Community Pharmacy, Influenza and Winter Pressures.

Many Pharmacies are gearing themselves up for flu vaccination season. Training done, posters up, vaccines in the fridge and ready to start. I am sure that Community Pharmacists will do a grand job to ensure that we have a significant level of community immunity, but it is not as simple as that and perhaps we need some additional urgent action on top.

Simon Stevens told the Health and Care Innovation Expo in Manchester that he is worried. There are questions remaining about the effectiveness of the vaccines and we might be hit by the same H3 strain that affected New Zealand and Australia. He is worried that we may not cope and he is making sure that plans are in place for between 2,000 and 3,000 beds to be freed up. There will be huge challenge to General Practice who are already stretched and working at capacity.

This is the time for community pharmacy to come forward and say – this is what we can do.

A rapid antigen diagnostic test for influenza A and B is available from Sekisui through Una Health. It costs £6.50 per test and takes just a few minutes to read after a simple nasal swab. Community Pharmacy could offer these tests privately or be commissioned through the NHS. Following a positive test the pharmacist could offer antiviral treatment, again privately through a PGD. This all could be commissioned by the NHS following Simon Stevens warning to make sure you are winter ready..

If the NHS wanted to enhance this service then the Community Pharmacists could offer a semi-quantitative CRP test. CRP seems to correlate well with the severity of flu and is a known marker for chest infections.

This may reduce the number of people attending General Practice with general symptoms of flu. Patients with flu will be given enhanced information and a fast track access to their GP should their health deteriorate or they develop signs of a chest infection or dependent on their CRP levels. The rapid diagnosis and administration of antivirals may help to reduce the impact of the disease on the individual. Hopefully this will reduce the pressure on out of hours and secondary care also.

In parallel Community Pharmacies could be commissioned to run strep A testing. Managing patients with sore throat in the community pharmacy may also be helpful to reduce pressure on General Practice over winter.

Winter is coming – and this one may be worse than many before. It is time to act.



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