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Pharmacists could save the NHS £1 billion by treating common ailments

Research from the Royal Pharmaceutical Society (RPS) shows that common ailments such as coughs and sore throats cost the NHS an extra £1.1 billion a year when patients are treated at A&E or GP surgeries rather than at community pharmacies.

Treatment results were equally good regardless of whether patients were treated at a pharmacy, A&E or GP practice.

The cost of treating common ailments in community pharmacies was found to be £29.30 per patient.  The cost of treating the same problems at A&E was found to be nearly five times higher at £147.09 per patient and nearly three times higher at GP practices at £82.34 per patient.

Overall, the study estimates that 3% of all A&E consultations and 5.5% of GP consultations for common ailments could be managed in community pharmacies.  This equates to over 650,000 visits to A&E and over 18 million GP consultations every year that could be diverted with a total annual cost saving of over £1 billion.

To give patients faster treatment and create more capacity at A&E and GP surgeries for patients with more complex needs, the RPS is calling on the NHS in England to provide a national common ailments service through community pharmacies.

Common ailments schemes provide public access to NHS treatment and advice for specific minor ailments at a local pharmacy. People who qualify for free prescriptions still receive any necessary medication free of charge under the scheme.

The two-year research study led by the University of Aberdeen examines data on consultations for common ailments from two A&E departments, six general practices and selected pharmacies in East Anglia and North East Scotland.

The most common simple problem patients sought help for across all locations were aches and pains in joints and muscles.  Other symptoms include respiratory problems such sore throat, cough, cold or sinus problems, stomach problems such as nausea, vomiting, diarrhoea or constipation, and eye problems.

Lead researcher Dr Margaret Watson from the University of Aberdeen said: “Treating these common problems places a substantial burden on A&E and GP services, especially over the winter period.  This can increase waiting times, reduce availability of care for more serious conditions and incurs much greater expenditure on treatment than necessary.

We must make the best use of NHS resources and give people the right advice in the right place, whilst making the most of the skills of NHS staff. You don’t need an A&E consultation to treat a short-term cough or a simple upset stomach.

RPS President Mr Ash Soni said: “The NHS can’t afford to wait any longer to create capacity in the system.  We need to be more strategic and change the services on offer to the public to make best use of the NHS workforce.

Pharmacists are central to relieving the ever-increasing demand on A&E and GPs and enabling them to focus their skills on diagnosing and treating patients needing their care.

Fast, same-day access to community pharmacists will be of huge benefit to patients, doctors, nurses and the bank balance of the NHS.

The NHS must act urgently to provide a nationwide common ailment service through all community pharmacies in England.  At present, the service is commissioned locally and only 1 in 3 pharmacies are able to provide it. 

People must be able to get the same service from a pharmacy wherever they live, rather than the current ‘hit and miss’ approach which drives patients straight back to overburdened A&E and GP services.”

Dr Clifford Mann, President of The College of Emergency Medicine said: “Pressure in A&E is a real concern for the NHS and we need the public to help by understanding where they can get the best care for their particular problem. Recognising that patients can use the skills and experience of pharmacists to treat common minor ailments would be an important step in this direction.”

Professor Nigel Mathers, RCGP Honorary Secretary, said: “Coughs and colds are everywhere at this time of year and they can make you feel rotten at the time. But in the majority of cases they will get better on their own or over the counter treatments will make them more bearable.

Pharmacists are ideally placed to give advice and it is they – rather than GPs – who should be the first port of call for common ailments. Pharmacists can also discuss the various treatments available, many of which will be cheaper than the cost of a prescription.

Of course, if the cough continues, particularly in children and older people, or it is associated with blood, shortness of breath, confusion, or high fever, then patients should contact their GP practice for further advice.

GPs want to do their best for all their patients, whatever their illness, but there is a major workload and workforce crisis in general practice and we do not have enough GPs to cope with the volume of patients, many of whom have complex and multiple conditions.

Over 90% of patient contacts in the NHS are dealt with in general practice – for just over 8% of the NHS budget.  GPs are seeing 340 million patients a year – 40 million more than even 5 years ago – and some family doctors are routinely seeing between 40 and 60 patients a day to try and keep up with the demand. Our own research shows that in the next year, there will be nearly 60 million occasions when patients cannot get an appointment with their GP or practice nurse.

We are extremely grateful to our colleagues at the Royal Pharmaceutical Society of Great Britain for issuing this sensible and timely advice. It will undoubtedly go a long way towards making sure that people with common ailments such as coughs and colds are treated most effectively – and that GP appointments are best used for our more vulnerable patients, such as the elderly.