Patients in one area of England have been told to visit their local pharmacy for hay fever advice and treatment, rather than visit their GP, in efforts to cut NHS prescribing costs and save patients money.

NHS Shropshire, Telford and Wrekin ICB said that over the past year, prescriptions to treat mild hay fever cost the local NHS over £300,000, totalling 60,167 items that would also have been ‘easily and cheaply available’ over the counter.

For example, it said that a box of 30 tablets to treat the symptoms of hay fever would cost patients £9.65 on prescription, but can cost as little as £3 over the counter. The ICB also highlighted that pharmacists can provide quick, free, expert advice without the need to book an appointment.

Gareth Harris, a Shropshire-based pharmacist, said: ‘A lot of people book a GP appointment for advice on hay fever, which isn’t needed. It’s far better to ask your local pharmacist if you’re not sure what treatment is suitable for the symptoms you have. Pharmacists are highly trained clinicians, and you can visit at a time that suits you.

‘We have a range of over-the-counter treatments in stock, including nasal sprays, eye drops and tablets which are often far cheaper than prescriptions. A simple nasal spray costs £8 in a pharmacy. It’s far cheaper, easier and quicker for patients to come to their pharmacist for help with hay fever.’

Dr Masood Ahmed, deputy chief medical officer for the ICB said that by visiting a pharmacy to discuss hay fever symptoms patients would save themselves time and money, free up GP appointments for people with urgent needs and help the NHS save money on ‘unnecessary prescription costs’.

He told patients: ‘We all have a responsibility to look after our own health and our NHS, and this is a simple way of doing just that.’

Meanwhile, Dr Avinash Hari Narayanan (MBChB), clinical lead at London Medical Laboratory, warned of higher pollen counts this normal this spring, due to warmer and wetter weather, which he said could lead to an earlier hay fever season as well as an increased risk of respiratory diseases.

Capacity to offer walk-in advice

A recent YouGov poll conducted on behalf of the Pharmaceutical Services Negotiating Committee (PSNC) found that 68% of adults in England would find it easier to seek health advice for common conditions, such as skin conditions or indigestion, at a community pharmacy rather than a GP surgery.

But many pharmacists have said that they are over-stretched, with PSNC telling the government earlier this month that pharmacies did not even have the capacity to offer services already agreed in the Community Pharmacy Contractual Framework, such as the contraception service, without additional funding for the sector.

Cross-sector campaign group Save Our Pharmacies has called for a nationally commissioned Pharmacy First service, which it says would enable community pharmacies to provide walk-in advice and ease pressure on the NHS as a whole.

The latest figures from a locally commissioned scheme in Cornwall suggesting that the walk-in consultation service (WICS) offered by community pharmacies saved over 6,000 GP appointments in its first 12 months.

Cost of medication for patients

In Nottinghamshire, a locally commissioned Pharmacy First scheme which also provides free medications for ailments such as hay fever has just come to an end. Nick Hunter, chair of the Nottinghamshire Local Pharmaceutical Committee (LPC), raised concerns that there was no direct alternative that would come into operation in time for the patients who use the scheme for free antihistamines.

Many patients can access free medications through prescription charge exemptions but would have to cover the cost of over-the-counter products themselves.

In January this year, a Healthwatch survey found that one in ten patients have avoided taking up an NHS prescription because of cost, while the same number avoided buying over-the-counter medication they normally rely on.

And the Prescription Charges Coalition recently said that the cost of prescriptions was leading to many patients not taking their medication, causing further health problems and greater costs to the NHS.

NHS England estimates that 90% of prescriptions in the community are dispensed for free under various exemptions to charges.

In 2017, over 8bn items were dispensed under free prescriptions – 61.6% to the elderly, 4.1% to young people and 8.3% to people with a maternity or medical exemption certificate.

Plus, 11.7% of free prescriptions went to patients on a low income under the NHS Low Income Scheme, which currently gives free prescriptions to those earning under £16,000 each year.

In total, 10.2% prescriptions in 2017 were paid for by patients, either under pre-payment certificates or at the point of dispensing, which brought in around £952m to the NHS.