Low acuity conditions are also referred to as minor ailments. While these are generally less serious than many situations that are treated in the urgent care system they are will not be minor to the person suffering. These conditions range from allergic reactions to earache, to lower back pain, to sore throats and vomiting. A full list of conditions is available in the service specification.

The initial triage of patients is undertaken by NHS111 call handlers using algorithms. The community pharmacist will generally be the first clinician to speak with the patient and the outcome of the consultation is to manage, treat, reassure and possibly refer that patient to another service. Pharmacists must be operating at a higher level than support staff when responding to symptoms (i.e. using more sophisticated techniques than WWHAM to identify the problem, work with a greater depth of knowledge and manage a wider range of symptoms and conditions).

The process

• Step 1

  Patients will be referred to the pharmacy by NHS111 after triage by a call hander. A message will be sent electronically via PharmOutcomes with a back-up referral sent by NHSmail.

• Step 2

  The patient phones the pharmacy. If the patient does not make contact within 12 hours of receiving the referral the pharmacy should make at least one attempt to contact the patient.

• Step 3

  The pharmacist assesses the patient’s need and the outcome of the consultation may be to: - Provide self-care advice and information along with reassurance - Refer to an appropriate local commissioned service (e.g. flu vaccination, PGD) - Provide self-care advice along with an OTC medicine (either purchased or through a Minor Ailments Scheme) - Refer to higher acuity care (e.g. GP, out of hours GP service or Accident and Emergency). The pharmacist should organise this referral for the patient.

• Step 4

  Complete the consultation on PharmOutcomes.

Records

• PharmOutcomes – notes should be recorded during the consultation and the consultation completed to authorise payment. This can currently be done using a paper record that is immediately transferred to the CPCS system. From April 1st 2020 IT facilities must be available in the consulting room to allow notes to be taken on the CPCS IT system
• PMR – it may be good practice to record the consultation and outcome on the PMR system to provide a complete patient record.

Where you deem it clinically appropriate information about the consultation and supply of medicine can be sent the the GP through PharmOutcomes. Consent does not need to be taken from the patient as this will be done by NHS111 when they initially speak with the patient.