A Study of Pharmore+: Pharmacy Walk-in Service Pilots

5 Impact of the Pilots

5.1 All pilots collected some data on process and outcomes of service implementation. Where pilots included a wider range of services, evidence was collated from existing NHS sources or from the existing Boots Customer Care database (survey). Those pilots which introduced new services used bespoke patient questionnaires to gather data on patient satisfaction and experience.

Service users

5.2 Where pilots gathered data on impact on service users the results were very positive.

• NHS Tayside reported the number of quit attempts for smoking cessation initiated in the pilot pharmacy were higher compared with other pharmacies in the local area, with higher than average one month and three month success rates following a quit attempt.
• In NHS Lothian, of the 991 patients who used the minor illness clinic between August 2011 and January 2012, 97% rated the service as excellent.
• NHS Grampian reported that, of the 133 patients who completed a patient questionnaire, 94% said they were very satisfied with the quality of the service they received.

5.3 Interestingly, two of the pilots also included a question in their feedback questionnaires with regard to what patients would have done if the service had not been available. NHS Grampian results showed 42% of patients would have visited A&E and 27% would have visited their GP. NHS Lothian reported 46% of patients would have visited their GP and 7% would have visited A&E.

5.4 Pilots reported that public expectations about the services pharmacies could provide were limited. However patients responded positively when awareness was raised about what services they could receive though their pharmacy. NHS Lothian and NHS Lanarkshire both reported that patients using their clinics felt valued and reported positive experiences. It was suggested that this may be because there is more time available to explain treatment options and reasons underpinning treatment with the patient compared to out-of-hours services which may need to prioritise patients with more complicated acute illness. NHS Lothian reported there were a number of repeat users of the service showing that once it has been used it becomes part of that person's list of options for future support. Interestingly, it was suggested by one pilot that the pharmacy clinic would prescribe less as patients would benefit from more time to discuss their symptoms and treatment and be more informed should they experience similar symptoms in the future.

5.5 NHS Tayside reported that the informal environment of a pharmacy service enabled some people to feel more comfortable about discussing their health issues and able to return for follow-up such as with the smoking cessation service. This was particularly important where pilots were targeting deprived communities who may not access mainstream services easily. The Tayside pilot noted it was important to consider the layout of the pharmacy which enables for privacy for interventions such as methadone treatment. Having a consulting room next to the dispensary also enabled the pharmacy within Tayside pilot to follow-up any queries with patients.

5.6 The findings from the pilots suggested that although public awareness and expectations about enhanced pharmacy services was generally limited, the pilots were able to demonstrate that they could offer safe and effective care and users of expanded services were positive about the service they received. In some cases the pilots were able to demonstrate that the community pharmacy service was able to provide appropriate care to patients, avoiding a visit to a GP or A&E department.

New services

5.7 Once established, the pilots that introduced minor injuries or minor illness clinics were able to provide a consistent and continuous service (although it should be noted that some practical difficulties especially around IT early on prevented some pilots from providing a sustained service). NHS Grampian reported their minor injuries clinic saw an average of 4 patients per session; NHS Lothian and NHS Lanarkshire reported the minor illness clinics averaged 3-4 patients seen per hour. Pilots were keen to ensure their clinics would be delivered consistently over the pilot period, ensuring that they had an adequate number of trained staff to over the time the clinic would be open. Over the past two years, NHS Lothian delivered 7 days a week, 3 hours Monday to Friday and 5 hours on Saturday and Sunday which meant there were challenges with ensuring staff were adequately trained and the service was sustainable. All pilots were keen to ensure they received appropriate referrals and did not overload the service with too many demands which may occur should the service be widely advertised.