Pharmacy-led common ailments schemes generate ‘significant national savings’, reduce GP workload and improve patients’ quality of life and symptom relief, a global survey carried out by the International Pharmaceutical Federation (FIP) has found.

Despite concerns of competition, FIP reported that common ailments schemes strengthened collaborations between GPs and pharmacists, while in Scotland, the Pharmacy First scheme had ‘no impact’ on GP remuneration.

But the Pharmacists’ Defence Association (PDA), a member of FIP in England, warned that the imminent Pharmacy First scheme could face challenges around staff training, public expectation and IT connectivity with GPs.

The FIP report, released today, was based on 25 survey responses from FIP member organisations in Australia, Belgium, Bulgaria, Canada, Denmark, England, Finland, France, Germany, Ireland, Israel, New Zealand, Nigeria, North Macedonia, Norway, Portugal, Romania, Scotland, Slovenia, South Africa, Spain, Switzerland, The Netherlands, Uruguay, and the United States.

Eight member organisations were delivering a common ailments scheme that was the same across the whole country, while five were delivering schemes with national variation. Around half of the respondents (representing 12 member organisations) were not delivering common ailments schemes at all.

Of those delivering a common ailments scheme, pharmacies in just three countries were reimbursed by a third-party for all the medicines covered under the scheme, while five were only reimbursed for some medicines and five were not reimbursed in this way at all.

In some cases, pharmacies were reimbursed by the government or health insurance schemes, while in others, patients had to pay out of their own pockets for the medicines dispensed.

The report concluded that common ailments schemes had ‘significant benefits’, ‘both clinically and economically’.

Because patients were able to access health care more quickly through a pharmacy, they reported ‘enhanced quality of life, symptom relief and triaging to GPs’ when a common ailments scheme was in place, noted the report.

Economically, common ailments schemes generated ‘significant national savings’ because they offered a more affordable alternative to traditional GP or emergency visits, it added.

However, FIP member organisations observed ‘significant resistance’ regarding pharmacies being remunerated for the scheme, ‘especially from doctors and nurses’.

Maurice Hickey, from the PDA in Scotland, was quoted in the report as saying that ‘GPs did not want their income stream to be interrupted [by the Pharmacy First scheme]’.

However, in the end, he said that ‘there was no impact on GP remuneration at all’.

In fact, FIP found that common ailments schemes strengthened collaborations between GPs and pharmacists, allowing GPs to focus on more complicated cases.

And common ailments schemes also offered a greater recognition of pharmacists’ expertise, which in turn reduced pressures on GPs and emergency departments, the report found.

Bharat Nathwani, who contributed to the report on behalf of the PDA in England, said in the report that the PDA anticipated challenges to the upcoming national common ailments scheme.

In particular, he warned that there could be issues around:

  • Trained support staff
  • Paid training time for pharmacists
  • Marketing – warning that ‘public expectation may exceed what is possible within the scope of the common ailments scheme’
  • IT connectivity with GPs – warning that ‘present systems rely on paper or unwieldy and clunky systems’

He also called for newly registered pharmacists to receive common ailments training from the outset of their education – as in Scotland, where undergraduate common ailments scheme training was described as ‘pivotal’.

Mr Hickey, from the PDA in Scotland, advised other nations planning to implement common ailments schemes that it was ‘not something which will happen overnight’.

In the case study of Scotland’s Pharmacy First scheme contained within the report, he added: ‘It will take planning and engagement by pharmacists, other health professionals and patients; the training requirements for the pharmacists involved are not inconsiderable, but such schemes have the advantage that they build on the unique skills pharmacists already have.’

He concluded: ‘I believe that as an example of best practice and good pharmaceutical care in the community, a well organised and run common ailments scheme must rank amongst the best patient-based services that pharmacy as a profession can offer.’

In the report, FIP said that gathering evidence on potential cost savings from a common ailments scheme was ‘imperative’ before presenting a proposal to taxpayers or governments.

And it added: ‘Strengthening collaboration between pharmacists and general practitioners is crucial, particularly in devising referral procedures.’

FIP also said that ‘clearly defining common ailments and designing systematic protocols, including a cost-effective medicines formulary’, were ‘foundational steps’.

Meanwhile, a standardised service procedure was ‘essential’ to ‘to ensure consistency and equal access across pharmacies’, it added.

Earlier this year, NHS England (NHSE) announced that a nationally funded Pharmacy First service would be launched in England before the end of 2023, subject to consultation.

And last month, Community Pharmacy England (CPE) chief executive Janet Morrison said the patient group directions (PGDs) that will enable community pharmacists in England to provide a common conditions service were being worked through.

Following that, IT and digital delivery systems would also need to be signed off before a start date for the service could be announced.

NHSE has also said that planning for a public-facing campaign to help raise awareness of the common conditions service in England is ‘underway’.