Changing patient consultation patterns in primary care: an investigation of uptake of the Minor Ailments Service in Scotland

Wagner, Andrew; Noyce, Peter; Ashcroft, Darren M.

doi:10.1016/j.healthpol.2010.07.002

Cited by 14 publications

(16 citation statements)

References 11 publications

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“…This is consistent with a recent study [15]. It is plausible that patients requested the services from pharmacists instead of GPs thus transferring work from GPs to pharmacies-PACT data seems to support this for the treatment of head lice, although the effect is not clear in other areas.…”

Section: Discussionsupporting

confidence: 90%

“…A small number of schemes have been evaluated and the findings are mostly published as reports, there is little peer reviewed literature [8][9][10][11][12][13][14][15]. The evaluation reports generally focus on the uptake of the scheme (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Evaluation results of existing minor ailments schemes have demonstrated that the schemes enabled the transfer of a number of consultations for minor illnesses from general practices to community pharmacies. The schemes were also well received by stakeholders, such as patients, community pharmacists and GPs [8][9][10][11][12][13][14][15][16]. A cost effectiveness study by Baqir et al [13] estimated that the minor ailments scheme had saved over £14,000 per month across five PCTs.…”

Section: Introductionmentioning

confidence: 99%

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A multi-method evaluation of the Pharmacy First Minor Ailments scheme

2011

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It appears that the Nottingham City Primary Care Trust is successful using community pharmacies to improve access to medicines and provide a greater choice in primary care for patients with minor ailments. Thus, the Primary Care Trust should continue the scheme, although there are some important issues (e.g. the restricted formulary, the lack of privacy in some pharmacies) that need to be addressed to improve and develop the service further. The Nottingham City Primary Care Trust should build on this success to further utilise the pharmacy in their primary care service development.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A multi-method evaluation of the Pharmacy First Minor Ailments scheme

2011

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“…18 There is also some evidence that locally commissioned enhanced services were more likely to be provided by chain pharmacies than independent pharmacies and that provision was greater in deprived and urban areas. 19 Other research into the implementation of pharmaceutical care services by community pharmacies worldwide has identified a number of organisational barriers to and facilitators of their provision, including the physical environment (particularly adequate space and privacy), organisational culture and leadership, having the necessary staffing and skill mix, relationships with GPs, equipment and technology, and work overload/conflicting workloads. 20 Studies of the implementation of MURs in English pharmacies suggest that although delegation of dispensing duties to pharmacy technicians or other support staff (to free up pharmacists' time) is supported by pharmacists, constant workload demands and interruptions still prevent pharmacists from conducting MURs.…”

Section: The Relationship Between Organisational Characteristics and mentioning

confidence: 99%

Investigating the organisational factors associated with variation in clinical productivity in community pharmacies: a mixed-methods study

Jacobs

Bradley

Elvey

et al. 2017

Health Serv Deliv Res

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Background Community pharmacies play a key role in health-care systems, dispensing prescriptions and providing medicine-related services. Service provision varies across community pharmacy organisations and may depend on organisational characteristics, such as ownership, staffing and skill mix. Objectives To inform the commissioning of community pharmacy services by (1) exploring variation in clinical productivity (levels of service delivery and service quality) in pharmacies, (2) identifying the organisational factors associated with this variation and (3) developing a toolkit for commissioners. Design Mixed-methods study: community pharmacy survey, administrative data analysis, patient survey, stakeholder interviews and toolkit development. Setting Nine socioeconomically diverse geographical areas of England. Participants Stage 1: community pharmacies in nine study areas. Stage 2: in 39 pharmacies, two consecutive samples of approximately 30 patients each following receipt of (1) dispensing and (2) medicines use review (MUR) services. Pharmacy and commissioning representatives from across all types of pharmacy and study sites. Main outcome measures Stage 1: dispensing, MUR, new medicines service volume and safety climate. Stage 2: patient satisfaction, Satisfaction with Information about Medicines Scale (SIMS) and Medication Adherence Report Scale (MARS). Data sources Stage 1: (i) community pharmacy activity data; (ii) socioeconomic and health needs data; and (iii) community pharmacy questionnaire (ownership type, organisational culture, staffing and skill mix, working patterns, management structure, safety climate, pharmacy–general practice integration), all linked by pharmacy postcode and organisational ‘F’ code. Stage 2: (i) patient questionnaire (background, patient satisfaction, SIMS, MARS); (ii) semistructured stakeholder interviews (variation in quantity and quality of service provision, opportunities and barriers to clinical productivity, mechanisms by which different organisational characteristics may help or hinder clinical productivity). Quantitative data were analysed by fitting a series of fixed-effects linear, logistic and multilevel logistic regression models in Stata® (version 13; StataCorp LP, College Station, TX, USA). Qualitative data were analysed thematically using a framework approach in NVivo10 (QSR International, Warrington, UK). Results In stage 1, 285 out of 817 pharmacy questionnaires were returned [valid response rate 34.6% (277/800)]. In stage 2, 1008 out of 2124 patient questionnaires were returned [valid response rate 46.5% (971/2087)]. Thirty pharmacy and 10 commissioning representatives were interviewed face to face or by telephone. Following integration of stage 1 and 2 findings, clinical productivity was associated with pharmacy ownership type, organisational culture, staffing and skill mix, and pharmacy–general practice relationships. Extra-organisational associations included local area deprivation, age profile and health needs, pharmacy location, public perceptions and expectations, supply chain problems, commissioning structures/processes, levels of remuneration and legal/regulatory constraints. Existing arrangements for monitoring clinical productivity focused primarily on quantity. Limitations Non-random selection of study sites and non-participation by four major pharmacy chains limited generalisability. Investigation of the full scope of pharmacy service provision was prevented by a lack of available activity data for locally commissioned services. Quantitative exploration of service quality was limited by available validated measures. Conclusions These findings have important implications for community pharmacies and service commissioners, highlighting the importance of ownership type, organisational culture, staffing and skill mix for maximising the delivery of high-quality pharmacy services and informing the development of a commissioners’ toolkit. Future work Future studies should (1) develop tools to measure community pharmacy service quality; (2) describe and evaluate different models of skill mix; and (3) explore how services are commissioned locally from community pharmacies and the extent to which local needs are met. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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“…21 A successful example of improved medication access and role optimization for pharmacists in a substitutive role at a nationwide level is the Scottish Minor Ailments Scheme (MAS). 22 Implemented in 2006, the MAS allows pharmacists to prescribe medications for minor ailments (eg, malathion for head lice and clotrimazole for vaginal thrush). 23 Economically disadvantaged patients have benefited the most from increased access to medications and pharmacists.…”

Section: Medication Classification Systemsmentioning

confidence: 99%

Expanding Consumer Medication Access: The Time Is Now

Huston

Kucukarslan

Patel

et al. 2013

Therapeutic Innovation & Regulatory Science

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The US FDA is proposing an expanded over-the-counter (OTC) medication policy to improve patient access to medications under the supervision of a pharmacist. Higher levels of medication access via multiple medication categories are common in other industrialized nations. Pharmacists are well trained and widely available. Expanding medication access can help alleviate the physician shortage by directing patients with appropriate health conditions that can be managed with medication to community pharmacists. Examples include migraine headaches and seasonal allergies, which have a significant impact on patients' quality of life and work productivity. Clinically relevant medications and dosages should be selected. Medication use guidelines should not be so restrictive as to defeat the policy intent. The proposed FDA policy is a long-overdue change that will help optimize available health personnel resources for patient care.

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Changing patient consultation patterns in primary care: an investigation of uptake of the Minor Ailments Service in Scotland

Cited by 14 publications

References 11 publications

A multi-method evaluation of the Pharmacy First Minor Ailments scheme

A multi-method evaluation of the Pharmacy First Minor Ailments scheme

Investigating the organisational factors associated with variation in clinical productivity in community pharmacies: a mixed-methods study

Expanding Consumer Medication Access: The Time Is Now

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