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Pharmacy first service: ‘We’ve noticed lots of cases of impetigo’

Impetigo on skin

By Saša Janković

13 Dec 2021

Stephen McDermott, pharmacist and owner of Abbeygreen Pharmacy in Lesmahagow, Lanark, talks to Saša Janković about treating skin conditions via Scotland’s Pharmacy First service.

Service type: Pharmacy First

Name and location of pharmacy: Abbeygreen Pharmacy, Lesmahagow

Name of pharmacist owner: Stephen McDermott

When did you start offering this service?

It started as a Minor Ailments Service in 2005 and changed to Pharmacy First last year.

Why did you start offering this service?

The consultation element of Pharmacy First gives you a bit more time with patients to really get to the bottom of what’s happening with them, and never more so than during the pandemic, when services such as general practice and dentists were not available to them.

For example, we see the deterioration in patients as they come in to the pharmacy every two weeks for a prescription, but their doctor won’t be aware as their medicine is on repeat. Then we can say “You’re not looking too good” and it starts the conversation.

There have also been patients whose families were concerned about their sudden weight loss, or passing blood, and we’ve phoned their surgery ourselves to emphasise how important it is that they are seen. In a few cases it was cancer, and this must have been happening UK-wide.

In a nutshell, what does the service involve?

Anyone can use NHS Pharmacy First Scotland if they are registered with a GP practice in Scotland or live here.

Our staff can do the initial consultation and then red flag it up to me to do the Pharmacy First side of it. Because we have to record consultations, referrals and when we prescribe through the Pharmacy First service, it’s definitely made things busier for us during the pandemic – particularly for treatment of UTIs, but also for some reason shingles and skin infections.

We’ve noticed lots of cases of impetigo, and hand foot and mouth has been high in the last month or so in this area, maybe because kids are run down. These days fewer people are aware of the symptoms of impetigo so you do get parents who are shocked it is that, and because it’s highly contagious it’s something you need to catch quickly, especially as kids interact with other children and adults so closely.

Are there any opportunities to sell OTC or prescription products during or after the consultation?

Skin problems can be very difficult to diagnose, and I always check for major signs so I can rule out things like meningitis straightaway. Parents automatically think the worst so they are relieved when you tell them it’s nothing serious, but then when you have to tell them it’s something that’s quite contagious and needs immediate treatment they still need reassurance, and they are always happy that we can provide the necessary treatment.

How have patients responded to the service?

They love the accessibility of the service as they can walk in and be seen immediately.

Roughly how often each month do you carry out the service?

We see about 400-500 people a month for Pharmacy First, with about 150 of those requiring items that are prescribed.

How much do you charge for the service?

It’s free.

Would you recommend offering this service to other contractors?

So many GP appointments have historically been taken up for things that could be so easily treated, and now pharmacies have become the first port of call during the pandemic we are seeing more and more people for this service who previously were not aware that pharmacy could help them in this way. Every pharmacist has the ability to do it once you read the PGD, and it’s what we were trained to do.

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