Help for ineligible patients

As with all of the Pharmacy First services, if patients don’t meet the gateway for the shingles service, the pharmacist will have to refer them back to their GP if they are insistent that they want some prescription medicines.

However, as Anil Sharma, pharmacist and director of Alconbury Pharmacy in Huntingdon points out, if the pharmacy is going to successfully generate a fee for triaging someone through the Pharmacy First shingles service – whether they end up being eligible for treatment or not – there is an important point that pharmacy teams need to be aware of.

“If the patient simply walks in and says they think they have shingles and either they don’t, or they don’t meet the criteria for treatment via Pharmacy First, then the pharmacy won’t get paid for the intervention,” says Anil. “However, if the patient contacts their GP first suspecting shingles, and their GP emails us to refer them to us, even if they don’t meet the Pharmacy First criteria for treatment, once the pharmacist has seen them and we have to refer them back to their GP, we still generate the service fee for the consultation. The other plus-point for the patient is that if we have to refer them back to the GP, they can get seen and have treatment quickly, rather than having to wait.”

And of course, no matter the outcome of the Pharmacy First consultation, there is always plenty of advice that pharmacy teams can give to support patients dealing with shingles.

Firstly, explain to patients that while there is no cure for shingles, they can ease their symptoms until the condition improves – which should take two to four weeks. People can treat symptoms of shingles at home by:

• Keeping the rash as clean and dry as possible
• Wearing loose-fitting clothing
• Using a cool, damp cloth to soothe the skin and keep blisters clean
• Trying calamine lotion to help relieve itching
• Not letting dressings or plasters stick to the rash
• Avoiding antibiotic cream, as this slows healing.

The pharmacist may also recommend other treatments for shingles, such as:

• Paracetamol
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Opioids – used for more severe pain
• Antidepressants – used for severe pain
• Anticonvulsants – used for severe pain.