Mark Robinson
I HAVE always shouted that the game is not to give influenza vaccines, but to create community immunity where everyone takes personal responsibility to reduce the risk of getting infected and infecting others.
In some places – well just one that I know about – the GP practice and the community pharmacies have come together to set joint immunisation targets. The GPs don’t send out costly reminder letters, and everyone works together to immunise as many people in the at risk groups as possible. It’s the way to do it, and the way that NHS England should have incentivised the contracts years ago.
Community pharmacy should go further: lots of people seek pharmacists’ advice about influenza like illnesses, so they should look at ways of reducing the spread and impact of such illnesses in the communities that they serve. The pharmacy team should mention the “catch it, bin it, kill it” campaign in every conversation, and ask whether they have some tissues, and if they have thought about using an alcoholic hand gel product. This is not a situation where self-selection is applicable – it should be an active recommendation in line with the NHS campaign.
Community pharmacists could also offer a point-of-care test to differentiate between influenza A and B and other viruses. I appreciate that the treatment may be similar, but we shouldn’t be fooled into thinking that these two conditions are the same – they are not. Influenza can lead to complications, particularly lower respiratory tract infections and there should be enhanced precautions to reduce spread.
I was talking last night about rapid antigen tests for strep A sore throats. Again, the game is to limit the spread of Strep A sore throats throughout our community. It is a nasty little condition that leads to absence from work and school. I was informed that a patient with an untreated strep A sore throat would remain infectious for up to 14 days – so there is a clear advantage to the community if people are properly diagnosed and treated.
There is a fine balance to find. We don’t want to use antibiotics unnecessarily, but we don’t want to leave strep A infections untreated. I am told by Phil Howard from NHS England that resistance to penicillin is falling, but Public Health England (PHE) says that the occurrence of scarlet fever and invasive strep A infections are rising.
So, I think that test and treat would be a valuable service for community pharmacies to offer around the country. The feasibility study shows that it is feasible, it will reduce unwarranted antibiotics, and unnecessary GP appointments at a time when they will be full to bursting.
Well, I am off to meet a colleague for coffee. I’ll stop in at a pharmacy on the way and buy a pack of tissues and some hand gel, as he has a cold and I have no intention of catching it.
Mark Robinson is director of Connect2Pharma
What are your thoughts on Strep A testing in community pharmacy? Feel free to comment below