Successful pharmacy ear health pilot will not be recommissioned

A pharmacy ear health pilot which had been seen to make 'a huge difference' to patients in South West London will not be recommissioned due to funding constraints, The Pharmacist has learned.

The ear care pilot, which was featured by NHS England in a recent national blog, found that delivering the service through community pharmacies drastically improved patient waiting times.

But an evaluation of the pilot warned that to make such a service sustainable, the fee paid to community pharmacies must be ‘realistic and viable’.

And The Pharmacist has now learned that the commissioning integrated care board (ICB) will not be re-commissioning the pilot when it ends at the end of this month (April).

As part of the pilot, 7,648 patients have been referred by 72 GP practices to 20 participating community pharmacies in the area and trained pharmacy staff performed digital otoscopy, earwax removal and hearing checks on patients using a three-in-one otoscopy device (TympaHealth).

On average, patients waited 14.4 days from their GP referral to community pharmacy contact, with nine in 10 saying they were offered an appointment in pharmacy sooner than they expected.

Amit Patel, chair of Community Pharmacy South West London, told The Pharmacist that while the pilot had ‘made a huge difference’ to patients, commissioning it was not possible due to a lack of funding.

‘Everybody we talked to is saying, we know it's the right thing to do, we want to commission it, but there's just no money,’ he said.

‘It’s really disheartening. We've got 20 pharmacies with trained staff. We've seen 9,000 patients [whose treatment has] been completed in community pharmacy, really low referral rates back [to GPs], we've put a 24 week waiting list down to four weeks [at a] maximum – in reality, most patients are seen between seven to 10 days.

‘[The pilot has] made a huge difference in people's lives. And we can't carry on doing it,’ he added.

‘Unfortunately, the whole of primary care is massively underfunded. And I think for this pilot, the ICB really wants to fund it. They just can't,’ he said.

He told The Pharmacist that he hoped the door would be open to reconsider commissioning the pilot in the future. ‘I don’t feel the conversation’s dead,’ he said.

While ‘everybody sees the value and everybody wants to do it’, Mr Patel suggested that the lack of funding for the service was ‘the reality of the healthcare system’ at the moment.

And he suggested that the pilot could be a prime candidate for national commissioning within Pharmacy First, which already includes otoscope skills through an earache clinical pathway.

A spokesperson for the NHS South West London ICB told The Pharmacist that it had ‘worked hard to find a new funding-source for this pilot’, but had been ‘unable to match the cost’, which came to around £1m a year.

‘However, to make sure patients in Merton, Wandsworth and Richmond can still receive ear health treatment in the community, we will be reviewing current GP practice provision,’ they said.