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Patients in the UK receive their primary care from a number of providers, with community pharmacies increasingly taking on minor illness work under schemes such as Pharmacy First. Nowhere is this more true than in deprived areas, where there are significantly more patients per GP,1 but historically good access to community pharmacies, with 99.8% of patients having a community pharmacy within a 20-minute walk.2
Streptococcal throat infections are a good example of this. Acute sore throat is the presenting complaint in 10% of primary care consultations3 and the 2022/2023 outbreak of streptococcal disease showed the need for additional surge capacity and highlighted the risk of GP services being overwhelmed. Carriage of streptococci is higher in deprived communities,4 and the educational impact on children isolating because of suspected scarlet fever, and financial impact of caregivers taking time off as a result, means that streptococcal throat infections have a disproportionate impact on children in deprived communities. Studies in Wales3 and elsewhere5 have shown that pharmacists can play a key role in managing these cases with good antimicrobial stewardship and represent a key aspect of primary care capacity.
The continuing demise of small community pharmacies is affecting deprived communities more than in more affluent areas, with 37.5% of pharmacy closures being in the most deprived 20% of the country between 2015 to 2023.2 The loss of this key component of primary care, in areas already under-resourced, risks further reducing access to health care and widening health inequalities. Reviewing the community pharmacy contract and commissioning strategy to arrest this decline should be an urgent priority for the new government before it is too late.
- © British Journal of General Practice 2024
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