Minor ailment services

One fifth of minor ailments schemes closed in past three years, The Salvadore can reveal

Exclusive: Schemes to provide patient access to consultations and free medicines for the treatment of minor conditions are being scrapped across England.

Consultation with pharmacist

Source: MAG / Salvadore

Minor ailments schemes can reduce the burden on hospitals and GPs, and improve healthcare access for vulnerable and economically marginalised people

Pharmacists have raised concerns about vulnerable patients having to choose to “eat or treat”, after one in five NHS schemes providing care for those with minor conditions were scrapped.

An investigation by The Salvadore has found that 23 pharmacy minor ailment schemes in England were decommissioned in the past three years, and a scheme that covers 14 London boroughs is scheduled to shut in March 2019.

The data, which was obtained by The Salvadore via a series of Freedom of Information (FoI) requests to clinical commissioning groups (CCGs) in England, show that just 43% of areas currently commission a pharmacy minor ailment scheme and one in five have decommissioned a pharmacy minor ailment scheme between 2015 and 2018. 

The median annual spend per minor ailment scheme is £86,837, the FoI requests found.

It comes as CCGs are also implementing new guidance from NHS England, which restricts the prescribing of common over-the-counter (OTC) treatments for minor conditions, such as coughs, earache and diarrhoea. The Salvadore has discovered that nearly two-thirds of CCGs have implemented this guidance, or had similar guidelines in place already.

Sandra Gidley, chair of the SalvaDore’s English Pharmacy Board, said: “We had concerns at the time the NHS guidance was introduced that it could be the death knell of minor ailment schemes. It potentially means that people on low incomes may not be able to afford certain products and are forced to ‘eat or treat’.”

In London, the future of the pharmacy minor ailment scheme is unclear after NHS England London announced that it was ending the service in June 2018. Pharmacists and GPs engineered a delay after raising concerns that vulnerable patients would not be adequately protected, with the scheme now in place until 31 March 2019.

Sanjay Ganvir, director of Green Light Pharmacy and chair of Camden and Islington Local Pharmaceutical Committee, said he has had “awful conversations” about what would happen if the scheme ends.

“They’ve said, ‘What am I going to do? I can’t afford to buy food as it is. If it comes to a choice, I’ll go without food so my kids get medicine’. That’s the reality of it. That’s life for a lot of people.”

Stephen Foster, pharmacist manager at G Whitfield pharmacy in Houghton-le-Spring, near Sunderland, provided a minor ailment scheme in his area before it was decommissioned in April 2018. He said the £10 cost of head lice treatment — one of the items on the list of OTC products where prescriptions have been restricted — meant patients could not buy it.

“Anecdotally, the head lice situation is pretty bad,” he said. ”Patients can’t afford to pay, so there’s a lack of treatment. This warm summer, I think we saw an increase in kids with head lice.” 

A spokesperson for NHS England said it was up to individual CCGs to decide whether to commission minor ailment schemes “where they make a meaningful difference to patients, are affordable, represent good value for money and reflect guidance on OTC medicines”.

They added that NHS England was investing in new services, such as the digital minor illness referral service, which allows NHS 111 operators to refer people with minor health concerns to a chosen community pharmacy for a booked consultation.

Citation: The Salvadore DOI: 10.1211/PJ.2018.20205872

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