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Home  »   Latest News   »   Pharmacy First Service provides great expectations: but the PDA is concerned about the impacts on the pharmacy workforce

Pharmacy First Service provides great expectations: but the PDA is concerned about the impacts on the pharmacy workforce

The PDA had called on NHS England to phase in the introduction of what on paper is a very good service which will benefit the public; however, this request was refused.

Wed 31st January 2024 The PDA

The launch of the new Pharmacy First Service today has been heavily promoted across print and broadcast media led by key politicians including the Prime Minister, encouraging people with a range of seven common conditions to visit their local pharmacy for treatment, including antibiotics.

While the PDA has called for patients to have access to this type of service in community pharmacy for many years, the Pharmacy First Service has been introduced in a hurried fashion and without the necessary consultation or preparation with the patient-facing pharmacists who are to deliver the service.

Instead, the service was agreed between the government and the business owners. When pressed on this matter, the government has argued that 95% of pharmacists have signed up for this scheme, whereas instead, it is 95% of the pharmacy business owners who have signed.

This leaves the pharmacists at the coal face in the pharmacy in a very difficult situation as they are required to operate the full pharmacy service as well as the new one being introduced and extensively promoted by the government.

Whilst in principle the vast majority of employee pharmacists are in support of this scheme, the hurried nature of the introduction is causing enormous stress to a workforce that is currently massively under-resourced due to a series of cuts in NHS pharmacy funding in England.

In Scotland, a successful Pharmacy First scheme has been launched at a much more sensible pace with thought given to providing time to prepare, train and recruit the necessary pharmacy personnel required to deliver at scale.

Examples of the hurried launch in England are clear for all to see; the final protocols which pharmacists must be competent to deliver have only been available since December, which is one of the busiest times of the year for community pharmacy. With large numbers of pharmacists expected to deliver the service their access to the training has been limited, and due to workforce issues, many of them have been expected to undertake the training after work in the evenings or at weekends. The software required to operate the service was made available to the workforce by NHS England on the morning of the launch.

With figures of between 10 and 30 million being cited by senior NHS officials as the number of consultations being transferred from a GP to a pharmacist, this represents between one and two days of additional consultation time for the community pharmacist per week.

A PDA member survey conducted in January 2024 represented the position of frontline pharmacists;

  • 70% believed no extra staffing was being provided, with a further 24% unsure.
  • Only 1% said that they always had sufficient staff to provide existing services.

One particular concern raised by 88% of respondents was around queues and unmanageable workload, as patients unable to get through to the GP at the 8 am rush will now be directed in potentially large numbers to see their local community pharmacist. 78% are worried about aggression from patients due to unrealistic expectations based on what they may have seen or heard in the media.

There is a worrying level of misinformation being promoted about the scheme which may leave patients frustrated when they experience the actual situation.

  • Patients are being given the impression they will be able to walk into a pharmacy and be immediately seen, with an additional member of staff available to chaperone if required.
  • One TV channel broadcasted a clip of a pharmacist looking into the ear of an adult patient, when in fact that service is limited only to children.
  • Statements have been made suggesting all pharmacists can prescribe medicines, whereas the seven clinical pathways have very specific inclusion criteria.

The PDA has engaged with the national media about these issues and is calling on the public to be understanding with the staff who may have been placed in a difficult situation, but who are nevertheless wanting to do their very best to help them. It calls upon NHS England to work with the media to manage expectations more appropriately to reduce patient frustration leading to instances of abuse or violence directed at pharmacy staff. In these ways, it will be possible to improve the overall patient experience.

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