PrescQIPP

Highly commended - To assess the effectiveness of a "Pharmacy First" approach in re-directing patients with minor illness and the 7 clinical conditions, from Urgent and Emergency Care services to community pharmacists. (2025)

NHS North West London Integrated Care Board (NHS NW London ICB)

Project summary

The NHS Long Term Plan aims to reduce pressure on Urgent and Emergency Care (UEC) centres by expanding out-of-hospital care. In North West London, Hillingdon Hospital's Urgent Treatment Centre (UTC) continues to face high demand and long waiting times. This project explored a "Pharmacy First" redirection model at Hillingdon UTC, aligning with national strategy, to improve patient access, support self-management, and promote community pharmacists as the first point of contact for minor illnesses, seven clinical conditions and medication advice.
A multi-stakeholder task and finish group supported the project. Representatives included NHS NW London ICB medicines optimisation and urgent care colleagues, Local Pharmaceutical Committee, Hillingdon Hospital UTC staff, NHS England representative and, urgent care clinicians.

The project ran 13th December 2024 – 9th March 2025

The project objectives were:

  • To reduce patient waiting times at UTC for minor illnesses and the 7 Pharmacy First clinical conditions management by facilitating referrals to community pharmacies.
  • To assess patient satisfaction with the redirection process.
  • To evaluate the impact of the redirection pathway on patient access to primary care services and the experience of patients, community pharmacy and UTC teams.

Of the 158 patients referred, 133 patients were successfully redirected to a community pharmacy. Patients referred were aged 7–66, evenly split by gender. The most common conditions redirected were sore throat, flu and earache. No patient safety incidents were reported and feedback from patients, pharmacists and UTC staff was positive.

Patient surveys revealed key reasons for UTC attendance:

  1. Patients perception that the UTC was the appropriate site for treatment
  2. Unable to access their GP Practice
  3. Convenient opening hours of the UTC (7-day service)
  4. A major barrier identified was low awareness of the Pharmacy First service.

This project is a first of its kind in London, demonstrating how Pharmacy First can support the wider NHS access agenda by safely redirecting patients to other suitable providers. The project has also highlighted the lack awareness of the Pharmacy First service and how this needs to be improved.
This project was successful due to strong collaboration between the multidisciplinary group overseeing the project, and dedicated service manager support at the UTC. Further support was provided by UTC patient champions who facilitated a referral to a pharmacy of the patient’s choice, after nurse triage.
The project led to the development of a permanent redirection pathway at Hillingdon UTC.
To summarise, this project showcases the potential of pathway transformation by embedding pharmacies more effectively within urgent care systems.