A walk-in consultation service (WICS) offered by pharmacies in Cornwall has saved over 6,000 GP appointments in its first 12 months.
Community pharmacies have delivered more than 8,000 face-to-face consultations with a pharmacist in a consultation room, without the need for a patient appointment or referral, through the locally commissioned WICS.
The Cornwall and Isles of Scilly Local Pharmaceutical Committee (LPC) reported that 80% of people who used the service had their symptoms successfully treated on site, while 100% of the patients questioned in a post-consultation survey said that they found the service easy to use and were happy with the consultation.
Nick Kaye, chief executive of Cornwall and Isles of Scilly LPC said that being able to send consultation notes to general practice via the pharmacy’s IT platform allowed pharmacists to deliver integrated care.
‘Community pharmacies are already a trusted place for patients to receive clinical advice and intervention,’ he said.
‘This service builds on that but joins up the consultation by placing full details in the patients notes at their GP practice automatically, this allows for fully joined up care and relieves pressure on GPs.’
He added that the scheme, which is locally commissioned by the LPC working with NHS Cornwall and Isles of Scilly Integrated Care Board (ICB), ‘helps bring much needed funding into community pharmacies after seven years of static funding which is forcing pharmacies’ doors to close’.
Analysis from the LPC suggests some 6,468 GP appointments have been saved as a result of the scheme over the past 12 months.
Marco Motta, interim head of prescribing and medicines optimisation at NHS Cornwall, commented: ‘Sometimes we just need to start something and see, rather than wait for something to come along.
‘I am super proud of what Cornwall has been able to achieve over the last 12 months. This service shows what integration and innovation means, with the ultimate goal of supporting our community.’
A year in numbers
The latest data, captured on Monday 20 March 2023 and shared with The Pharmacist, shows that 79% of patients who used the service would otherwise have tried to book a GP appointment.
At least 137 pharmacists participated in the scheme across at least 84 pharmacies.
In nearly half (49%) of the 8,188 patient consultations, the pharmacist was able to give the patient appropriate advice and sell a medicine, while in 11% of cases, appropriate advice given and referral was made to a local patient group direction (PGD) service – which in Cornwall could include treatments for bacterial eye infections, thrush and shingles.
One in five patients only needed advice, while 15% were signposted to another service and 5% were escalated.
Skin problems were some of the most popular reasons people used the service, with rashes accounting for 1,481 consultations.
Pharmacists also dealt with 832 urinary tract infections (UTIs), 599 sticky or watery eyes, 454 red or irritable eyes, 263 people with a cough and 179 with a sore throat or hoarse voice.
More than 200 people sought advice from a pharmacist for an insect or spider bite or sting, 135 had an allergic reaction and 156 had wound problems.
The service was particularly well-used among older people and children, with the highest rates of use from those aged under 10 or over 50. Nearly 1,500 consultations were delivered to patients aged between 71-80.
Calls for Pharmacy First throughout England
On Monday, The Pharmacist reported that the 20-year NHS contract for Nottinghamshire’s Pharmacy First scheme was coming to an end, following a change in commissioning arrangements, with no direct alternative or continued service replacing it.
Pharmacy leaders have been calling for a national Pharmacy First service to be commissioned in England, saying that locally commissioned services could result in regional differences, and would have a slower impact on primary care recovery than the ‘immediate’ potential of a national scheme.
Alastair Buxton, PSNC director of NHS services, told The Pharmacist that locally commissioned pharmacy walk-in consultation services like the Cornwall scheme were 'excellent proofs of concept' for a fully funded national Pharmacy First scheme.
He added that 'local and national agendas for pharmacies must be aligned', and that a nationally commissioned service would have 'immediate impact' across the country, help with the post-pandemic recovery in primary care and 'mirror the success' of similar Pharmacy First services already implemented nationally in Scotland and Wales.