Pharmacists could be suspended from delivering a Pharmacy First service if concerns over antimicrobial resistance (AMR) and patient safety emerge, NHS England (NHSE) has said.
The service specification for Pharmacy First – which will roll out on 31 January 2024 – has now been published, including details of how NHSE intends to oversee the scheme.
The specification document stated: ‘This service will be closely monitored and evaluated. If concerns emerge regarding antimicrobial resistance or patient safety, NHS England reserves the right to withdraw all or any part of this service with immediate effect.’
It goes on to explain that concerns regarding an individual contractor or group of contractors delivering the service could result in the commissioner suspending them from providing the service ‘with immediate effect whilst further investigation is carried out and until satisfactory assurance is provided’.
The focus on AMR was further highlighted in a recent letter outlining the Pharmacy First service by the Department of Health and Social Care (DHSC), NHSE and Community Pharmacy England (CPE). This also stated that antimicrobial supply would be ‘closely monitored’, with an evaluation of the service’s impact on AMR to be commissioned by the National Institute for Health and Care Research (NIHR).
Earlier in the year, a coalition of scientists wrote an open letter to prime minister Rishi Sunak warning that Pharmacy First could have harmful consequences unless implemented with ‘due consideration’ to antibiotic resistance.
Alastair Buxton, director of NHS services at Community Pharmacy England said: ‘Antimicrobial resistance is considered to be one of the biggest risks to the future of modern healthcare and mitigations against it have to be part of any new services being commissioned by the NHS, whoever is providing them.
‘We know that community pharmacists can and will manage this risk and are pleased to have successfully persuaded the NHS of this, but we should not be surprised to see the health service wanting to monitor this: this is something they are actively monitoring across the NHS.’
Meanwhile, Gareth Jones, National Pharmacy Association (NPA) director of corporate affairs, said: ‘AMR is a critical issue that community pharmacists take very seriously.
‘The NPA is very confident that the Pharmacy First service will not increase AMR. Pharmacists, as medicines experts, are just as conscious of the risks of antimicrobial resistance as are their GP colleagues.
‘Where this has been tested and evaluated in practice, such as in the Welsh sore throat test and treat service, pharmacies have shown themselves to be responsible stewards of antibiotic use.’
Today's specification document also outlined objectives for the Pharmacy First service, including that it will ‘further utilise the clinical skills’ of community pharmacy teams and provide ‘urgent access’ to patients who are not registered with a GP for low acuity minor illness treatment.