To think Pharmacy First id a load of bollocks

[goneaway2]

Went to two pharamcies today to get me ear looked at as suspect I'm getting my 2nd ear infection within about 6 weeks. Neither would look at my ear, despite one having the pharamcy first advert on their counter stating they deal with ear infections, because I'm over 18! Phoned the Dr, they told me to go to the Pharmacy, told them what had a happened and no appointments. I have to phone 1st thing tomorrow for an emergency one. NHS direct tell me to use Pharmacy first for ear infections, as do the Out of hour service.
What on earth is the point of Pharmacy First? Would it really have killed them to take 20 seconds to look at my ear?

I am sorry you are poorly. Why wouldn't they see you?

I have used pharmacy first and found it a brilliant scheme, hence asking why they wouldn't see you!

Well I guess it depends if pharmacists have actually had any training in examining ears, differential diagnosis, when antibiotics are indicated and which ones depending on previous history etc. I imagine they aren’t and yet again it’s another patch on actually providing enough GPs to make medical decisions…

They can only treat children between 1 and 17 for suspected ear infections. The age ranges are different for all the ailments they can treat. If you can't get aa appointment call 111 or go to am urgent treatment centre.

https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/

They can't asses or treat ear infections (under the pharmacy first scheme) in patients 18 and over. I suspect their insurance only covers diagnosis in the patient groups specified, hence the reluctance to give you an opinion.

Then why do the GPs, 111 and out of hours constantly tell you to go to the Pharmcist for a suspected ear infection?

It’s bollocks isn’t it. Did you take antibiotics for your last infection? If so, can you speak to anGP over the phone and ask for some different ones? My GP will phone me instead of me going in with a recurring health problem I have and give me a prescription.

I was prescribed antibiotics by a pharmacist for a ear infection, a few months ago. They weren’t the most appropriate kind though and unfortunately I needed up in AandE, hallucinating with a 40 degree temp and blood pressure through the roof because I couldn’t get a Gp appointment to get anything stronger and 111 took too long to call me back.

so yes, I agree that pharmacy first is a pile of shit.

I’m actually in what was one of the original pilot areas for the scheme and I’ve used them a few times. This is how it went:

Suspected UTI: couldn’t treat because pain was in my kidney. Couldn’t get GP appointment. Ended up seeing Emergency OOO Dr.

Rash: Sent pics (some of an intimate area) to my GP, who forwarded them to a pharmacist without my consent. Misdiagnosed with a fungal infection. Was actually a herald patch for a different sort of rash.

deer tick bite with circular rash: pharmacist advised GP. GP phone appointment. Advised it was probably fine, come back if flu symptoms occurred.

eczema (partner): wouldn’t treat as it was wet eczema. GP appointment needed.

So all in all, a complete waste of time!

Yabu. The GPs or receptionist are being unreasonable because they should be aware of the inclusion/exclusion criteria but usually aren't. Before pharmacy first was rolled out GP practices should have had some training on what or who can or can't be treated. They are often so short staffed though so it isn't happening and patients get passed from pillar to post. I frequently have to apologise to patients when they are referred to us by the GP receptionist and pharmacy first has been rolled out in Scotland for ages. Its a pain for the patient who gets irritated and a pain for me as I usually have to deal with the brunt of their anger.

NICE guidelines advise that most ear infections do not require antibiotics. The Pharmacists have a vested interest to prescribe you treatments which you might not need, as they get paid for each one but your GP does not

i went to the pharmacy last week because a sore throat is listed as something they treat (not because i was told to by GP but because its drummed into us to go there first,) Difflam Spray and Chloralieve lozenges were recomended. It didnt touch the sides Neither did copious amounts of Lemsip Pain is even worse today and i cant swallow without pain even when drinking water. I have a GP appointment at 5pm but had to physically go in to book it as there were already thirty ppl in front of me when i rang at 8am. If i had gone to the GP first i would have saved myself at least an extra five days of pain, particularly todays excrutiating pain and trouble swallowing. GP first all the way from now on. Throat looks red and inflamed at the back. It started as part of a bad cold ten days ago and got worse.

In my opinion Pharmacy First is a total waste of time. They can only treat certain conditions within very specific Patient Group Directions. Some GP staff are unaware of this seemingly.
I have been sent by GP receptionist twice once for oral thrush and once for severe UTI. They refused to treat me as i was outside the patient group directions. Back to the cycle of phone calls/call back/attempted fob off. What a waste of surgery admin time, pharmacist time and my time.
I totally agree OP - it’s bollocks.

If you can, try gargling with soluble aspirin. I found it helped really well. Obviously won't cure the problem, but it eased my pain very quickly.

Seems i was a bit presumptuous. I saw a Physician Associate

I went to my local pharmacy in the grip of a full blown panic attack once and was told by the assistant that I needed to 'make an appointment' to talk to a pharmacist.

Pharmacy First, my arse!

Because GPs and 111 actually know very little about pharmacies and how they function.

Pharmacy first has been bought online with no extra staff - so the pharmacist is having to do normal - holiday vaccines, sorting out prescription meds , answering queries .. so it is another badly funded idea tbh

I don’t think many people understand how many responsibilities and duties a pharmacist has. They just think they stand checking prescriptions all day.

Thank You

DD had a UTI (shes over 18) and couldn't get a GP appointment for a week or so. I phoned a Pharmacist that advertised this Pharmacy 1st thingy to be told that we had to give DDs details and then a lady called Moira would call back hopefully that day and speak to DD and then see if they could prescribe. After waiting about an hour I phoned another pharmacist that said while they did do it in theory they were too busy and then finally I did get a pharmacist who agreed to see DD if she called in. She had her meds around 20 minutes later and felt better pretty quickly.
Moira never did call back

How is this Pharmacy First thing supposed to work?

DS came out in an allergy rash and I went to the pharmacy. They looked at him then told me I had to buy Piriton, they can't provide it as part of Pharmacy First.

Pharmacy first isn't to provide free medication as far as I know, its about treating some conditions (such as UTI's) without needing to see a GP.
Are you unable to buy piriton or similar? The same unbranded stuff is probably available from a supermarket much cheaper if cost is an issue

This website says normal NHS prescription charges should apply, which would be free in my childs case?

Pharmacy First: what you need to know – Department of Health and Social Care Media Centre

Will I have to pay for my medication?
Usual prescription charges will apply for the seven common conditions. Patients that were already exempt from prescription charges will still be exempt.

Would love to know how the service is supposed to work for future reference.

I don't think it's a very safe plan. Essentially overwhelming numbers of people are looking to be seen by someone/anyone for their symptoms so this is just service provision. It's felt to be justifiably safe because the majority of short lived simple presentations/uncomplicated patients - which fall under the remit of pharmacy first will get better without any treatment/didn't really need an assessment in the first place. Hence the attempt at placating the public by seeing someone vaguely medical in the hope that they're satisfied.

Whilst pharmacists are extremely valuable/experts in their own field, there's no way they're being given appropriate training or oversight to assess undifferentiated patients. It's just a quick follow x guidance on the pamphlet for the standard presentation. But not going to consider unusual differentials or subtle anomalies a GP would.

For what it's worth to the OP, it's very rare that ear infections benefit from antibiotics. If having severe pain/hearing changes absolutely I don't think it's unreasonable to see a Dr for assessment, but if it's a simple middle ear infection, whilst can be extremely painful treatment is paracetamol and ibuprofen (if you can take them). Majority are short lived (3-7 days).

Antibiotics in studies don't reduce the severity of pain, duration of symptoms or occurrence of complications in middle ear infections. However due to the short lived nature of the condition anyone who takes abx attributes getting better to them - but that's the normal cycle - i.e prob see the Dr on day 2-3, if a 5 day course of amox is issued you're making the normal resolution through the course.

There's a really big push at present to stop prescribing abx for ear infections as historically very much overprescribed to. In addition to stop prescribing any medications that are available over the counter - i.e. piriton, mild steroid creams, antifungals....

Double posted by error.