Pharmacy First Scotland launch follows COVID-19 response

Community pharmacies will now be working differently, coming at a time when the sector is emerging from the COVID-19 crisis.

On the 29^th of July a new contractual framework comes into being for community pharmacies. Called ‘Pharmacy First,’ it will see changes to how pharmacies work with people to play a greater role in advising on, treating and maintaining health for those with new and longer term conditions. Helping people to self manage their conditions is a key element.

Community in Action spoke to Matt Barclay, Director of Operations at Community Pharmacy Scotland, to explore the rationale behind the changes and how the new framework will work in practice. Matt explained that the idea behind the new government policy in practice is that more people will be seen for their healthcare needs closer to home. By definition, community pharmacies are in the community and are ideally placed for this function.

The move builds on the existing minor ailments function of pharmacies and recognises that not just treatment, but advice and referrals are at the core of services. With regards to treatments, however, pharmacies are playing a greater role in prescribing for conditions such as urinary tract infections (UTI) for women and impetigo, offering an accessible and timely form of treatment in a local setting. It is hoped that this will be built on through the Pharmacy First framework.

Pharmacies will also continue their role in making the correct referrals for people, whether that be signposting people to their GP or a secondary care setting like A&E. Though Matt points out that ensuring the correct referral is made feeds into the whole healthcare chain and benefits the public and healthcare professionals alike.

Key to Pharmacy First is maintaining the rapport pharmacists and pharmacy teams have with people. Interactions will be changing slightly; people may be asked to give their name and address at the start of consultations, with staff recording reasons for presentation and outcomes to create rich data that will allow Pharmacy First to be developed. Such reporting will allow pharmacies to capture how they operate out of hours, on weekends for example, as opposed to the way they work during the week when other healthcare professionals are available. This will present an overall picture of how and when people engage with their pharmacy teams to further develop services.

In capturing the crucial services provided by pharmacies, Matt expressed his thoughts on the response to COVID-19: “Community pharmacy has stayed open and accessible to the public. We’ve had to adapt but without pharmacies providing life-saving medication the NHS could possibly have collapsed.

“I was in pharmacies during the first few weeks of the pandemic and people were rightly worried about accessing their medicines and where they could get advice for general things as other health care professionals adapted how they worked and maybe weren’t as accessible.”

Moving forward, a key element of Pharmacy First is supporting people to self manage new and existing conditions. Matt points out that pharmacies are best positioned to do this due to the ongoing relationships they have with people who access services. Pharmacists are familiar with patient treatments and can advise on drug interactions and provide more general advice on self management before referring to other services. Crucially, the service gives people the option to self manage on the basis of receiving advice and opting for treatment or not.

In terms of intentions for the future, Matt wishes to see more independent prescribing: “We have started skilling up more pharmacists to be independent prescribers so my vision would be that people routinely come into their pharmacist for the minor things but also the more complex minor things like UTIs and they can see the pharmacist taking this prescribing approach to deal with more common clinical conditions so they don’t have to go to the GP.”

Matt would encourage anyone accessing pharmacy services to speak to their local pharmacist and ask about the new Pharmacy First model to find out how it could benefit them in terms of advice, referrals and treatment to meet their healthcare needs.

It is clear that pharmacies play a major role in attending to the needs of people in the local community and Pharmacy First is empowering pharmacies to have more of an impact in this area. Pharmacies are a mainstay of community life and with upskilled professionals we are likely to see them play a greater role in our healthcare now and into the future.