In Analysis

Follow this topic

Bookmark

Record learning outcomes

This will be the first winter of Pharmacy First in England…and arguably the biggest test pharmacies have ever faced. Victoria Goldman reports…

As this year’s cold and flu season sets in, community pharmacies are likely to see an influx of customers seeking over-the-counter products and advice.

In England, this will be the first winter of Pharmacy First, and many pharmacy owners are concerned about how much of an impact Pharmacy First will have on the busy winter season.

Community Pharmacy England (CPE)’s June snap poll revealed that nearly a third of pharmacies had stopped provision of some Advanced services and, without further investment in the sector, there is a risk that more will do the same.

Alastair Buxton, director of NHS services at CPE, says this winter will be the biggest test so far.

“The launch of Pharmacy First earlier this year marked a step change in how the Government and NHS wanted the public to use healthcare services and paved the way for pharmacies to deliver more clinical services in the future,” he says.

“The operation of Pharmacy First across its first full winter period will provide the best opportunity yet to demonstrate just how valuable the service can be for patients, the public and the wider NHS.

“It will also give us an important check on how the service is going and more data on the impact of seasonality.”

Under pressure

Lindsey Fairbrother at Good Life Pharmacy Ltd, and regional representative (North and East Midland) at CPE, is expecting community pharmacy to be under significant pressure this winter.

“We welcomed Pharmacy First since we already did private consultations, but other pharmacies may be struggling depending on how many consultations they do and the level of referrals,” she says.

“We are deliberately overstaffed in our pharmacy. There are three checkers in place, so business can continue as normal if I’m stuck in a room elsewhere. We are making sure the team is ready and well-trained before the winter season sets in.”

Ade Williams, a Fellow of the Royal Pharmaceutical Society and Bristol-based community pharmacist, says that community pharmacies are becoming a much more visible destination for winter illnesses.

“If GPs are referring patients to the pharmacy, this further reinforces the pharmacy role,” he says.

“However, pharmacies are already under-sourced with increasing workloads. Planning is essential, involving a whole team approach and the delegation of tasks – asking what needs to be done, and when.

“Everything needs to be done well, focusing on system sustainability without being overwhelmed, to avoid damaging the pharmacy brand.”

Vaccination services

Rebecca Shepherd, professional and regulatory standards pharmacist at Well Pharmacy, says that flu vaccinations remain a key strategy this year.

“The UK population is ageing, and that means more high-risk individuals who are eligible for NHS vaccines,” she says.

“All Well Pharmacy stores offer flu vaccinations, and we are continually increasing the number of Covid clinics to improve accessibility to allow the public to keep themselves inoculated.

“Well Pharmacy operates on an assessment of local demand; in cases where there is a high demand for vaccines, we can upskill pharmacy colleagues to become trained vaccinators.”

In June 2024, the NHSE announced that NHS flu vaccinations for most adults will be beginning on 3 October this year, while pregnant women can get doses from their GP from 1 September.

The reason for changing this year’s start date is based on evidence that flu vaccine’s effectiveness reduces over time in adults. By moving the start date to October, this means that most vaccinations will be completed by the end of November, closer to the time that the flu season commonly begins.

“In our flu vaccination hub, you can find letters, posters, flyers and social media content,” says Alastair Buxton.

“This year, pharmacy teams will also want to explain to their patients about the later start to the programme, as has been set by NHS England. To help with this, we have developed a poster on the timing changes for use in pharmacies, and the UKHSA has also issued a patient leaflet that may be useful.”

Many pharmacies have pre-booked vaccinations with patients early this year to make sure they have enough NHS stock allocation.

“We were already booking flu jabs by the end of August, asking patients over 65 if they would like one and to book in advance,” says Lindsey.

“We are having to be very proactive, such as putting a flag on every relevant prescription, such as diabetes or steroids for asthma. With flu jabs, we control the stock and booking, but with Covid jabs we are dependent on the booking system and need to make sure the stock is in place.

“Customers will want to have both flu and Covid jabs at the same time but can’t book them together online, which is more work for our vaccinations planning team.”

Supply and demand

Pharmacy First isn’t simply about prescribing antibiotics when appropriate, but also focuses on pain relief and self-care advice. Lindsey says that Pharmacy First and vaccination services may help to highlight coughs and colds in other conversations and therefore link sales.

“Use cardboard shelving units from the manufacturers to pick up sales, especially near the tills, and arrange a seasonal winter remedies window display,” she says.

“Social media can be helpful to target patients for vaccines and share Pharmacy First videos and key messages. When choosing products to stock, it’s worth looking at some of the pharmacy awards as these will highlight popular products.”

Deciding which winter remedies products to stock can be a challenge, especially for smaller pharmacies with limited space.

“It’s important to stock a range of cold and flu products,” says Rebecca, “including proprietary brands, generics and own label covering a range of price points, so as not to deter patients from self-care due to the cost of the treatments.

“Pharmacists can also offer advice on how best to support the immune system through vitamins and other supplements.

“Manufacturers of key brands will often provide support materials for pharmacists to use when advising patients. These may include information leaflets, posters and other display materials.”

Ade says it’s beneficial to show that the pharmacy understands what’s available and also understands its customers.

“Pharmacies need to stock a range of evidence-based products to suit patient preferences,” he says.

“For example, health-conscious customers may want sugar-free versions. Since pharmacists may not be directly involved in counter queries, they should offer refreshers to their team to ensure they can answer queries confidently and competently.”