The government has committed to 'maximising' Pharmacy First approaches to ear, nose and throat (ENT) health as part of its elective care plan, published today.

Prime Minister Sir Keir Starmer laid out the new ‘elective reform plan’ this morning, which ‘sets out a whole system approach’ to meeting the 18-week referral to treatment target for 92% of patients by the end of this Parliament.

The target, set out in the NHS Constitution and re-committed to by the new Labour Government, says that patients should not have to wait more than 18-weeks between being referred to and being seen by a specialist.

In the plan, the government said it would 'bolster' community ENT services, 'by expanding non-surgical community-based ENT services, maximising pharmacy first approaches and developing one-stop clinical models to support patients needing ear care and patients with rhinitis'.

Community pharmacy bodies have welcomed the potential use of the pharmacy sector in ENT care but stressed that it must be supported with an urgent uplift to funding.

MPs 'positive' about pharmacy ENT services

Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), said the organisation was 'pleased that the government is seeing the potential of community pharmacy in this area'.

And she highlighted that IPA had shared 'how community pharmacies can play a big role in management of ear conditions' at its parliamentary event in October, when MPs could take part in having an ear examination.

'They were very positive about how the process can be done so professionally by pharmacists,' she told The Pharmacist.

'We have always maintained that investing in community pharmacies brings accessibility to care closer to people’s home and saves money for the tax payer. We are willing to support the NHS but the government must urgently tackle the ongoing financial crisis in community pharmacies and address the funding shortfall,' Dr Hannbeck added.

CCA reiterates calls for ear health Pharmacy First expansion

The Company Chemists' Association (CCA), which has previously suggested Pharmacy First could be expanded to help fill gaps in NHS earwax removal provision in England, told The Pharmacist today that it would 'absolutely support a Pharmacy First-style approach to ear, nose and throat services'.

'Pharmacy First has proven to be a success in a short space of time, and expansion into new conditions will ensure even more patients benefit,' CCA chief executive Malcolm Harrison said today.

'If the government and NHS England are serious about shifting care into the community, as well as freeing up GP capacity, they should consider how they can help turbocharge Pharmacy First.'

'A greater proportion of funding must go into primary care'

But he added: 'Solving the NHS' strains will only be possible if people can access the right care, in the best place, as soon as possible.

'A greater proportion of funding must go into primary care if patients are to access the care they need from the NHS.'

And amid widespread closures of local pharmacies, they 'urgently need an uplift in funding so they can continue to provide the ‘walk-in’, extended hours, access that people need and expect', Mr Harrison said.

CPCF negotiations still yet to restart

Alastair Buxton, director of NHS services at Community Pharmacy England (CPE), said that the negotiator had also 'long been a proponent of building on the Pharmacy First service for the benefit of patients, the public, and the wider NHS'.

He added that any changes to services 'would be subject to CPCF negotiations', which the negotiator stands 'ready to restart immediately'.

'However, we have also repeatedly made clear that there can be no expansion of services without financial stabilisation of the sector,' Mr Buxton added.

Pharmacy providers in England are currently working under the terms of a contractual framework agreed in 2019, that expired in March this year.

Before Christmas, pharmacy minister Stephen Kinnock said that he was 'very focused on getting these [CPCF] negotiations started early in the new year'.

And health and social care secretary Wes Streeting said on 18 December that he was 'working through' a funding package to stabilise the community pharmacy sector.

'Expanding clinical services provides patients with greater choice and convenience'

Tase Oputu, England Board chair for the Royal Pharmaceutical Society (RPS) in England, also said the she welcomed the government’s commitment to maximising Pharmacy First approaches, which she said 'highlight the important role pharmacists play in delivering care closer to home and managing demand across the health service'.

'Expanding clinical services, including ear care, provides patients with greater choice and convenience.

'However, as pharmacists take on more responsibilities, it’s essential this is matched with appropriate investment and workforce support to ensure sustainable, high-quality care,' Ms Oputu added.

'More clarification needed on what this looks like in practice'

Gareth Jones, director of corporate affairs at the National Pharmacy Association (NPA) said that the government's promise to maximise a pharmacy first approach was 'positive' but 'needs further clarification about what it might mean in practice'.

He told The Pharmacist: 'From what we know of the elective recovery plan overall, it underplays the potential of community pharmacy to help bring down waiting times by building up community based support for prevention and hospital discharge.

'Community pharmacy has the potential to play a hugely expanded role, taking pressure away from our overstretched hospitals and delivering first class care on people's doorsteps.

'However, this cannot happen when pharmacies are closing at record rates and are faced with massive uncertainty about their future funding.'

Pharmacy ear health pilot was not recommissioned due to funding constraints

The government's elective care plan also highlighted a South West London ENT pilot that used community pharmacies to deliver comprehensive ear care has improved patient waiting times and accessibility and has empowered pharmacy teams.

But in April last year, The Pharmacist reported that the pharmacy-based ENT service was not recomissioned or expanded as sufficient funding could not be found.

The Pharmacist is seeking clarification on whether this is still the case.