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Minor ailment service
Envy of pharmacists outside Scotland
From Mr N. J. Wicks, MRPharmS
I had to respond to the recent letters about the Minor Ailment
Service in Scotland. My experience of working in one of the busiest MAS
pharmacies
in our health board is completely different to that of Nadim Ali (PJ,
March 8, p273) and David McNaughton (PJ 15 March 15, p307).
This service has given me room to spread my wings professionally as an
NHS prescriber. It also provides an invaluable service to patients who
wish to access the NHS for information and treatment of minor ailments.
I have never had patients come in with a medicines shopping list. What
I have had is patients who have been registered at another pharmacy coming
to us with misconceptions about what the service is about. On closer
examination this has usually been due to a poor explanation by the other
pharmacy when signing up the patient or, less commonly, a misunderstanding
by the patient.
I think it does MAS a great injustice to focus on the occasional problem.
In my experience across our group of 10 pharmacies the key to a successful
MAS service is ensuring that patients understand what it is and what
it is not.
It is also important to ensure that there are appropriate resources in
the pharmacy to offer a good service. If these are in place then our
experience would indicate little decline in over-the-counter sales, the
main reason being that those ineligible for MAS choose us and not the
supermarket to purchase medicines because of the word of mouth about
how we add value.
MAS is the envy of pharmacists outside Scotland and rightly so. It provides
patients with a walk in NHS service in the heart of their community without
the need for an appointment. How many others can boast that?
Noel Wicks
Managing Director ACMS Ltd
Larbert, Stirlingshire
All about patient care
From Mrs T. Orr, MRPharmS
I would like to point out a couple of facts that Nadim Ali (PJ, 8 March,
p273) seems to have missed at the training days for the Minor Ailment
Service. I was one of the community pharmacists involved in the pilot
study in Ayrshire and I also gave the community pharmacist’s perspective
at the two NHS Education for Sscotland training days at Stirling (which
is now part of the NES implementation pack).
The aims of the MAS are well documented and I cannot believe that anyone could
think it is an ineffective service unless they do not fully understand it.
The people who will not fully understand the service are patients, and who
could blame them? It is a service in its infancy so it is the pharmacist’s
responsibility to understand how it is meant to work and then communicate this
to patients.
The two issues Mr Ali addresses in his letter are amply covered in the NES
pack, and they are:
People are meant to be treated for a minor ailment that they are experiencing
at that moment. It is not for stocking up their medicine cabinet “just
in case”. This scenario happened many times during the pilot and people
soon got the message if pharmacists or their assistants take the time to explain
how the system works.
These patients would previously have had to be referred to their GP, as they
do not pay prescription charges, so a sale may not have happened anyway. This
is not a service we give for free, unlike the countless delivery services and
monitored dosage systems that pharmacists provide for little if no payment
and in far greater numbers than treatments for minor ailments.
I urge Mr Ali to read the implementation pack and learn how to make the scheme
work because at the end of the day it is all about patient care.
Toni Orr
Livingston, West Lothian
The service must be
re-explained
From Miss C. N. Cormie, MRPharmS
Although it is encouraging to read recognition of Scotland’s advances
in community pharmacy, I disagree with the overall comment in Nadim Ali’s
letter (PJ, 8 March, p273).
Most customers I see present for the Minor Ailment Service the way it
was intended: with the pharmacist making a recommendation based on an
ailment that has been
discussed with the customer. For the occasional customer who presents for “medicines
on demand”, the service must be re-explained. The analogy of a GP visit
can be helpful: patients visit their GP with an ailment, not a demand; this
service should be treated the same way.
I would also dispute the points about “little clinical intervention” and
a reduction in over-the-counter sales. In my experience, having a greater opportunity
to engage with customers through provision of MAS positively encourages clinical
intervention. This varies from simple intervention such as recommending a customer
buys a nit comb as the pack provided on MAS does not contain one, to detailed
interventions, for example, uncovering long periods of self-medication that
has been masking serious underlying conditions. The former style of intervention
has lead to an overall increase in OTC sales in my store since MAS implementation.
The latter style provides the patient with an appropriate referral and treatment,
contributing to a multidisciplinary health service.
To conclude, I believe MAS has been highly beneficial to patients in Scotland,
providing an excellent, well used service. My concern now is, what will happen
when the Scottish Government scraps prescription charges in a few years time?
Will all be eligible for MAS? Or only those currently exempt from prescription
charges? Or, as would possibly be simpler, will the MAS be scrapped altogether?
Clair Cormie
Edinburgh |
The
Pharmaceutical Journal