these common conditions, blood pressure checks and oral contraception).

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Other pharmacy led schemes introduced by the Government

What are the potential impacts of the Pharmacy First scheme?

The main anticipated benefit of the Pharmacy First scheme is that, by diverting patients with these common conditions to pharmacies for treatment, there will be more time freed up for GPs to see patients with more complex diagnoses. 

Targeting health inequality 

Another anticipated benefit of the scheme is to address health inequalities across England, as community pharmacies play an important role in their local communities by providing wider access to healthcare and support than GPs.

There are twice as many pharmacies in deprived communities, although these are often much more likely to close than their counterparts in affluent areas.

Where care can be provided from pharmacies, access to care is much quicker and more convenient, making people more likely to seek it out and receive treatment and advice.

To that effect, in the first month of the service, it was reported by the Company Chemists’ Association (CCA) that a third of consultations at participating pharmacies were provided in the 20% most deprived communities in England.

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What are the potential impacts of the Pharmacy First scheme

Lack of funding and staff

There are, however, concerns raised by both pharmacies and GPs as to the allocation of funding and the escalation in demand for pharmacy services by patients.

The Government has invested £645 million over the last two years to help community pharmacies, and also supports the sector with £2.6 billion every year.

That being said, it is estimated that there has been a 30% drop in funding in the last 7 years and a funding shortfall for independent pharmacies of £1.1 billion each year.

In addition to funding woes, pharmacies must contend with rising patient demand alongside rising operational costs and staff shortages.

Many local pharmacies are unable to survive this pressure, with 160 having closed in the last 2 years. Pharmacy First increases the available services offered by local pharmacies, without the corresponding growth in staff and support, which only increases the workload on an already reportedly ‘overworked’ sector.

The CCA reported that the public was demonstrating ‘a level of initial patient engagement not seen before’, with patients accessing the Pharmacy First service outside of usual working hours and at weekends.

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Lack of funding and staff

Concerns regarding anti-microbial resistance

There have been concerns raised that Pharmacy First will increase anti-microbial resistance, due to more widespread access to these medications.

The Government’s response is that the scheme is not anticipated to result in larger volumes of antibiotics being prescribed, and patients must undergo a consultation with a pharmacy before any medicine is prescribed, which will take into account the clinical appropriateness of prescribing any treatment.

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Concerns regarding anti microbial resistance

Increased public awareness

Finally, it is anticipated that the scheme will increase public awareness of and patient support in pharmacies, particularly as a primary point of contact for care.

Indeed, a week before the launch of the scheme, a Charac survey in partnership with YouGov found that nearly half of patients had limited to no awareness of Pharmacy First, although this is anticipated to change with the positive take up of the scheme that has been seen so far. 

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Increased public awareness

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We have experience in advising pharmacists and businesses engaging pharmacy services on contractual obligations under relevant agreements and related arrangements.

If you have any questions in relation to the matters discussed this article, please contact our Life Sciences Solicitors.

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