Winter pressures in the community pharmacy

Many community pharmacies are getting ready for winter. Yes they are stocking up on a whole variety of remedies, but some are thinking differently and doing a little more.

Pharmacists are recognising that this year may be different. There will be no rush in winter payments to General Practice, hospitals and other providers – no crazy new services often planned and rolled out a bit late – the whole NHS will have to cope on their own and within current resources.

“The NHS needs me to step up my game, help more to manage demand, provide a better service that people will look out for and GPs can refer to”.

This pharmacy is offering an enhanced minor ailment scheme around sore throats and colds and flu.

“Most of the sore throats are viral. All of the counter staff know the four centor criteria and ‘red flag’ signs and will filter these people for me to see. Obviously some I will send some straight to the GP, but others I will offer a point of care strep A test”. “I have started advertising the service with posters and have pointed it out to all of the people having their flu jab here. I have even had someone sent by the GP”.

It is a simple service that will help to focus people on the skills of the pharmacy team in managing common conditions. It can take the guesswork out of diagnosis and the patient out of the practice. In a recently published feasibility study only a quarter of the patients reaching centor 3 and 4 actually tested positive for strep A- so it could also reduce antibiotic use and using delayed prescriptions.

It is also not easy for the GP who will see centor 3 and 4 patients and will not have the benefit of a strep A test to help them choose who to prescribe an antibiotic to.

“I have a lot of people who come in with a cold who think that they have flu. I had never thought about offering influenza A and B test before, but I might try it this year”.

The treatment for a cold and influenza might be similar, but the course and severity of the conditions are not the same. Community pharmacy could do more than report ‘influenza-like-illness’, but actually report proven cases of flu in the community. I suspect that the healthcare response to a person with a cold might be different to that to a person with a diagnosis of influenza.

It may be a simple start, but the NHS will need all community pharmacies to do even more to reduce demand on General Practice during the winter – I suspect that they will be busy enough!



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