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The Scottish Minor Ailment Service — we need to do it right

WE recently reported on the new updated guidance to inform pharmacists and pharmacy contractors in Scotland on how to deliver the Scottish Minor Ailments Service (MAS).

The new guidance revolves around 10 core principles for the delivery of the service. On the one hand I’m disappointed that the government even needed to produce this guidance. On the other, I feel that the format of this guidance could not be clearer, and that creating concise summaries, where appropriate, in other circulars would be something I would welcome.

I think as pharmacists or contractors we need to be absolutely ‘squeaky clean’ in the way we deliver this service. The main reason for this (aside from being professional, of course) is because we have been trusted to diagnose, prescribe and dispense at the same time under the same roof. The significance of this must not be underestimated. There could be a perceived conflict of interests, especially in the commercial environment, if as pharmacists or contractors we supply unnecessarily, or perhaps try to boost numbers of patients on the scheme.

This is not only a short-sighted approach, it may also inhibit the massive potential for community pharmacists to contribute in the future. I recently wrote an article about the benefits to patients of MAS.

Professionalism is key.

If it feels wrong, well it probably is wrong.

Setting targets is not appropriate and I was delighted to see this written explicitly in the new guidance. Care should be assessed on a patient-by-patient basis.

Why would you ever need to batch register MAS patients? Even in times of IT issues I think there should be close justification or even pre-approval from the health board to do this.

Payment for the scheme depends largely on the number of patients registered. This is a departure from the volume-based payments for other schemes like the English medication use reviews (MURs). The overt urgency to prescribe multiple items is taken away as a result, but there is still competition for registrations. An element of competition should still remain. The pharmacist on the high street who gives the highest quality care and is most patient-focused deserves to dominate the local market.

If the patient uses the scheme then they should be registered, otherwise not in my view.

The rest of the UK do no have such a scheme and from what I see written most would be delighted to have our version of MAS. So, we need to reflect on our own practice but also not let the minority ruin it for the majority of pharmacists/contractors but most of all for patients.

Johnathan Laird

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