1. Evaluation of Pharmacy First Surgery at Barnton Pharmacy
Sally Arnison FRPharmS & Leanne Carey MRPharmS
Barnton Pharmacy & Travel Clinic, 195 Whitehouse Road, Edinburgh, EH4 6BU
Introduction
Results
253 patients accessed the service (67% female, 33% male) ranging in age from 9 months to 95 years old.
On average the pharmacists have seen nine patients per week with a peak before Christmas of 20.
Barely a day goes by without reading news of pressures on GP practices. It is clear that to reduce these pressures, we need to change the ways we work in primary care. We know that consultations for minor ailments are an avoidable burden on GPs and A&E departments.
Barnton Pharmacy, in partnership with Cramond Medical Practice, has established an extended minor ailments service (locally called the “Pharmacy Surgery”) to offer more rapid access to advice and treatment for a range of common clinical conditions whilst freeing up same-day appointments in the GP practice for more complex patients. This service takes place in the pharmacy and makes full use of community pharmacists’ clinical assessment and prescribing skills.
Figure 1 shows that the most common presenting conditions within the pharmacy were viral respiratory infections accounting for 28% of all presentations.
Fig 1
Figure 2 shows that only 7% (17/253) of consultations required onward referral to another HCP and this included telephone advice.
Aims
This project aims to investigate the type of workload which could be transferred from GP practice to community pharmacy
This report will discuss the background and implementation of the Pharmacy Surgery and detail the activity in the first six months of the service.
Figure 3 shows the types of medication supplied and includes all medication supplied whether over the counter, on EMAS or on prescription.
Implementation
Diana’s story.
“I hadn’t been feeling very well for a few days in January of this year and I didn’t even manage to get to the shop to buy the Sunday papers which I love to read. By 4pm on the Monday afternoon and I realised I’d not eaten for a few days and I was exhausted. A friend phoned me and told me I had to do something. I thought it was too late for the doctors and I’d heard good reports about the pharmacy service and so I phoned Sally and she told me to come straight over to the pharmacy.
Sally welcomed me into the wee room in the pharmacy and did all sorts of tests on me and told me she felt I really ought to be in hospital. I was a bit phased by this but she made me an appointment straight away at the GP practice.
The doctor repeated the same tests and told me the same thing and she arranged for me to be admitted to hospital straight away. In hospital I was put onto fluids and oxygen straight away. I found out I had level 3 pneumonia and was in hospital for eight days.
Looking back I don’t want to think what would have happened if I had not seen Sally that day and just gone to my bed. I will not forget her. I think this pharmacy offers an excellent service which is much needed. I would not hesitate to recommend this service to others.”
Pharmacists:
Independent prescribing pharmacist
NHS Education for Scotland: Core Clinical Assessment Skills
NHS Education for Scotland: common clinical conditions course
Pharmacy:
Consultation room – fit for purpose.
Equipment e.g. stethoscope, sphygmomanometer, otoscope, pulse oximeter
Staff training and protocols
Clinical governance.
GP practice
Collaborative meeting to establish service
Agreed protocol for referral
Training for reception staff.
Conclusions
The evaluation has demonstrated that this service can increase capacity for patients seeking GP surgery same day appointments.  
20% of the outcomes in which a medication was supplied could be managed by a consultation via the minor ailments service, showing that more can be done on highlighting and signposting patients to existing community pharmacy services.
Service roll out
Advertising: Surgery website, noticeboard, newsletter
Frequently asked questions.
SBAR consultation report form is ed to the
practice’s clinical inbox.
If a patient still needs to see a GP they will be referred back to the practice and seen that day.
Acknowledgements
This service continues to evolve with support from NHS Lothian and the doctors and staff at Cramond Medical Practice in particular Dr Patricia Donald.
References
Survey highlights pressure on GPs in Scotland
Community Pharmacy Minor ailments Study