Plans for the Boots sore throat service to be rolled out nationally have been strongly criticised by pharmacy contractors who have called NHS England’s intentions as “vague, unconstructed, and unsupported”.
CCGs are being given the option of commissioning the service, which was first piloted in 35 London Boots stores in 2014, with the aim of enabling patients complaining of a sore throat to be swabbed and tested for bacteria to see whether or not they should go to the GP for antibiotics.
Boots estimates that if the service were rolled out nationwide 800,000 more patients could avoid going to the GP and be seen by a pharmacist instead, which would help in the battle against antimicrobial resistance.
Amish Patel, contractor for Hodgson Pharmacy in Kent said it was “an interesting thing” but it was frustrating that it comes at a time when pharmacies are having to be very cost efficient because of the cuts.
Some pharmacies are working at a risk level that is borderline unsafe as a result of staff cuts, said Patel. “We are working on minimum staff but we have to provide more services and do more work. If I haven’t got the staff to do this, then how can I deliver the service safely and effectively?”
Hodgson Pharmacy comes under Dartford, Gravesham and Swanley CCG. “I’m almost certain my CCG won’t be taking it up,” Patel said. “Because they have not commissioned a single service yet.”
Mike Hewitson, superintendent pharmacist at Beaminster Pharmacy agreed that the programme was unlikely to be commissioned by his CCG in Dorset either. “They only want things with really clear outcomes. If you’re saving time in a GP practice, it doesn’t really save them any money, as daft as that sounds, because they still have to pay for the GP to be there.
He questioned why local commissioners would back the plan when they could implement a national minor ailments scheme (MAS), which would save them more money.
“This is certainly not the way that you would want to launch a service,” he said. “You wouldn’t launch it before you had concrete service spec., or before you new that you had a commissioner signed up to deliver it. And then you would go out and find pharmacies that were interested in providing it.
“Don’t get me wrong, I think this suits Boots down to the ground. They’ve got a high footfall and they have a more retail-driven business. So in the case of a viral sore throat, they can sell the customer more products at a higher sales margin.
“If a commissioned service came along that was viable to deliver, then we would deliver it. Unfortunately I can already see the way the commissioners’ minds would work in this respect,” Hewitson said.
Graham Phillips, superintendent pharmacist at Manor Pharmacy in Hertfordshire agreed that it is up to the NHS to develop better strategy for pharmacy. “In principle the service makes sense but as with everything with NHS England they use it to pay lip service to pharmacy and then do nothing.
“Until there is a national strategy to actually use pharmacies for that and many other things, plans will continue to be vague, unconstructed, unsupported, and probably unimplemented. And people will continue to visit their GP and A&E unnecessarily for things that could be done much more cheaply and effectively in community pharmacy. It’s completely mad!
“I believe that CRP testing should be the norm in community pharmacy for much more than just sore throats. If done right it could have a massive effect on GP workload particularly at this time of year.
“The NHS haven’t even committed to a proper funding strategy for anything. It’s absolutely consistent with everything else in community pharmacy – wasted potential due to prejudice at the top of the NHS.”
NHS England’s chief pharmacy advisor, Keith Ridge, said the scheme has been promoted to CCGs in order to reduce pressure on GPs and cut down on use of antibiotics.