Chemists find formula for taking the heat off a&E

THERE are few things more enraging for stressed hospital managers than the sight of a person showing up at accident and emergency who doesn't need to be there.

Cut knees, headaches and phantom flu symptoms are all regular features of the casualty ward. Not only are these people clogging up the system - meaning those who really do need emergency attention have to wait longer - but they're putting themselves through an unnecessary ordeal which can last up to four hours.

For a huge slice of these "patients" there are better, quicker and often more local alternatives - not least the NHS 24 telephone and internet service.

And now in the centre of Edinburgh another facility has opened which can take the strain off casualty wards, and cater for busy people who don't have the time nor will to make a GP appointment.

The Pharmore partnership between NHS Lothian and Boots opened last weekend at the store on Shandwick Place.

Already around seven people a day have called on its assistance, presenting with a range of conditions from skin infections to allergic reactions.

And while it doesn't want to be considered as a satellite of the accident and emergency departments at the Royal Infirmary or St John's Hospital in Livingston, this new scheme is hoping to take some of the heat off both busy wards.

Work done by the health board has established that almost everyone who ends up in casualty of their own accord took no prior advice before going, while figures over recent years have revealed a gradual rise in attendances at Little France, making it the busiest A&E in the UK.

Pharmacist Ina Donat, who is based at the city centre outlet, said: "We are here primarily to deal with minor illnesses and ailments, but we can also point people in the right direction.

"Part of this service is to not have people turning up unannounced to accident and emergency, and we can often provide that reassurance to people that they don't need to be going there. We are so centrally located that it can be better than the minor injuries unit at the Western General."

The walk-in chemist facility is one of eight pilot sites across Scotland. Holyrood will assess their impact at the end of March next year before deciding whether or not to roll out the scheme further.

The other site is a pharmacy in the Inch, which has less of an emphasis on catching the office workers whose lives are too frantic for a GP appointment.

Instead it focuses on sexual health testing, depression and screening for both hepatitis and HIV.

Of the Shandwick Place resource Mrs Donat said: "We've only just opened so it isn't too busy yet, but we expect that to change. Since Saturday we've had mainly tourists in here for the Festival, but that will change over time.

"The real advantage is our location and the fact you don't need an appointment.

"But we are not an express GP or anything like that - the actual treatment won't be quicker, we still take the same amount of time and, like the GPs, if there are people in front of you, you will have to wait.

"Really it is people who have minor ailments or illnesses that don't have the time to make an appointment with their GP, or don't want to take time off work to do so, but do have something that is troublesome for them."

Staff at Pharmore are linked in with hospitals and other health systems across the Lothians, and can help speedily refer people on if their illness is too complex to deal with.

In the short time the unit has been open, they have already dealt with urinary tract infections and chest pains, as well as other less severe problems.

The trial is the latest in a progression of healthcare from the hospital to the local pharmacy.

In recent years smoking cessation, help with alcohol and even minor mental health problems have all been diagnosed and treated within a pharmacy setting.

Last year the Apple Pharmacy in the New Town became the first in Scotland to offer members of the public use of a cardiopod which, after a brief assessment and questionnaire, predicts how likely the user is to have a heart attack.

"The Scottish Government wants to move health services closer to where more people are and this is part of that," added Mrs Donat.

"It's early days so we don't know exactly how it will work out, that's why it is a trial.

"We can't treat people with broken legs or injuries like that, but in those cases we could still have a look and tell them where they should be.

"So far the feedback we've had from patients has been terrific and really encouraging."

Another advantage the scheme is hoping to maximise is the more tolerable environment.

Rather than entering the daunting walls of a hospital or the grim magazine-filled waiting room of a GP surgery, the high street chemist offers a more sympathetic surrounding in the form of a specialist treatment room that has been purpose built for the initiative.

The opening times, which are currently 4pm until 7pm on weekdays, and 11am to 4pm on weekends, could change with experience.

It is understood, however, that it won't be opened late on into weekend nights to avoid becoming a "field hospital" for city centre drinking casualties.

Pat Dawson, NHS Lothian's director of pharmacy, said: "The ability to drop-in and get health advice, treatment and medication from community pharmacists with expert knowledge will I am sure be welcomed by residents, shoppers and visitors in the Lothians.

"Our community pharmacists have undertaken advanced training in order to offer this service to the public."

A matter of life and death?

Emergency ambulances and calling 999 - if you think your life is in danger.

Accident and emergency: Based at the ERI and St John's Hospital in Livingston, this is designed for health problems that are "urgent and emergencies".

NHS 24: Both the website and the phoneline (08454 24 24 24) can be used as a first port of call for many things. Available 24/7.

Minor injuries unit: Based at the Western General, this a quick, efficient facility where a huge number of A&E patients should go rather than the busier, more intense casualty ward. Open from 8am to 9pm every day.

GP surgeries: Should be a first stop for the majority of ailments. Openings vary, but generally Monday to Friday, 9am-5pm.

General community pharmacies: Expert advice on health and nutrition, including help with smoking and drinking problems. Opening times vary.

New Pharmore pharmacies: To deal with minor illnesses and injuries, ranging from allergies to chest pains.