George Thomas argues that diagnostics offer community pharmacies valuable revenue streams whilst relieving pressure on other parts of primary care…

Community pharmacies have never had a better opportunity to relieve the pressure on primary care by offering health diagnostics, like blood testing, in the community.

Patients increasingly want to take control of managing their wellness before symptoms arise and pharmacies are the experts when it comes to offering symptom-led and condition-management diagnostics.

Communities have always recognised that pharmacies are a trusted source of medical advice – they’re accessible, they’re convenient and there’s a consistency of service from the one to one relationships pharmacy staff build with the community.

It is recognised that patients can live healthier and longer lives when disease progression is prevented or delayed or when patients recover through timely diagnosis. Diagnostic information may also enable informed choices regarding, for example, reproduction, nutrition, and changes in lifestyle.

Furthermore, diagnostic information may help to avoid hospitalisation, decrease inappropriate medication use, or shorten the length of sick leave, thereby bringing economic value.

Traditionally diagnostic testing would have been the responsibility of GPs, however primary care is still under an unprecedented amount of pressure as a result of the pandemic.

Not surprisingly, the top priority for improving the NHS identified by respondents to a recent British Social Attitudes (BSA) survey was to make it easier to get a GP appointment.

This is partly due to a lack of GPs – health secretary Sajid Javid has already admitted that the government is not on track to meet its commitment to boost the GP workforce. Staff sickness is also a significant issue as the UK continues to deal with more transmissible variants and fewer virus  controls.

Staff shortages aren’t the only issue facing GPs, an unprecedented 6m strong NHS waiting list is driving up pressure on primary care as practices manage patients through waits for treatment of up to a year according to a report by the National Audit Office.

Being able to work alongside community pharmacies when it comes to testing could take some of the pressure out of the situation. But what do GPs think? A recent study showed that GPs believe that uptake of diagnostic tests by pharmacists could potentially improve health outcomes, be more convenient for patients and reduce visits to GP clinics.

Diabetes testing is one area where simple training to use an Abbott Affinion 2 device can enable community pharmacies to offer HbA1C and cholesterol testing, with results provided to patients immediately. This allows the pharmacist to offer instant advice and support, as well as redirecting the patient back to primary care if required.

According to Dr Jamie Brosch, a GP with over 30 years’ experience, “raised cholesterol and prediabetes are conditions where you don’t necessarily experience any symptoms, so there wouldn’t always be warning signs.

“They are also key modifiable risk factors for ischemic heart disease, so early intervention, whether that is lifestyle changes or medication, leads to improved outcomes. For the majority, the tests will show normal results and give reassurance. However, for a small number where results are abnormal, then those patients can seek appropriate guidance”.

Statistics from Diabetes UK show that more than four million people in the UK live with type 2 diabetes. Early diagnosis is vital – complications can begin five to six years before some people find out they even have the condition.

Emma McManus, a research fellow at Manchester university, says diabetes is a “growing problem” for the country and the NHS spends about 10 per cent of its annual budget on treating it.

Cases of type two diabetes are on the rise according to recent research which found that people who recovered from Covid-19 within the past year are 40 per cent more likely to receive a new diagnosis of diabetes, compared to those who weren’t infected. This alone could result in millions more new diabetes cases worldwide and presents a huge challenge for primary care.

In addition to being able to provide diabetes testing and finger prick test kits, the availability of free phlebotomy training means pharmacists are also able to offer a whole suite of blood tests that require venous draw, including well women and well man profiles; liver, kidney and heart checks; hormone and vitamin levels and everything in between.

More complex, disease-led profiles are now also becoming available – including a complete cancer check for example, offering vital peace of mind for concerned patients.

Along with the benefits of health diagnostics to the community and primary care, blood testing also provides an attractive commercial opportunity for pharmacies. Pharmacies can enjoy additional footfall – especially from new demographics – and incremental sales. Pharmacists can also access a whole host of other benefits including training and equipment – which means there is no financial risk or outlay, just access to a reliable revenue stream.

George Wickham, from Luxton’s Pharmacy is already reaping the commercial benefits of implementing testing in his pharmacy. He says: “We have seen a significant increase in footfall to the pharmacy and it’s rewarding to see how we are fulfilling a real need in the local community”.

It has been one of the toughest years in NHS history and the battle continues to bring down waiting lists, tackle GP shortages and improve access to GP appointments, however pharmacies are definitely part of the solution.

Working in partnership with the community has always been the priority of pharmacy teams. The trusted relationship shared between pharmacist and patient provides the ideal platform on which to extend the level of diagnostics and care available in the community pharmacy.

Creating new pathways for health diagnostics is a positive move forward for primary care, pharmacies and the communities they serve – he perfect relationship where all parties will benefit equally.

George Thomas is managing director of Goodbody Clinic.

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