Hamde Nazar1, Zachariah Nazar2, Andre Yeung3, Mike Maguire4, Alex Connelly5, Sarah P Slight6. 1. School of Pharmacy, King George VI Building, Newcastle University, Newcastle-upon-Tyne, UK. Electronic address: hamde.nazar@newcastle.ac.uk. 2. School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, PO1 2DT, UK. 3. Local Professional Network - Northumberland, Tyne and Wear, NHS England, Newcastle-upon-Tyne, NE15 8NY, UK. 4. Local Professional Network - Durham, Darlington and Tees, NHS England, Durham, DL3 7DR, UK. 5. North East & North Cumbria Emergency Care Network, North of England Commissioning Support, Durham, DH1 3YG, UK. 6. School of Pharmacy, Sir James Spence Institute Building, Newcastle University, Newcastle-upon-Tyne, UK.
Abstract
BACKGROUND: National Health Service (NHS) 111, a medical helpline for urgent care used within the England and Scotland, receives significant numbers of patient calls yearly for a range of clinical conditions. Some are considered high acuity and mainly directed to urgent and emergency care. Low acuity conditions are also directed to these costly, overburdened services. Community pharmacy is a recognised setting for effective low acuity condition management and could offer an alternative. OBJECTIVE: To design and evaluate a new NHS111 pathway re-directing patients with low acuity conditions to community pharmacy. METHODS: Two consensus development stakeholder workshops were undertaken. A "low acuity" condition was defined as one that can be clinically assessed by a community pharmacist and requires a treatment and/or advice available within a community pharmacy. Retrospective NHS111 patient data (February-August 2016) from the North East of England and access to the NHS Pathways clinical decision support software were available to stakeholders. The NHS111 data demonstrated the volume of patient calls for these conditions that could have been redirected to community pharmacy. RESULTS: Stakeholders reached consensus that 64 low acuity conditions could be safely redirected to community pharmacy via NHS111. This represented approximately 35,000 patients (11.5% of total) being shifted away from the higher cost settings in the North East region alone during February-August 2016. The stakeholder group discussions provided rationale behind their classifications of conditions to ensure patient safety, the care experience and added value. CONCLUSIONS: The resulting definitive list of low acuity conditions that could be directed to community pharmacy via NHS111 could result in a shift of workload from urgent and emergency care settings. Future work needs to evaluate the cost, clinical outcomes, patient satisfaction of a community pharmacy referral service that has the potential to improve integration of community pharmacy in the wider NHS.
BACKGROUND: National Health Service (NHS) 111, a medical helpline for urgent care used within the England and Scotland, receives significant numbers of patient calls yearly for a range of clinical conditions. Some are considered high acuity and mainly directed to urgent and emergency care. Low acuity conditions are also directed to these costly, overburdened services. Community pharmacy is a recognised setting for effective low acuity condition management and could offer an alternative. OBJECTIVE: To design and evaluate a new NHS111 pathway re-directing patients with low acuity conditions to community pharmacy. METHODS: Two consensus development stakeholder workshops were undertaken. A "low acuity" condition was defined as one that can be clinically assessed by a community pharmacist and requires a treatment and/or advice available within a community pharmacy. Retrospective NHS111patient data (February-August 2016) from the North East of England and access to the NHS Pathways clinical decision support software were available to stakeholders. The NHS111 data demonstrated the volume of patient calls for these conditions that could have been redirected to community pharmacy. RESULTS: Stakeholders reached consensus that 64 low acuity conditions could be safely redirected to community pharmacy via NHS111. This represented approximately 35,000 patients (11.5% of total) being shifted away from the higher cost settings in the North East region alone during February-August 2016. The stakeholder group discussions provided rationale behind their classifications of conditions to ensure patient safety, the care experience and added value. CONCLUSIONS: The resulting definitive list of low acuity conditions that could be directed to community pharmacy via NHS111 could result in a shift of workload from urgent and emergency care settings. Future work needs to evaluate the cost, clinical outcomes, patient satisfaction of a community pharmacy referral service that has the potential to improve integration of community pharmacy in the wider NHS.
Authors: Rafaella de Oliveira Santos Silva; Dyego Carlos Souza Anacleto de Araújo; Pedro Wlisses Dos Santos Menezes; Eugênio Rodrigo Zimmer Neves; Divaldo Pereira de Lyra Journal: Int J Clin Pharm Date: 2022-04-05