The NHS Pharmacy First Service – two months in: meeting patient need

The latest data collected by the Company Chemists’ Association continues to demonstrate strong patient demand for the NHS Pharmacy First service.

Two calendar months in and:

• 90,000+ Pharmacy First consultations were delivered by CCA members alone.
• Of these, 81,627 (88%) were eligible to receive NHS-funded care through the service[1].

The CCA has conducted a deep-dive of the first month’s of Pharmacy First data which shows that:

• Over 90% of eligible patients received the care they needed through Pharmacy First, without the need for further referral.
• For 75% of consultations, a medicine was supplied showing that in the vast majority of instances community pharmacies can be the first port of call to deal with these seven common conditions.
• 1 in 5 patients were referred to the service from GP surgeries.
• Initial data shows that pharmacists are acting as stewards of antibiotic use, supplying antibiotics only when absolutely necessary, indicating that previous concerns that Pharmacy First would drive antibiotic resistance are so far unfounded.

The data shows that patients continue to respond favourably to the Pharmacy First service and the access that it offers, allowing patients to visit their local pharmacy and, if clinically appropriate, receive medicines they need without having to visit a GP.

Moreover, for the seven common conditions, the vast majority of patients are receiving the care they need in the community pharmacy itself. By administering the care patients require from start-to-finish, patients need are met without the need to be referred elsewhere. This demonstrates that prior concerns that Pharmacy First would lead to large volumes of referrals to other parts of the NHS are, so far, unproven.

The data shows that patients continue to self-refer themselves and walk into a pharmacy to ask about the service. Nearly three quarters (73%) of all consultations involved a patient attending themselves. Interestingly, there appears to be strong patient confidence to self-refer for each of the seven Pharmacy First conditions.

Meanwhile, a fifth of all CCA member Pharmacy First consultation referrals were from a GP surgery and 6% of referrals were via NHS111. Whilst these figures should rise with time, there is an urgent need to ensure these referral routes work optimally so all that patients who need to, can access care for any of the seven conditions.

CCA modelling shows that a fully-funded and ambitious Pharmacy First service in England, akin to approaches taken in Scotland and Wales, could free up 30m+ GP appointments each year[2]. The Government hopes that once scaled up the Pharmacy First service will free up 10m GP appointments by next winter[3].

The CCA is urging policymakers to:

• Provide targeted support for General Practice to enable them to refer more patients into Pharmacy First and reduce pressure on GPs.
• Invest further in high-quality and targeted public engagement campaigns to raise awareness of this new service available to patients and members of the public.
• Commit to fund the NHS Pharmacy First service beyond March 2025[4], so pharmacies can continue to deliver the service for patients with confidence and to invest accordingly

Malcolm Harrison, Chief Executive of the CCA said: “The Pharmacy First service continues to show immense promise.

Over 90% of eligible patients treated via the Pharmacy First service have received the care that they need within their local pharmacy. This shows that Pharmacy First is providing access to NHS care when and where patients need it.

Whilst early signs are promising, we need GPs to be given targeted support to refer more patients into Pharmacy First and further high-quality and targeted engagement campaigns to raise wider public awareness.

Most importantly, the pharmacy sector needs a commitment from policymakers to fund Pharmacy First beyond March 2025. This needs to be accompanied by a package of measures to address historic underfunding for the sector and action to ensure patients can continue to access the prescription medicines they need”.

Notes to editors:

Pharmacy First

• The NHS Pharmacy First service launched on 31^st January 2024. The service allows pharmacists to provide advice and where clinically appropriate, prescription-only medicines for seven common conditions: acute otitis media (earache), impetigo, infected insect bites, shingles, sinusitis, sore throat, and uncomplicated urinary tract infections in women.
• The service is currently funded until March 2025.
• For each of the seven conditions, a clinical pathway must be followed. A clinical pathways consultation can only be accessed when a ‘gateway point’ in one of the clinical pathways is crossed. Once a ‘gateway point’ is reached, the patient is eligible for NHS-funded care. See NHS England, Community Pharmacy advanced service specification – NHS Pharmacy First Service for further information.
• In many cases a Prescription-Only Medicines (POM) can be supplied by the pharmacists through a legal mechanism called a Patient Group Direction. This sets out clear criteria for which patients and under what conditions they can be provided with prescription medicine, previously only available from a GP.

CCA data collection

• Data was collected by the Company Chemists’ Association, the trade association for large pharmacy operators across Great Britain, from members across a sample of 3,000+ pharmacies between 31^st January and 31^st March 2024.
• Data from 3,000+ CCA member pharmacies shows that 92,384 Pharmacy First consultations were recorded between 31^st January and 31^st March 2024. Not all of these patients were eligible for Pharmacy First, despite an electronic record being made of the consultation. There were 81,627 eligible patients (88%).
• The in-depth analysis of patient activity was completed on data from the first month of the service, 31^st January and 3^rd In this time there were 42,027 eligible patients. This number refers to analysis of referral routes, activity, and outcomes.

Community pharmacy

• The CCA’s latest analysis of NHS data[5] shows that there are now 1,110+ fewer pharmacies in England since 2015. Since the start of the 2023/24 financial year alone, there has been a net loss of almost 400 community pharmacies in England.
• Since 2015, there has been a real terms cut in core funding of over 30%[6].

References

[1] For each of the seven conditions, a clinical pathway must be followed. A clinical pathways consultation can only be accessed when a ‘gateway point’ in one of the clinical pathways is crossed. Once a ‘gateway point’ is reached, the patient is eligible for NHS-funded care. See NHS England, Community Pharmacy advanced service specification – NHS Pharmacy First Service for further information.

[2] CCA, Pharmacy First and Independent Prescribing, June 2023

[3] DHSC, Pharmacy First: what you need to know, February 2024

[4] The May 2023 Delivery Plan for Recovering Primary Access announced that the Government would “invest up to £645 million over the next two years to expand community pharmacy services, subject to consultation”

[5] CCA analysis of NHS Digital Organisation Data Service data (downloaded as eDispensary files), February 2024

[6] Community Pharmacy England, Information for politicians