Minor ailment schemes reduce GP consultations
Pharmacy-based minor ailment schemes can lead to reduced GP consultations, suggests a new study, which was funded by the Pharmacy Practice Research Trust.
The Pharmaceutical Services Negotiating Committee said the study provides a helpful summary of the “significant evidence base” that has accumulated over the years for minor ailment schemes. Alastair Buxton, head of NHS services at the PSNC, told PJ Online that it continues to lobby for the service to be commissioned at a national level.
The PSNC recently discussed the issue with NHS England and NHS Employers in the light of the challenges being experienced by the fledgling NHS 111 service and hospital accident and emergency departments. Minor ailment schemes have been introduced in Scotland, Wales and Northern Ireland, while England funds them as “enhanced” services within the community pharmacy contract.
GP consultations declined
The systematic review, published online in the British Journal of General Practice (1 July 2013), identified 31 UK schemes after screening 3,308 studies. It found that the total number of GP consultations and GP prescribing for minor ailments often declined following introduction of a pharmacy-based minor ailment scheme (PMAS).
Re-consultation rates in general practice, following an index consultation with a PMAS, ranged from 2.4 per cent to 23.4 per cent. The proportion of patients reporting complete resolution of symptoms after an index PMAS consultation ranged from 68 per cent to 94 per cent. The average cost per PMAS ranged from £1.44 to £15.90.
Conditions covered in the schemes included head lice, diarrhoea, constipation, thrush, sore throat, hay fever, headache, nappy rash, cystitis and psoriasis.
The study examined patient and stakeholder views, finding that 90 per cent or more users were willing to reuse the scheme and expressed general satisfaction with their consultation and the expertise of pharmacy staff.
Community pharmacists expressed positive attitudes towards the schemes, with extension of their professional role highlighted as one of the key benefits of the service, the study says. However, patient misuse of the service was often cited as a barrier to efficient service provision.
The researchers, from the universities of Aberdeen and East Anglia, argue that minor ailment schemes provide a suitable alternative to general practice consultations, but that evidence from economic evaluations is needed to inform their future delivery.
Challenge is to change GP funding
Mr Buxton added that, historically, one of the main reasons that national commissioning has been rejected by the Department of Health has been the difficulty of changing general practice funding, so GPs are not funded to provide management of minor ailments at the same time as community pharmacy.
He added: “NHS England, as the new national commissioner of all primary care services, is in a strong position to review the roles of the different primary care providers and we believe that should include another examination of the opportunities presented by a national minor ailment scheme so that precious GP time can be better focused on patients with complex needs. In the meantime, it is reassuring to see that many clinical commissioning groups are following the example of many predecessor primary care trusts, by commissioning minor ailment schemes at a local level.”
Citation: The Pharmaceutical Journal URI: 11122958