CCA: Pharmacy First could release 30.5m GP appointments per year

Community pharmacy could shift “at least” 30.5 million annual urgent care GP appointments to a Pharmacy First service, according to the Company Chemists’ Association (CCA).

Community pharmacy can “immediately improve” GP access

The CCA yesterday (February 8) published a “prospectus for community pharmacy”, which said that community pharmacy could “release over 42 million appointments from general practice each year” with additional funding.

The report explained that “at least” 30.5 million of these could be absorbed by a “walk-in urgent care service” in pharmacies.

“The pandemic began the journey of changing the public’s mindset, making pharmacy a preferred choice for NHS urgent care,” it said.

Read more: PSNC kicks off ‘proper discussions’ on Pharmacy First with DH

“This developing role of community pharmacy needs to be recognised and harnessed” via “an ambitious Pharmacy First service”, it added.

“Over 30.5 million urgent care appointments can be shifted away from general practice every year by trusting patients to know when they need care,” the report said.

“A walk-in urgent care service, incorporating the supply of prescription only medicine (and independent prescribing) will, in effect create over 11,000 ‘minor urgent care centres’ with an ever-growing scope of care”, it added.

How the CCA reached its figures

Describing the methodology behind its calculations, the CCA said that the 42 million GP appointments is made up of 30.5 million “urgent and same-day appointments”, 10 million routine vaccinations and two million contraception appointments.

The NHS Business Services Authority (NHSBSA) has estimated that 6% of all GP consultations – equivalent to 20.4 million appointments per year - could be transferred to pharmacies through the GP Community Pharmacist Consultation Service (CPCS).

Read more: ‘GPs on the cheap’? Pharmacists must not be seen as GP substitutes, says RCGP

But in addition to this, the CCA estimates that pharmacies could treat five million urinary tract infections each year, 1.75 million sore throats, 2.5 million back pain appointments, and 1.25 million adult chest infections.

These 10.5m additional appointments, added together with the roughly 20 million covered by the CPCS, equate to around 30.5 million appointments currently delivered by GPs.

Potential for an “incredibly bright” future

CCA chief executive Malcolm Harrison said that “the future of community pharmacy has the potential to be incredibly bright” – including by helping to “immediately improve” GP access.

However, he added that “policymakers cannot escape the fact that the current business model for community pharmacy is broken and that the pharmacy network is no longer economically viable”.

Read more: ‘We're exactly the same’: Pharmacists should be paid like GPs, says APPG chair

“If the government wants to deliver a tangible difference to the healthcare of the nation, it will take forward recommendations outlined in this prospectus,” Mr Harrison said.

But if it is “not serious”, it will “be making a conscious decision to wind down the sector”, he warned.

Aligned vision for independents and multiples

National Pharmacy Association (NPA) chief executive Mark Lyonette said the prospectus is “positive” and “aligns” with the NPA’s “own can-do approach, provided pharmacy services are fully funded”.

But he added that the NPA would want to “push the boundaries of community pharmacy practice still further” in the longer term, so that “the sector’s offer becomes ever more compelling and truly transformative”.

Read more: Pharmacists are not 'cheap' substitutes for GPs – we are so much more

“Independents and multiples have a shared interest in developing a clinical future, and a shared challenge in terms of current underfunding and workforce pressures” – with the pharmacy contract in England “failing everyone”, he said.

And chief executive of the Pharmaceutical Services Negotiating Committee (PSNC) Janet Morrison added that the CCA report is “a valuable contribution to future thinking for the sector” that “shares many of the ambitions” the negotiator “wants to see come to fruition”.

Other benefits

As well as freeing up GP appointments, the CCA prospectus set out a variety of areas of healthcare that could benefit from better utilisation of community pharmacy.

This includes:

  • The screening of over five million people each year for undiagnosed hypertension, which could identify over 200,000 newly diagnosed patients
  • Releasing two million bed days every year by “supporting changes in medicine”
  • Reducing annual hospital readmissions by 65,000
  • Moving at least 70,000 GP emergency hormonal contraception (EHC) appointments annually to community pharmacy through the commissioning of a national pharmacy EHC service

However, it stressed that “the potential described in this prospectus requires investment and a significant re-imagining of community pharmacy funding”.

Read more: Patient groups set out vision for ‘future role’ of community pharmacy

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