Let’s extend and invest in Scotland’s Minor Ailment Service, abolish exemptions for patients and relieve the pressure across NHS Scotland

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Scotland’s Minor Ailment Service (MAS) has been a well regarded success in the field of pharmacy over the best part of the last decade. It has opened up as a credible alternative to waiting for an appointment with the GP for many patients north of the border when it comes to treating a selection of self-limiting conditions for certain groups of patients who qualify to use this service.

And particularly given how I’ve been often hearing anecdotes of patients struggling to book an appointment with the doctor in recent times and where access to them is unavailable during out of hours times such as the weekend where pharmacies up and down the country are open, MAS has been truly appreciated for it’s availability and for being utilised as a way to treat minor ailments such as athlete’s foot, skin conditions and threadworms.

So is it not time to abolish the exemptions which determines the eligibility of patients for MAS, open up this service to all patients in our country, extend the autonomy of pharmacists in treating a wider range of conditions and transform MAS into a proper clinic-style service within community pharmacies across Scotland whilst enabling investment into appointing pharmacists to provide this revolutionised service whilst at the same time granting them full access to patient notes in order to provide the best quality of care? Such a service should not be seen as a way to demonise the autonomy of doctors, but rather to relieve the pressure on GP’s and other parts of NHS Scotland.

There is opportunity for real and radical change to improve the provision of such services and improve accessibility to healthcare for patients. It cannot be doubted for a second that pharmacists are a major asset to healthcare and seen as the medicines experts by society. You don’t need to book an appointment to speak to one or ask a question. And given that under devolution in Scotland we have seen radical progress and a well earned increasing recognition of the ability of pharmacists to provide a variety of useful services as set out within the community pharmacy contract, there is a strong track record which has the potential to be built upon for the future.

The Minor Ailment Service is a key element of Scotland’s community pharmacy contract. According to the following set of statistics from ISD Scotland, by the end of March 2015, nearly a million people in Scotland (around 1 in 5 of the Scottish population) were registered with the service. Over two million items were dispensed coming to a cost of £5 million in 2014/15. And every community pharmacy has patients who are registered with the service.

But why should our Minor Ailment Service be limited to patients who happen to fall within a certain age bracket or claim benefits? Why should a student aged 19 or a low paid worker who doesn’t fit within one of the exemption categories at the back of a MAS form be denied access to healthcare via MAS? As mentioned earlier, it isn’t all that easy these days to get an appointment booked with the doctor in many places. Demand on our health service is high and will remain so for a long while to come, whether it’s the peak of the winter or the middle of the summer. But with this difficulty, lies opportunity for Scotland’s pharmacists.

I believe that there is opportunity for the Minor Ailment Service to be extended to all patients across Scotland and to act as a service that allows pharmacists to treat patients for not just a common selection of self-limiting conditions as normally set out within various health boards formularies, but for a wider range of commonly encountered conditions probably via Patient Group Directives (PGD). It is down to health boards and NHS Scotland as a whole to determine which conditions should be treated by pharmacists, but PGD’s already exist in Scotland for conditions such as conjunctivitis and a recent one was launched to allow pharmacists to provide Varenicline for smoking cessation.

As a pharmacist, I have encountered many a prescription from a GP where the medicines prescribed were for conditions that could have easily been dealt with by a pharmacist. GP surgeries are under incredible pressure and much has been made through social media and even advertising campaigns to encourage patients to go to a pharmacy first in order to get healthcare advice. But isn’t it pointless, inconvenient and time consuming for a patient to walk into a pharmacy and only receive advice on an issue without getting the full care necessary there and then, because the pharmacist does not have the fully granted autonomy required to provide the necessary pharmaceutical care necessary?

An expanded Minor Ailment Service under the full circumstances as outlined within the third paragraph of this article will go a long way to creating a win-win situation for pharmacists and GP’s and become a credible alternative in contrast to the forthcoming savagery of the community pharmacy budget in England propose by the UK Government. But simply expanding MAS without investment in staffing resources and opening up access to full patient notes will not suffice. However,  given that the Scottish Government published Prescritiption For Excellence in 2013, the opportunities are endless for pharmacy in Scotland.

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