Eight community pharmacies in Bootle, Merseyside, are coming to the end of a four-month trial of treatment by pharmacists of self-limiting ailments that would otherwise have been treated by a general medical practitioner at one of the area's surgeries.
Since October, 1999, patients seeking an appointment or repeat prescription for any of 12 conditions (see panel) have been asked whether they would prefer to see a pharmacist quickly rather than wait to see a doctor. Patients are then asked to indicate which of the eight participating pharmacies they want to visit.
The pharmacy is sent a referral form by fax so that the pharmacist knows who is coming and what is the presenting complaint.
After consultation with the pharmacist the patient may be offered advice on self-care, treatment with a medicine from an agreed formulary of over-the-counter products or an urgent referral back to the GP. If a medicine is supplied, it is free if the patient is exempt from prescription charges, otherwise a prescription charge is collected. Both pharmacist and patient complete a locally produced form similar to an FP10 prescription form, which goes to Sefton health authority for reimbursement. The pharmacist is also paid a consultation fee by the health authority, regardless of the outcome of the consultation.

Referral conditions

The 12 conditions for which patients are offered pharmacy referrals are:

• Cough
• Thrush
• Sore throat
• Indigestion
• Headlice
• Constipation
• Hayfever
• Headache
• Earache
• Nasal symptoms
• High temperature
• Diarrhoea

Miss Zoe Whittington (research associate, National Primary Care Research and Development Centre, Manchester university) told The Journal on January 25 that the purpose of the project was to see if treatment of minor ailments could be transferred from GPs to community pharmacies.
"We found earlier that a major barrier to pharmacy treatment is the patient's exemption status," she said. "People would visit a pharmacy to get advice, but then go to their GP for a prescription."
Baseline data on consultations at the GP surgery and over-the-counter sales and consultations at the pharmacies were collected for four months before the trial began.

Bootle pharmacists are being paid by their health authority to treat minor ailments