Pharmacy 5 Point Forward Plan: details and references

Below we set out background information and references for the five action points contained within PSNC’s Pharmacy 5 Point Forward Plan.

1. Giving patients easier access to urgent medication

Patients who have run out of regular medicines often use expensive out of hours services.

–> Commission an urgent supply service so community pharmacists can supply routine NHS prescription medication at weekends and out of hours if patients run out.

Benefits: Ensures patients have uninterrupted and convenient access to medicines. Contributes to 7-day NHS working and saves around £45 per patient.

PSNC calculated this figure using the NAO Out-of-hours GP services in England 2014 report which gives GP costs at £68.30, and the Primary Care Foundation out of Hours Benchmark – Index and summary which states costs of £61.14. It was therefore decided to use a figure of £60 for the cost of an out-of hours GP consultation.

The PSNC Briefing 044/15: Analysis of Emergency Supply services – commissioned during 2014/15 in England (August 2015) was created following an email survey and a review of Emergency Supply of Medicines at NHS expense service specifications and other associated documents. The fee pharmacy contractors receive for providing this service ranges from ‘£10 consultation fee with an additional £1 for each item over and above the first item supplied’ to ‘£20 consultation fee with an additional £2 for each item over and above the first item supplied’. It was therefore decided to use a figure of £15 for the cost of a pharmacist to provide this service. The difference between the two is therefore £45.

2. Offer people advice at their own convenience, using pharmacy as a first port of call

Patients often consult GPs when they can obtain advice and help quickly and conveniently from a pharmacy.

–> Use community pharmacists to advise people with symptoms, offering treatment or referral as needed.

Benefits: Reduces demand for GP appointments, creating capacity within practices and a net saving of £25 per patient per GP consultation, and offering speedier support for patients.

PSNC calculated this figure by using PSSRU – Unit Costs of Health & Social Care 2014 which states that the cost of a GP surgery consultation ranges between £35 and £46 (depending on whether direct or indirect care staff costs are included and whether qualification costs are included or not). The lowest figure, £35, was therefore used.

Very few pharmacy minor ailments advice and support services like this exist locally, but analysis of minor ailments services with different specifications suggests that a £10 fee might be a reasonable estimate; therefore the difference is £25.

More information on this point can be viewed at: PSNC website – Minor Ailments Service

3. Care for frail and older people

Many house-bound patients and people discharged from hospital receive no help with their medicines which can lead to health complications and readmission.

–> Community pharmacists can provide support to frail and older people and their carers at their homes if necessary. This ensures they are using medicines properly and safely, particularly after hospital discharge.

Benefits: Helps patients as they move between hospital and their home, reducing avoidable health complications and the costs of caring for those, saving around £2,000 per hospital admission. Medicines advice can also improve health outcomes and prevent readmission to hospital.

£2.000 saving per hospital admission figure comes from Isle of Wight Enhanced Reablement Service Report April 2013.

More information on this point can be viewed at:

4. Support people to manage their long-term conditions more effectively

People with long-term medical conditions need support to use their medicines properly to avoid poor outcomes, hospital admission and sometimes even fatal complications. But regular GP appointments are not necessary for some patients.

–> Community pharmacists should support and monitor people with simple hypertension and asthma to help them manage their own health.

Benefits: Offers convenient care, support and advice that can lead to significant improvements in disease control and quality of life. Also reduces workload for GP practices releasing capacity for them to carry out other roles.

More information on this point can be viewed at:

5. Help people identify with undiagnosed respiratory disease

Nearly 3 million people in the UK are thought to have undiagnosed chronic obstructive pulmonary disease (COPD). Failure to diagnose and treat the condition at an early stage can lead to a worsening of the disease which requires additional expensive care or hospital treatment.

–> Community pharmacists should provide risk assessments for people potentially at risk of having or developing COPD, followed by advice and stop smoking support or referral.

Benefits: Early diagnosis and intervention contributes to public health efforts, and subsequent support offered by pharmacists improves outcomes from medication, reducing expensive treatment of exacerbations and improving patients' quality of life.

More information on this point can be viewed at: