Pharmacy First service launched

14 February 2024 (Last updated: 15 Feb 2024 16:57)

The new Pharmacy First Service will enable community pharmacists to manage patients for seven common conditions, including sore throat, earache and sinusitis, following specific clinical pathways.

Wendy Smith, ENT UK Director of Education and long-term expert advisor to the Royal Pharmaceutical Society, was asked to contribute to the development of this service in advance of its formal launch in January.  Along with other experts, Wendy contributed to the advice and guidance provided to ensure that the service was developed with appropriate challenge, assurance, expert advice, and consensus at every stage of the development process. 

There have been lots of concerns about overuse of antibiotics, including potentially inappropriate antibiotic use and the pathways used in Pharmacy First have been rigorously produced in line with current NICE guidance and have been developed to try and prevent this.

In the case of acute rhinosinusitis, non-antibiotic treatments (including self-care) will always be offered/provided first.  Additionally, the age bracket for treating acute sinusitis under Pharmacy First is 12 years and over: this is specifically because NICE guidance recommends use of intranasal steroids (if indicated) in 12s and over: and the clinical pathway development group wanted to ensure that non antibiotic treatments were offered before antibiotics for this condition. 

For a patient to be offered an antibiotic for acute rhinosinusitis they must:

• have had symptoms for at least 10 days (with no improvement),
• have at least 2 indicators for ABRS, and

• tried an intranasal steroid for 14 days with little symptom improvement (or an intranasal steroid deemed inappropriate to use).

NHSE have developed a series of FAQs which give more detail in terms of the monitoring of antibiotic use.  The service will be closely monitored by the NHSBSA and an NIHR study has also been commissioned. Additionally, if it is deemed that antibiotic use for a particular condition is inappropriate it can be "switched off".  This applies locally (to individual contractors, local areas), regionally and nationally. 

ENT UK is not unduly concerned about overuse of antibiotics as a result of this Service; however, will keep this under review and if you have any feedback please share this with us at entuk@entuk.org.

https://www.england.nhs.uk/long-read/launch-of-nhs-pharmacy-first-advanced-service/