Private pharmacists are helping to treat A&E patients for the first time in a trial to see if the move can ease pressure on hard-pressed hospitals.
A trial in Manchester that has involved them seeing patients with minor injuries and common ailments such as burns, scalds and sprains, is likely to be extended to other parts of England. Urgent care specialists suggest that the move could free two doctors or nurses a shift to treat those with more serious conditions.
The experiment at North Manchester hospital, which sees more than 100,000 A&E patients a year, has been funded by the Lloyds Pharmacy chain and has so far lasted 10 weeks. The clinic in the emergency department aims to see patients within 30 minutes of arrival and 15 minutes after triage by a nurse.
The move has been made public only now because those involved wanted to see the results from the busiest weeks of the winter for A&E units. North Manchester, part of the Pennine acute hospitals trust, already has GPs working in the department and is said to be among the best performers in England in meeting the four-hour target for seeing patients. So far, the hospital and company have developed clinical pathways for 21 minor injuries and ailments.
Jimmy Stuart, clinical director of urgent care at the trust, said: “The clinic enables us to refer appropriate patients to have their conditions efficiently and effectively treated; this could potentially free up the equivalent of two clinicians per shift who can concentrate on patients with more serious conditions.
“Pharmacy has an important role to play in bridging the gap between care in the community and secondary care, and is an important piece within the solution-jigsaw to the problems currently experienced by the NHS.”
Under the scheme, patients over 16 report to reception and have to be seen by a triage nurse in the usual way. They are then offered the option of treatment by a pharmacist, although there is no obligation for them to accept it.
If the pharmacist decides that the problem may be more serious, they can refer the patient back to A&E or the relevant hospital department without them having to wait longer. For example, if the pharmacist thinks a sprain might be a minor fracture, they can refer them straight to radiology for an x-ray.
Steve Howard, superintendant pharmacist at Lloyds, said: “We have been trialling a minor ailment and injury clinic in three of our community pharmacies and with our initiative with trust we have developed this approach to meet the needs of an A&E unit. We have had extremely positive feedback from patients who have used the clinic so far, indicating a willingness and confidence in patients to consider using pharmacy as an alternative to A&E.
“We’re all aware of the pressures the NHS is experiencing and we believe pharmacy has an important role to play in easing those pressures, both in the community and in secondary care settings. Pharmacists are highly qualified health professionals who are capable of far more than dispensing medicines. We’re keen to demonstrate those capabilities so we can help a wider number of patients and better support local NHS services.”
Figures suggest that about one in four people who visit the A&E department at North Manchester general hospital could be treated more quickly and more appropriately by a pharmacist or another local NHS service such as a walk in centre or GP practice.
Nationally, 15% of people who go to A&E do not have urgent problems and could have been seen by a GP, according to the College of Emergency Medicine. The real figure could be higher as Sir Bruce Keogh, medical director of the NHS, has said that two in five people who go to A&E are discharged needing no treatment at all.
The NHS is also offering incentives for GPs to bring more high-street pharmacists into their practices, something that is rare at present.
