In the first of a new series, practice manager Mike Neville explains how the Government’s new Pharmacy First scheme can be beneficial for GP practices.
In January, the Government announced the Pharmacy First Scheme (PFS), which gives community pharmacists the ability to supply certain prescription-only medicines without the need to see a GP first.
Whether or not it is the right way that the Government should have invested funding for our patients (or our practices) is a conversation for another day; however here are some helpful tips for you and your team to get the best out of the scheme, and to be implemented successfully.
Inform and empower your non-clinical team
Your team should know the seven common conditions that can be treated as part of the PFS:
- Sinusitis
- Sore throat
- Earache
- Infected insect bite
- Impetigo
- Shingles
- Uncomplicated urinary tract infections
Many of your team will have already been trained in spotting red flag symptoms such as left sided chest pains, breathlessness, sudden loss of sight, possible anaphylaxis etc that require urgent assessment at A&E rather than in the practice. The PFS should be simply viewed as an extension of this training with certain symptoms that can and should be treated by the appropriately trained pharmacists in the community.
If you have already implemented the total triage model, then this can also be incorporated into your protocols of navigation.
The more information and training you give to your teams, the more that not only will they feel confident in directing patients appropriately, the more they will be able to do so safely.
Communicate with your patients through the PPG
Your patient participation group (PPG) members are the voice of patients and will give you an invaluable perspective on how your patients will react to the implementation of navigating to this service.
The feedback that they give you will enable you to shape how you present the service to the wider patient population. Hopefully, this should mean that your practice teams receive less resistance from the patients who may feel they ‘need’ to see the GP.
It is never too late to prepare and share some FAQs for patients based on your PPG feedback. These can also manage expectations for both practice and patient as to not only the ‘what’ is going to happen, but also the ‘why’ and ‘how’.
Under the accessibility standards this should be done in as many ways as feasibly possible. Use of text messaging, practice website, posters, letters, videos, as well as on any social media your practice has – all are great forms of getting the message out to the patients.
For those practices with a patient demography with a higher portion of English as a second language, it may be useful to look at trying to provide information translated, or (if not already) form relationships with local mosques, synagogues, churches as well as community groups that are prevalent in your community to assist in delivering the message.
Partnership working with the community pharmacists involved
Practices should try to maintain a good working relationship with the local pharmacies that are offering the service.
Many will only have one, possibly two people who are qualified to offer the service therefore, if they are off, then they will not be able to fulfil the consultation. The patient will then return to the practice and end up either back on the GP triage list or must wait longer to be seen at all.
Ensuring you have a way for them to communicate issues such as this will mean that you can manage both the patient expectations, as well as the staff navigation pathways more easily.
The duty of candour from both parties is key to maintaining control of how the patients experience this offer.
Agree protocols of care navigation with local practices
There is nothing worse than a community being told different things by their different practices! This is especially important in inner city locations where there will be likely many practices very close to each other.
Every practice operates its appointment book slightly differently which is the beauty of the partnership model, as the system works well for the practice as well as the patients in their own way.
There should, however, be underpinning guidelines that all should follow before getting to the appointment book. Many practices have independently been doing this for a long time before the PCN enhanced service specified a separate ‘care navigator’ role as an actual job title.
Practice managers working together (alongside the PCN manager if appropriate), should make sure that there is a directory of all local services to navigate patients to including PFS. This way, when patients discuss with the friends about what each practice does, they will be more accepting of it as it’s not just something that you are doing to ‘stop the patients seeing their GP’.
Don’t reinvent the wheel
If all local practices are all working to the same protocol, you should also be using the same material to communicate to the patients. From a practical point of view, it is one less thing you must worry about!
For example – Community Pharmacy England have published a suite of Pharmacy First promotional resources to promote the service to the public. This includes:
- Posters for display within pharmacies and for more general use (e.g., in general practice waiting rooms)
- Social media tiles and suggested social media posts about Pharmacy First
- Videos and digital screen graphics
- Small flyers about Pharmacy First; and
- Template local press release for Pharmacy First launch
Utilise these resources and make sure the other local practices use the same (even if not these ones specifically – it should be consistent).
Don’t expect the world to change
As many of us experience daily, the demand on the practice will still be generally maxed out whether you offer 30 appointments or 300 appointments on the day.
The PFS is a resource capped at 3,000 consults a month, each paying the pharmacy £15 per consultation. There is also an extremely low minimum that each pharmacy needs to provide each month also, starting from 1 per month to just 30 per month by October 2024 for the pharmacy to be eligible for a bonus payment of £1,000 per month.
If you extrapolate your local population and compare it to the number of local pharmacies taking this work on, it is not likely that it will have a huge impact on your practice demand in its current iteration – but every little helps…
A final consideration…
Community pharmacy is also extremely busy and have seen similar cuts to their NHS funding as has general practice.
The PFS scheme is great in the sense that the simpler presentations can be treated by another partner of the community MDT. The level of benefit to practices is yet to be seen, but we should try to work with partner organisations for our patients, as we always do, with the resources we have.
Mike Neville is a managing partner in Manchester and is the Institute of General Practice Management’s national lead for England North
