Since the start of 2024, the role of pharmacists in your local community has expanded even beyond dispensing prescriptions and offering specialist services, and now includes the treatment of certain common conditions.
This new system, known as the Pharmacy First service, is an extension of previous community pharmacy trials where patients could not only receive a prescription but could be consulted and prescribed medicines for not only conditions that would benefit from over-the-counter solutions but also certain clinical pathways that require prescription medication.
Whilst the exact future of Pharmacy First is unlikely to be revealed until after 4th July 2024, it appears as if the role of community pharmacies is likely to expand further, covering more common illnesses and forming an important pathway for patients to get treatment without delay.
Whilst Pharmacy First is a relatively new service, this is far from the first time it has been attempted, and the barriers that have stopped it have been as much philosophical as they have been financial and practical.
Doctors Prescribe, Pharmacists Dispense?
The roles of pharmacists and doctors when it comes to the provision of medication have been relatively nebulous and flowing ever since they were more commonly known as physicians and apothecaries.
The start of separation of the roles into distinct medical disciplines arguably started with
Johnathan Goddard in a polemic written to the Royal Society.
In it, he was particularly angry at the idea that apothecaries could both diagnose and prescribe, but whether this was because he genuinely believed that it was a less effective way to provide treatment to most patients or out of an existential fear for his profession in an age well before the healthcare sector we know today is unknown.
Whilst there was an unwritten rule that physicians prescribe and apothecaries dispense, something that continued as medicine became more advanced and the roles changed to doctor and pharmacist respectively, it took until 1913 for this to become official in the United Kingdom.
When the National Health Insurance scheme (NHI) was first introduced as a precursor to the modern National Insurance regime in 1913, then-chancellor David Lloyd George explicitly separated prescribing from dispensing.
Whilst there were examples of dispensing doctors or prescribing pharmacists, there was a desire as the UK health system slowly moved in the direction of what would become the National Health Service to partition the different departments and allow for greater oversight.
However, whilst this made a limited degree of sense in an era when pharmacists would not only dispense prescriptions but often produce the compounds themselves, as the pharmaceutical industry evolved and the role of pharmacists expanded to provide advice about over-the-counter medications, the line between prescription and dispensing blurred once again.
This was especially true for smaller communities where there is a much greater need for dispensing doctors, or general practitioners who can not only prescribe but also provide prescription medications, as well as community pharmacists who serve rural communities.
The biggest turning point where pharmacists started to play a much larger role not only in hospitals but in wider communities was in the 1980s and a series of events that led to the Nuffield Report in 1986.
It started with a 1981 address by Gerard Vaughan, then the Minister for Health, to the British Pharmaceutical Conference where he claimed to not see a future for community pharmacists, and even this early the report noted that because pharmacists see people sooner than GPs they could be a critical part of the healthcare pathway.
It would take until the end of the century for these plans to start to take shape, with community pharmacists playing a much larger role in the so-called NHS Plan 2000, the recommendations of which were later part of the 2001 Health and Social Care Act and came into force in 2003.
This would officially be known as Supplementary Prescribers and not only include pharmacists but also nurses, paramedics and some other non-medical roles in healthcare.
Whilst Pharmacy First is a major step forward in this field, it is far from an unprecedented one, and depending on factors outside of the pharmacy itself, the concept of pharmacists being one of several entry points to healthcare is not only possible but exceptionally likely.
The trials and the early reports of Pharmacy First have reported that people are satisfied with the care they receive from a community pharmacist, and the inherent benefits of being treated for common conditions sooner stop conditions from escalating and improve care and quality of life overall.
Frequently Asked Questions
Yes. Pharmacists are highly trained healthcare professionals who can assess and advise on many common illnesses, such as sore throats, coughs, hay fever, minor skin conditions and uncomplicated urinary tract infections in eligible patients. They can also recommend treatments or refer you to another healthcare service if needed.
Pharmacists can provide advice and treatment for a wide range of minor illnesses, offer emergency contraception, support smoking cessation, carry out blood pressure checks in many pharmacies, and help you manage long-term medicines. Services may vary depending on your local pharmacy.
You should seek medical attention if your symptoms are severe, persistent, worsening, or accompanied by warning signs such as chest pain, difficulty breathing, severe bleeding or sudden weakness. A pharmacist can also advise when a GP or emergency care is more appropriate.
Some pharmacists are qualified independent prescribers and can prescribe medicines for certain conditions. In addition, pharmacies may supply prescription-only medicines through NHS services such as Pharmacy First or under specific legal arrangements, depending on the patient’s needs.