Impact of a Pathfinder Sore Throat Test & Treat service in community pharmacies on GP sore throat related consultation rates

Problem

Workload in General Practice has increased substantially over the last decade. As a result, there is increasing interest in widening the roles of other primary care health professionals who can safely and effectively meet the needs of patients who would traditionally see a GP. Community pharmacists are key members of the primary care healthcare team and can help to provide sustainable services for a range of minor illness presentations.

One of the conditions whose management could be transferred to community pharmacies to ensure timely access to services, is uncomplicated sore throats. A pathfinder Sore Throat Test and Treat service (STTT) was rolled out in 56 community pharmacies in Wales in November 2019. One of the aims was to safely rebalance management of uncomplicated sore throats between GPs and community pharmacies.

The aim of this study was to explore the feasibility of measuring changes in sore throat consultation rates in general practice, in areas where the STTT service was piloted.

Approach

A national GP audit tool, Audit+, was used to obtain data for Read-coded GP sore throat related consultations, between November 2018-March 2019, for one GP practice adjacent to four community pharmacies in which the STTT service was available (list size=10220). Data were analysed using Microsoft Excel® and IBM SPSS® v23 to obtain descriptive statistics and undertake more detailed statistical comparisons. The study was registered with NHS Research and Development departments.

Findings

It was feasible to extract sore throat consultation data from the GP practice prescribing system using Audit+. Monthly sore throat consultation numbers were used to estimate the average consultation rate per month for the study practice before the introduction of STTT.

Sore throat consultations rates decreased from 0.71/1000 patients in March 2018 (prior to STTT) to 0.36/1000 patients in March 2019 (4 months after STTT). The number of sore throat related GP consultations during the study period was lower than the lower band of the 95% confidence interval band calculated from the average consultation rate per month for 2014-18, per 1000 patients (average for March: 0.72).

Consequences

Our findings suggest it is feasible to look at individual case studies of Read-coded consultations in GP surgeries. Preliminary data suggests that the new service may have a role in rebalancing management of uncomplicated sore throats within primary care. We will build on this work using interrupted time series methods and locality level data to look at trends in quinsy rates and sore throat consultation rates before and after implementation of STTT.