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Common and minor ailment services

'Pharmacy first' is a big opportunity

The expansion of Scotland’s minor ailments service is welcome, but pharmacy teams need support to deliver it.

Pharmacy first a big opportunity if risks are managed

Source: Mclean /

The launch of the new NHS ‘Pharmacy first’ scheme in Scotland will be a major milestone for the profession. Launching in April 2020, it will aim to encourage patients with minor conditions to consider their local community pharmacy as the first port of call.

The scheme will be more consistent and easier to manage than the previous locally run minor ailment service, which was developed and delivered locally. No longer will pharmacists have to have an awkward conversation to verify whether patients are eligible by asking for their age, the benefits they receive, or whether they are pregnant. 

Now, all patients registered with a GP — or resident — in Scotland will be able to access the ‘Pharmacy first’ scheme and have any suitable medication provided for free. 

It is vital that pharmacists are equipped to handle the range of cases that may present in the pharmacy from day one

A “white list” of eligible medicines is also under development to ensure a consistent provision across Scotland and community pharmacies will be remunerated, at least in part, for the advice they provide rather than just the number of patients using the service, which was the case with the previous scheme. This is a welcome shift in emphasis towards recognising the clinical skills of pharmacists and the care they provide.

And the signs on funding are good. Community Pharmacy Scotland told The Pharmaceutical Journal that the Scottish government would increase the overall package of funding by £5m in the first year, and this will rise to £10m, bringing the eventual total funding for the whole scheme to £30.8m by 2022/2023.  

This is all excellent news. As Jonathan Burton, chair of the Royal Pharmaceutical Society Scottish Pharmacy Board, said in the Scottish Parliament this month, this is the “correct direction of travel for community pharmacy”.

However, there is likely to be some apprehension about the scale of the scheme in community pharmacies themselves. Burton told MSPs that he was “excited” but also concerned about the pressure this expanded role may put on pharmacists and their teams. 

It is not clear how many patients will take up the scheme, but it is vital that pharmacists are equipped to handle the range of cases that may present in the pharmacy from day one. For instance, as a result of increased demand following the roll out of the community pharmacy consultation service, there have already been warnings in England that pharmacists should ensure that they undertake training on how to spot the signs of sepsis.

There is also a chance that public expectations will be whipped up by the launch, meaning that policymakers must ensure communications around the scheme emphasise the importance of self-care as a way to manage minor conditions.

Communications, training and ongoing evaluation will be required to ensure that community pharmacy can make a success of the new and improved ‘Pharmacy first’ scheme. There will likely be a learning curve over the first few months but, hopefully, it will become yet a further staging post in the advance of the profession into a more clinical role in the health service.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20207705

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