Pharmacies are seeing 'double' the demand for Pharmacy First consultations on Sundays than would be expected in line with reduced opening hours, a new report from the Company Chemists' Association (CCA) has suggested.
The CCA said a 'surprising volume' of weekend consultations demonstrated the value of access to the service out-of-hours.
Today marks the one year anniversary of the service's launch in England, and despite 'working as intended', CCA chief executive Malcolm Harrison said there was still 'room for growth' and expansion.
'When GPs are unavailable, patients access pharmacies'
Drawing on data from its member pharmacies – large pharmacy multiples that make up around a third of England's community pharmacy network – the CCA found that around 8% of Pharmacy First consultations take place on a Sunday, despite this making up just 4% of CCA pharmacies' opening hours.
The CCA explained that this showed 'double the demand' that Sunday opening hours alone would account for.
'There is an expected spike in demand on Mondays following the weekend. However, there is a surprising volume of consultations at the weekend — especially considering the fewer number of pharmacies open,' the report added.
And nearly twice as many consultations were provided in more deprived areas, reflecting the higher prevalence of, and greater access to, pharmacies there.
'When normal routes to care, such as general practice, are unavailable, patients turn to pharmacies,' the CCA report said.
Pharmacy First consultations provided by CCA member pharmacies across the week - Source: CCA
CCA proposes expanded eligibility and conditions
Nearly 1.5 million patients were seen through Pharmacy First in the first nine months of the service and this could reach 2.5 million patients by the end of March 2025, the CCA suggested.
It proposed that Pharmacy First could be expanded to see pharmacies taking on an even bigger share of primary care consultations – the equivalent of up to 40 million GP appointments each year.
To do so, the CCA suggested that the eligibility criteria for the seven conditions be reviewed and expanded, with independent prescribing incorporated 'as soon as possible'.
The CCA also proposed that more conditions be added to the service, including:
- Eye infections, which it said could relieve GPs of up to 3 million appointments each year
- Migraines, which could save up to 2.5 million GP appointments
- Acne Vulgaris, which could see 3.5 million GP appointments be dealt with in community pharmacy
- Chest infections in adults, which could free up 2.5 million GP appointments
- Lower back pain, which could free up to 5.5 million appointments in other parts of primary care
- Dental pain, which could save over 0.5 million appointments in other parts of primary care
Similar services in Scotland and Wales already enable patients to access help for a greater range of conditions such as acne, thrush, backache, eczema, headache and hayfever.
Call for walk-in access to Pharmacy First and OTC meds available free
Pharmacy First should also be a 'walk-in' service, with pharmacies funded to treat minor ailments without the need for a GP referral, the CCA's report added.
And to support this, over-the-counter medicines should be made available from pharmacies free of charge to patients eligible for free prescriptions, so that the cost of medicines does not drive people to seek a GP appointment.
North-south divide in Pharmacy First consultations
The CCA also stressed that more public awareness of the service is needed to enable better access for patients.
In particular, it highlighted a north-south divide in the provision of Pharmacy First consultations, with pharmacies in the North West outperforming pharmacies in other parts of the country.
And pharmacies in The Black Country provided over two and a half times more consultations than North Central London, when adjusted for population size.
The CCA said this likely reflected greater patient awareness in areas where similar services had previously been commissioned locally, such as the 'ByeByeUTI' pharmacy UTI treatment pilot in the North East and North Cumbria Integrated Care Board in July 2022.
And it said that as Pharmacy First becomes embedded, patient awareness would continue to increase, further driving up consultation volumes.
NHSBSA data for Pharmacy First consultations by ICB, November 2024 - Source: CCA
Pharmacy First 'working as intended' and must now 'move through the gears'
Chief executive of the CCA, Mr Harrison, commented: 'In a short space of time, the community pharmacy sector has established a new access route into NHS primary care.
'Pharmacy First is allowing patients to be seen in a timely manner and freeing up vital GP capacity, so that they can focus on more acute and complex care. There is, however, still significant room for growth.
'An expanded service could free up 40 million GP appointments – over four times as many as we estimate the current service will free up – and around a tenth of all GP appointments.
'It’s clear that Pharmacy First is working as intended but the NHS must now allow us to now move through the gears and expand the service to deliver greater patient access into primary care.'
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