Ashley Cohen, an independent contractor and committee member of Community Pharmacy North Yorkshire, asks why Pharmacy First still has not been nationally commissioned in England, despite years of talk and the success of a similar service in his own area.

I vividly remember being invited to a national conference at Westminster in 1994 when I was working as a pharmaceutical adviser for a local Health Authority. The guest speaker was the health secretary at the time, Virginia Bottomley, who announced that the Government intended to introduce a national Pharmacy First programme, where the community pharmacy sector would be the first port of call to manage minor ailments and help support and take pressure off general practice colleagues.

Fourteen health secretaries later, the intention remains – but Pharmacy First has still not been commissioned. There is a national network of healthcare professionals, suitably trained with open access to help reduce pressure off primary care colleagues – yet we are still debating and discussing the merits of a national rollout. Sure, we have CPCS and GP CPCS, but both these services rely on referrals from other organisations (NHS111, OOH and general practice). In over four years since CPCS has been launched, the uptake is patchy at best and non-existent in some areas. From my experience, pharmacy teams are still seeing many patients simply being sent inappropriately (i.e. without a referral) to their local pharmacy. This causes much frustration with the sector:

1) There is no data capturing information via PharmOutcomes that can be used to ‘prove our value’

2) We are not being remunerated for our work and professional input despite us having to respond directly to the walk-in patient who has been told to ‘simply visit their pharmacy’

I was extremely disappointed when I read in The Guardian last week of a £28.6m contract awarded by NHSE to an advertising firm to help reduce the mounting pressures facing medics and to suggest alternative models of care including visiting a community pharmacist.

This £28.6m advertising contract could have purchased:

However, at a time when it seems impossible for the Treasury or Department of Health and Social Care to find any new money to be invested into frontline Pharmacy sector (it’s been over seven years since we received any increase in funding), it can be easily found for a TV campaign.

In North Yorkshire, we know how successful Pharmacy First could be.

Community Pharmacy North Yorkshire (CPNY) was recently successful in funding form NHSE North Yorkshire and Humber for 3,000 walk-in consultation services within the locality to measure how impactful the service could be over the winter period.

The project has only been live for one month, but the data provided to date is incredible and again shows the immense impact open access pharmacists have on the local health footprint

In the first four weeks alone, these are the headline outcomes for North Yorkshire:

  • 29 active pharmacy providers have signed up to the service.
  • 319 consultations have been performed.
  • 24 escalations (18 for urgent GP appointments, 2 for A&E, 4 for urgent walk-in hubs.
  • 49 patients signposted to non-urgent GP appointments.
  • 174 GP appointments saved and 6 OOH GP callouts avoided. This alone will have more than covered the cost of the programme in full.
  • 9 A&E presentations avoided.
  • 17 NHS111 calls avoided.
  • 41 patients who would have ‘gone without advice’ and 4 of these were for urgent A&E/walk in hub escalations.

CPNY has given permission for me to share the data/information. Community Pharmacy Humber is part of the joint pilot as well with a total of 6,000 walk-in consultations available across the region of North Yorkshire and Humber.

There is still plenty more to collect and more work to be done around ensuring the local community is aware of this open access point of care. But after only one month, not only are we able to already show we are proving our professional input, but the programme is clearly saving the NHS money. Reducing OOH, NHS111 and GP referrals is clearly reducing bureaucracy and time in the system, and allowing the sector to actively help support triaging of patients within the system

CPNY will be looking to do more extensive analysis when more data is available, and sharing this with local commissioners and PSNC to ensure it can be used to help apply more pressure on relevant stakeholder, budget holders and politicians to make the brave decision and invest in this service.

But I am still asking: Nearly thirty years on from when I first listened to a health secretary describe a fully funded walk-in service utilising the pharmacy sector, when will this become commonplace and rolled out nationwide?

Hearing of significant backlogs, difficulty in getting a GP appointment, the pharmacy sector – and Pharmacy First - is part of the solution, not part of the problem.

We have the workforce available; we have the trained staff, we have the platform for monitoring and sharing information, we have the patients who ideally want to use Pharmacy First. All that is missing is national funding. This could be started literally in weeks with the right political will.