Scotland paves the way for UTI treatment in pharmacies


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10 Feb 2016

Health boards north of the border are leading a scheme that sees community pharmacy treating urinary tract infections (UTIs) with antibiotics without patients needing to visit their GP.

In 2012 NHS Greater Glasgow and Clyde undertook a small study on the identification and treatment of UTIs by pharmacists, which included an option to provide antibiotics.

However the service did not move beyond the trial stage as the board anticipated a national rollout.

Elsewhere, in NHS Grampian the scheme is running in 100 pharmacies following a pilot in November 2013 while NHS Borders now offers diagnosis and treatment in 15 community pharmacies.

Adrian Mackenzie, lead pharmacist for community and social care at NHS Borders, explained more about the service.

“This is not about savings. This is about making use of the skills that pharmacists have.

“It’s about delivering care to a patient close to where they live,” he said.

“The driver was that it is the most common reason why we are referring patients for a general practice appointment.

“Given the pressure we know surrounds GP members it was a fairly obvious way of how to support our GP colleagues and move the pharmacists into managing common clinical conditions.”

Symptomatic UTIs affect 50% of women at least once in their lives with more than a quarter of sufferers experiencing a recurrence.

While antibiotic treatment is often unnecessary antibiotics are recommended to treat moderate to severe cases and can shorten the duration of symptoms by one to two days.

Mackenzie said: “If somebody presents with symptoms of a UTI what the pharmacist will do is screen them to ascertain whether they need referral to a GP.

“If it is very clear cut in terms of symptoms – pain during urination and increased frequency of urination – and they are female aged between 16 and 64, we would treat them with trimethoprim if clinically appropriate.”

Patients with mild infections are provided with advice while patients with more aggressive symptoms are referred to the appropriate provider.

Moving the treatment of UTIs to community pharmacy has also benefitted the patients who can access help outside standard GP opening hours.

In Grampian more than 150 patients were treated for uncomplicated UTIs with trimethoprim in community pharmacies in December 2015 alone.

Patient questionnaires revealed that pharmacies saw almost 90% of cases in less than 10 minutes and over 70% in premises less than five miles from their home.

Additional comments from some patients noted it was quicker and easier than obtaining a GP appointment and now feedback from Borders is beginning to show a similar picture.

“It is still early on but the feedback we have had in terms of being able to actually offer the service has been very positive,” said Mackenzie.

Alison Wilson, director of pharmacy for Borders, added: “I am delighted to introduce the UTI service to community pharmacies in the Borders.

“This service demonstrates the continuous improvement we are making to the quality of women’s health services in the Borders.”

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