An NHS England pilot beginning in Cornwall next month will see pharmacists trained to spot early signs of cancer and refer them for screening, with the aim of reducing pressures on general practice and the wider NHS.
More than 11,000 pharmacies in England will be able to access training about how to spot signs of cancer, such as patients who repeatedly come into buy cough medicine or other medicines to manage symptoms such as coughing, chest pain, breathlessness, changes in bowel habits or bloating.
Nick Kaye, vice-chair of the National Pharmacy Association and member of Cornwall and Isle of Scilly LPC, told The Pharmacist that nine pharmacies in the Penwith area of Cornwall had expressed an interest in taking part in the pilot, with two more likely to join.
He added that one pharmacy, a Day Lewis branch in Penzance, was aiming to go live with the pilot on 1 February, and that the others would follow later.
Health Minister Lord Markham said in a statement last week that the ‘crucial role’ played by pharmacies in this ‘innovative new pilot’ would not only benefit people who might not otherwise have asked for help, but it also help ease pressures on GPs.
But in response,, Malcom Harris, chief executive of the Company Chemist’s Association (CCA) to that the CCA was ‘very concerned’ that ‘this cancer detection pilot, and all other pharmacy services’ would be at risk ‘if the NHS is not prepared to inject urgently needed funding into the sector’.
Mr Kaye said that it would be interesting to ‘learn as we go’ and understand how the referral process would impact other areas of the system as well as the day-to-day experience of pharmacists.
He said that the pilot would help to test whether there was appropriate capacity and funding for the service, and that funding arrangements had not yet been finalised. The Pharmacist has approached NHS England for more information.
Mr Kaye added that in Cornwall, the service would build on the locally commissioned walk-in service, which already sees community pharmacies receive a fee for delivering clinical consultations, whether or not a referral is made.
‘We have got a track record of delivery, if the investment is there,’ he said.
‘We’re picking up more things that people are asking us in those consultations. What happens with those red flag symptoms so that we don’t have to put more pressure on our general practice colleagues?’ he added.
Mr Kaye said that while the majority of referrals would turn out to be benign following investigation, he encouraged community pharmacy teams to make referrals based on agreed indicators.
‘We’re always worried about what extra demand [this creates], what extra workload are you going to put in, is this appropriate. Part of what I’ve learnt is this: quite often, we don’t know. That’s why we need to be really honest with the [rest of the] system and say these are the criteria for which we’ll be referring on, and the numbers are the numbers that come out.’
He added that the pilot would provide an opportunity to explore whether the referral criteria was appropriate. ‘Some things will go really well, and some things might be tricky. Unless you’re prepared to go for it, you never know,’ he said.
He said that good communication between the different parties involved in the process was crucial, saying that the LPC was working with the local Cancer Alliance and others involved in the referral process.
‘I've requested joined up meetings with the people actually managing the referral, the community pharmacies, GP representation and secondary care representation, can all come to meet each other, understand each other [and have] open lines of communication, because I think that's going to be important as things go on. We're trying to be cohesive,’ he said.
Professor Sir Stephen Powis, national NHS medical director said that early detection of cancer was ‘vital for giving people the best chance at having successful treatment’.
He added that ‘encouraging people who would not normally seek help is yet another example of the NHS doing all it can to make getting potentially lifesaving tests and checks as convenient as possible’ and said that ‘high street NHS community pharmacies are playing an increasing role in protecting hundreds of thousands of people’s health’.
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